School of Health Professions, University of Plymouth, Plymouth, UK.
NIHR Applied Research Collaboration South West Peninsula (PenARC), University of Plymouth, Plymouth, UK.
J Hum Nutr Diet. 2023 Oct;36(5):1760-1770. doi: 10.1111/jhn.13217. Epub 2023 Aug 1.
Expanding the primary care workforce to alleviate general practitioner (GP) workload, improve access and improve quality of care is a current UK strategy. Evidence suggests dietitians can improve patient outcomes and make cost savings. The present study aimed to evaluate a dietitian working as an expert generalist and first contact practitioner (FCP) in a general practice multi-disciplinary team (MDT) to provide appropriate care to patients and reduce GP workload.
A dietitian was employed for 6 months at 0.6 full-time equivalents in a group of general practices in Devon, UK. Data were collected on the referral source, patient satisfaction, health outcomes and changes in prescribing data for all patients seen by the dietitian. Focus groups and interviews provided data to understand the experience of introducing a dietitian into the team.
This model of service delivery showed the dietitian acting as an expert generalist, a FCP and able to educate the MDT. A range of professionals within the MDT referred patients with a wide range of diagnoses (both paediatric and adults) and the dietitian acted as a FCP for 29% of patients. Saving were made for the optimisation of medicine management.
The dietitian can improve patient-centred care for several patient groups; enhance learning for staff around nutrition and dietary issues; and contribute to more efficient working and cost savings around prescription of nutritional products. This was an evaluation of one service and further research is needed to understand the value dietitians can contribute and the factors supporting effective and efficient working in this context.
扩大基层医疗服务人员队伍以减轻全科医生（GP）的工作量、改善可及性并提高医疗质量是英国当前的一项战略。有证据表明，营养师可以改善患者的治疗效果并节省成本。本研究旨在评估一名营养师作为专家全科医生和一线接诊医生（FCP）在全科医疗多学科团队（MDT）中的工作情况，以为患者提供适当的护理并减轻 GP 的工作量。
在英国德文郡的一组全科诊所中，聘请了一名营养师担任全职当量 0.6 的工作，为期 6 个月。收集了营养师接诊的所有患者的转诊来源、患者满意度、健康结果以及处方数据变化方面的数据。焦点小组和访谈提供了有关引入营养师进入团队的经验数据。
这种服务交付模式表明，营养师可以充当专家全科医生、FCP，并能够为 MDT 提供教育。MDT 中的各种专业人员为各种诊断的患者（包括儿科和成人患者）转诊，而营养师为 29%的患者充当 FCP。通过优化药物管理实现了节省。
营养师可以改善多个患者群体的以患者为中心的护理；增强员工对营养和饮食问题的学习；并有助于提高工作效率和节省营养产品处方方面的成本。这是对一项服务的评估，需要进一步研究以了解营养师的贡献价值以及在这种情况下支持有效和高效工作的因素。
