Future Challenges for Renal Dietitians:

Primary Care and New Ways of Working

Debbie Sutton, Portsmouth

It seems unlikely that there will ever be the number of specialist renal dietitians required to provide the standard of care outlined in the Criteria For Success document.
Specialist renal dietitians will always have a role, but collaborative working must be the way forward.Finding effective ways of working with other dietitians, particularly in the field of diabetes and heart disease as well as offering clinical supervision to dietitians in District hospitals who are increasingly likely to meet renal patients are both strategies that could be developed. Dietetic Assistants already do important work in many units. Renal nurses and Support Workers who have regular contact with patients could be more than a conduit for referrals. There could be more support enabling them to recognize problems and start to tackle them.

Most non-renal dietitians are already working with diabetic, hypertensive and overweight patients, a minority of whom will become renal patients.  An exchange of skills and knowledge between us and them would be of benefit to both. In the field of prevention, changes in diet and lifestyle are all about motivating behaviour changes that can be sustained. Community dietitians working in Primary Care are ahead of us here.But some of their messages will sound contradictory to patients when they reach us. We need to work together to agree an approach that will suit the majority, but not confuse the minority.