Meet Your Global Partners: UK 
PEN is an international collaboration - we work internationally on a daily basis developing PEN content. The benefit of working so closely is that we can respond to the needs of our users and reflect practice from each of the collaborating countries. While we are all nutrition and dietetic professionals, the practice in each of our countries can vary greatly. PEN provides the foundation of dietetic practice, but its application might be different, depending on the political and structural differences of health care delivery in our countries. Here we detail the practice, policy and politics of nutrition and dietetics in the UK and how the application of the evidence in PEN responds to this.
The United Kingdom is made up of four countries: England, Scotland, Northern Ireland and Wales. While the UK Parliament (the highest legislative authority in the UK) is based in London; Scotland, Northern Ireland and Wales each have a devolved Parliament. In short, a number of powers have been passed from the central government to each of the devolved institutions. Although these powers vary across the four countries they all have devolved powers (can create, amend or repeal legislation) regarding healthcare and each of them has their own systems of delivering National Health Services (NHS) services. PEN aims to reflect each of these healthcare systems and when reviewing or writing PEN content, policy and guidelines from each country is consulted.
The UK NHS began in 1948 it provided, for the first time, medical care free at the point of delivery. Most of the 7,800 dietitians in the UK are employed in the NHS. NHS dietitians can work in primary or secondary healthcare in a number of different settings including hospitals and GP practices (General Practitioners/Family Doctors employed by the NHS). Many other dietitians in the UK work in research, education, and industry or freelance/private practice. With so many dietitians being employed within the NHS, the potential value in having pooled our collective resources into one knowledge translation platform is massive. It means we can focus our energies on applying PEN into our practice and reduce the additional workload that evidence-based practice can present.
PEN users can be reassured that no matter what is happening on a political level, PEN provides the findings from the latest available research. Over the last two years we have seen examples of policy and guidance being published where PEN content already reflects the recommendations. We know that there is emerging science in so many nutrition and dietetic fields; we also know that our national policy may take some time to catch up. This said, when new evidence emerges that changes practice, PEN’s team of international experts reflect this in a timely and effective manner.
The title of dietitian is regulated and protected in the UK and all dietitians are required to have studied in an approved university degree course and be registered with the UK regulatory body, The Health and Care Professions Council (HCPC). Most dietetic degree courses are a 4 year university programme of study but there are also 3 year intensive programmes and masters programmes. The British Dietetic Association (BDA) aids the development of curriculum standards and communicates them to education and training providers. Work is currently ongoing which aims to advise the higher education institutions about how they can incorporate PEN into the curriculum.
The BDA is the only professional membership organisation for dietitians in the UK and represents around 80% of those registered with the HCPC. In addition to registered dietitians, the BDA also has other membership categories for a number of different careers including dietetic assistants, nutritionists* and other health professionals that have a working interest in nutrition and dietetics.
* “Nutritionist” is not a protected title in the UK, in effect meaning that anyone could call themselves a nutritionist. This said, nutrition degrees (without the clinical dietetic training) are available at UK universities and it is graduates of these degrees that can become members of the BDA. PEN can be accessed by all of the BDA’s members. BDA members can find out more about PEN at:
www.bda.uk.com/pen
Following the passing of the
Health and Social Care Act (2012) the NHS in England is currently facing the biggest restructure in its history; with responsibility for commissioning NHS services being transferred to GP’s [family doctors]. Local Government also takes over responsibility for public health services and overall health and social care needs assessment. This will take effect from April 2013. The purpose of this is to commission services locally to meet local health needs while meeting national health outcomes. However, there are concerns that the changes introduce competition into the delivery of health care and could lead to fragmentation and that there will be a great variety in services provided.
Never before then, has a resource such as PEN been more essential for nutrition and dietetic professionals in the UK. Our members have already reported a reduction in the funding available for them to continue their professional development. Alongside evidence-based practice, continued professional development (CPD) is an essential part of HCPC registration, which has to be proven by way of a CPD portfolio; this can be called on for auditing every two years.
PEN facilitates CPD perfectly allowing dietitians to gain insight into both the established and emerging nutrition and dietetic research. This in turn will help dietitians practice in an evidence-based manner. Over 2200 of our members have signed up for PEN since December 2010, if you haven’t yet joined your international colleagues why not take a look today at:
www.pennutrition.com there’s even a 15 day trial. You have nothing to lose, just a world of international collaborating to gain!
Article written by Sylvia Turner BSc, RD
PEN Project Development Officer/KTP Associate, British Dietetic Association