The BDA are undertaking a review of working practices amongst members in order to update the 2016 Safe Staffing, Safe Workload document. This guidance document will be helpful in supporting Dietitians in their workplace by providing evidence for safe caseloads, highlighting complexity factors, assisting with skill mix options for service provision, identifying where additional training may be required, providing details for business case planning and highlighting to other professions and management the skill and diversity of Dietitians' work.
In order to make these updates, we need the Dietetic Workforce to complete our survey.*
*Please note: this online survey is for dietitians and the dietetic support workforce who are working for the NHS, or delivering NHS care either freelance or for a private company. If you have more than one post, please provide information for your main (or only) post.
Prior to completing the survey, we suggest that you read through the below information, so that you can easily answer the questions online. The information we require is about your current workload and the time you spend carrying out patient related activity and non-patient related activities. Your job plan should be helpful for this. You will also be asked about the average number of new and follow-up direct patient contacts you have (in a full working month) with both individuals and and groups. For those that are not familiar with job plans, the definitions below should help with this.
There is also a section on patient complexity which is an important part of determining safe caseload management. However, it’s not always clear as how to define ‘complexity’. For this survey, we are using a Dietetic Complexity Tool, developed at St George’s Hospital London, which has provided definitions of high, low and medium complexity. This tool is being validated in both acute and community settings for use within all four nations. We would like to know your opinion on the complexity of your own caseload based on this tool and your views on this tool. See further information below.
Job plans describe how working time is divided up according to specific categories.
Direct Clinical Care (DCC) relates to all the patient related work and is split into two parts.
Individual Patient Attributable DCC
This relates to all the time taken for specific patients’ direct clinical care that are usually face to face and all the associated activities required for that patient contact.
Non Individual Patient Attributable DCC
These activities do not involve direct communication with the patient (and do not count as patient contacts). This includes MDT meetings, telephone conversations and emails with other care professionals.
Most other activities are categorised as SPAs. However, additional responsibilities (ANR) and external duties (usually externally funded) may occasionally be used.
Examples of SPA are clinical service management, practice/clinical supervision, training of staff, time allocated for students and CPD.
Patient complexity is important in delivering safe caseload management. Complexity is based on patients' needs and intervention types, not on how difficult the Dietitian personally found the task. Differing bands of Dietitians and Assistants working in specialist areas will feel more competent to assess more complex patients in that specific area.
View the Complexity Tool. The Tool has 10 different domains to calculate an end score for 'high, medium, low' complexity.
Once the Dietetic Complexity tool has been validated, you should be able to use it in your clinical practice as the final validated version will be on the BDA website.
It can help job planning by determining the number of patients who can be safely seen per day and to allocate caseloads within a team's mixed banding of staff. The Tool will assist in supporting business cases, in education and disseminating understanding of the variety of work undertaken by Dietitians.