A First Contact Practitioner (FCP) is a diagnostic clinician working in Primary Care at the top of their clinical scope of practice at Masters level. This allows the FCP to assess and manage undifferentiated and undiagnosed presentations.
Dietitians working towards First Contact Practitioner status will be at indicative Agenda for Change Band 7 or equivalent and above. They should have at least 5 years of postgraduate experience, including at least three years of postgraduate experience in their professional specialty area of practice before starting Primary Care training to become an FCP.
Dietitians may be termed First Contact Practitioners (FCP) or First Contact Dietitians (FCD). These terms should only be used following a period of primary care specific training and assessment, as outlined in Health Education England's profession specific roadmap: First Contact Practitioners and Advanced Practitioners in Primary Care: (Dietitian) A Roadmap to PracticeFirst Contact Practitioners and Advanced Practitioners in Primary Care: (Musculoskeletal) A Roadmap to Practice (hee.nhs.uk)
Please note due to recent changes with the roadmaps the above documents are currently being updated by NHSE (was HEE) you can find information about the changes to the roadmaps here: https://www.bda.uk.com/resource/roadmap-changes-for-first-contact-dietitians.html. You can also find useful information on HEE website regarding roadmap changes and first contact practice FAQs Roadmaps to Practice | Health Education England (hee.nhs.uk).
Following successful assessment against HEEs profession specific roadmap, the dietitian will be entitled to use the title First Contact Dietitian.
Careers in Dietetics: First Contact Dietitian
What is the difference between a FCD and an Advanced Practitioner?
A FCD is working at level 7 clinically and likely to have some experience of the other three pillars of advanced practice as defined by advanced practice frameworks across the UK (Leadership and Management, Education and Research). Whereas, an Advanced Practitioner (AP) is working at level 7 in all four pillars of practice: Clinical, Leadership and Management, Education and Research.
The current key requirements for these roles can be found within the Network Contract Directed Enhanced Service (DES) Contract Specification 2021/22 – PCN Entitlements and Requirements.
The role of the First Contact Dietitian
First Contact Dietitians may cover one of more of the following areas of practice, depending on their knowledge, experience and scope of practice:
- Gastroenterology including functional bowel disorders, irritable bowel syndrome and coeliac disease
- Overweight and Obesity
- Frailty
- Diabetes
The roles may include other conditions, dependant on a dietitian’s scope of practice. Dietitians working with undifferentiated diagnosis in paediatric populations must have relevant masters level training and education in the management of nutrition and dietetic practice in paediatrics.
BDA Primary Care Webinars
The BDA is producing a series of videos with input from Health Education England, discussing the new roles in England within primary care.
1. The first in the series of videos is aimed at dietitians working, or considering working in primary care as well as dietetic managers being contacted by PCNs and covers:
- what we mean by first contact practitioners (FCPs)
- what the FCP to advance practice roadmap is, and how the implementation of these roles will be supported by the roadmap
- examples of FCP within dietetics
- what the BDA is doing to support these roles.
2. If you're a primary care training hub or are employing/considering employing occupational therapists (OTs) and dietitians, watch our webinar which provides an overview of the expertise dietitians and OTs can bring to primary care, along with how you, HEE and professional bodies can support these roles. You can access the slides here.
Health Education England has a webpage with a Roadmap FAQ section.
We’d like to hear any feedback you may have following the video, please get in touch by emailing [email protected].
Additionally, Tanya Rumney (Lead Therapist for Nutrition and Dietetic Service and Paediatric Therapy at Cheshire West Integrated Care Partnership and Primary Care AHP Ambassador for Health Education England) presented a webinar on dietitians as First Contact Practitioners in primary care on 16 February, you can watch this here.
3. An introduction to the First Contact Practitioners and Advanced Practitioners in Primary Care dietetic roadmap
This webinar is aimed at dietitians working in primary care to provide an overview of the roadmap for First Contact Practitioners and Advanced Practitioners.
HEE's Amanda Hensman-Crook provides a short introduction into the development of the roadmap before opening the session up to questions from panel members.
4. Primary Care First Contact Dietitians and Advanced Practitioners in Primary Care: Dietetics Roadmap launch
This webinar is aimed at dietitians working in primary care/interested in working in primary care and those employing dietitians.
It provides an overview of the Roadmap for First Contact Practitioners and Advanced Practitioners development and implementation process along with supporting documentation.
Points to consider when signing a contract with a primary care network
If you are applying for a role and will be employed by the primary care network directly, before signing a contract, consider the follow:
1. Hours of work:
The contract will say the hours per week but may not necessarily stipulate days of the week. Therefore, the primary care network (PCN) could request you work in evenings or weekends.
2. Pension:
The PCN may provide the NHS pension scheme, their own or the state one – it’s worth checking with them.
3. Holidays:
PCNs have to provide 20 days statutory leave plus bank holidays. They may also give additional leave but this is unlikely to be the same amount as the NHS – it’s worth checking with them.
4. Sickness:
They have to provide statutory sickness as a minimum. The NHS provides 6-month full pay and 6-month half pay. It is very unlikely that the PCN would provide the same.
5. Pay:
If you are being employed under the Additional Roles Reimbursement Scheme, the annual maximum reimbursement amount for dietitians is £54,841 (if working at masters level clinically) or £62,705 (if working AS AN Advanced Practitioner). However, PCNs can set their own rate of pay.
6. NHS Service:
If you are employed directly by the PCN, you will break your NHS continuous service (break of more than one week) so if you return to the NHS, you will start collecting towards continuous service again and have to work for 2 years to qualify for redundancy pay.
7. CPD:
They will support training and development possibly with paid time but it is most likely to be to be related to the job your employed by them to do (standard in private sector).
If you want to do something to develop your skills with view to getting better job (outside the PCN) that may have to be done in your own time.
8. Employment rights:
Should you need to go to a tribunal, you will need to work for the PCN for 2 years to qualify for employment rights to go to tribunal with a case regarding unfair dismissal (some exceptions may apply).
If you have any questions about any of the above, please contact the trade union team.
Resources
Download our digital resources to use on surgery TV screens and social media:
- First Contact Dietitian TV Screen resources - Slide 1, Slide 2
- First Contact Dietitian Instagram carousel - Slide 1, 2, 3, 4, 5
Access our resources to highlight the benefits of the First Contact Dietitian to GPs, available for you to download and print:
- First Contact Dietitian A4 poster
- First Contact Dietitian A4 flyer
- What could a first contact dietitian do for you? postcard
- Diabetes and Obesity: Dietitians can support diagnosis & management of pre-diabetes and diabetes postcard
- Frailty: Dietitians can reduce frailty & manage malnutrition postcard
- Gastro: Dietitians can support diagnosis & management of IBS postcard
If you would like to request any of the above resources please complete the form below:
Important links
- For further information please visit the HEE Roadmaps to Practice webpage.
- Please read the BDA Dietitians in Primary Care: A Guide to General Practice to learn more about the effectiveness of dietitians in primary care. The guide also includes information on pay structures and a useful checklist for primary care networks (PCN).
- Access the BDA's 'Dietitians in primary care: A guide for general practice'
- The BDA have developed an example job description outlining the role of FCP and AP dietitians in primary care. Please download and adapt as required.