Dietitian

Dietitians assess, diagnose and treat diet-related and nutritional problems and raise awareness of the link between food and health at both an individual and wider public-health level

As a dietitian you'll translate the most up-to-date scientific and public health research about nutrition into practical advice to help people make health-conscious decisions about food and lifestyle.

You will use your skills to treat a range of complex clinical conditions such as:

• chronic fatigue
• diabetes
• eating disorders, such as anorexia, bulimia and avoidant restrictive food intake disorder (ARFID)
• food allergies and intolerance
• irritable bowel syndrome (IBS)
• kidney failure
• malnutrition.

You will also help to prevent illness and disease, promote good nutritional health, and help people to improve their health and fitness levels through diet and nutrition.

As well as working in the NHS and private clinics, you can also find employment in areas such as sport, the community, the food industry, learning disabilities, mental health, public health, acute settings and teaching. You will also advise on food and health policy at a national, local and individual level.

Dietitians are a key part of the healthcare team and are the only nutrition professionals that are statutorily regulated.

Responsibilities

When working in a hospital or community setting, you'll need to:

• undertake nutritional assessments of patients with a range of complex medical conditions
• educate and advise patients with diet-related disorders on the practical ways in which they can improve their health by supporting them to make appropriate lifestyle and food choices
• devise, monitor, review and improve nutritional care plans
• deliver group sessions to patient groups
• work with a multidisciplinary team (including GPs, hospital consultants, psychologists and speech and language therapists) to ensure patient-centred care is provided
• liaise with hospital staff and external agencies to ensure the smooth transition of patients discharged from hospital back into the community so that they can continue to receive the dietary support needed
• promote health and wellbeing by informing the public about the importance of diet and nutrition
• educate other healthcare professionals about food and nutrition issues
• advise hospital catering departments about any specific patient dietary requirements
• support schools in the provision of healthy school meals
• run clinics in hospital outpatients departments or GP surgeries
• record all assessments and interventions, write reports and case notes, and maintain accurate records
• prepare information packs, flyers and other promotional materials
• undertake research in nutrition to better understand its effects on health and disease.

With experience, you may be involved in training and mentoring pre-registration students, as well as supporting and supervising less experienced staff.

If you're working with athletes and sportspeople, you'll need to:

• advise on how diet can optimise their performance and recovery from injury
• educate them to understand the physiology and biochemistry of different types of exercise and the role nutrition has in these processes.

In other roles, you may be involved in developing new food products and evaluating their nutritional content, setting up and monitoring clinical trials, or advising the food and pharmaceutical industry.

Salary

• Jobs in the NHS consist of nine pay bands and are usually covered by the Agenda for Change (AfC) Pay Rates. Starting salaries for qualified dietitians range from £28,407 to £34,581 (band 5).
• Dietitians at specialist level (band 6) can earn between £35,392 and £42,618. At advanced dietitian/dietetic team manager level (band 7), you can earn between £43,742 and £50,056.
• Salaries for roles such as consultant dietitian, division lead or advanced practitioner can range from £50,952 to £81,138 (band 8a to 8c).

There are on-call and special-duty allowances for dietitians working in the NHS. In London and the South East, a cost of living allowance is available.

Salaries outside of the NHS vary depending on the type and size of your employer, the nature of the work, and your skills and experience.

Income figures are intended as a guide only.

Working hours

If you're working in the NHS you're likely to do a standard 37.5 hours a week. Elsewhere, you'll usually work 9am to 5pm, but may need to work some extra hours or weekends if required.

If you're self-employed, your hours will need to suit your clients' availability and may include evenings and weekends.

Job-sharing, part-time work and opportunities for career breaks are possible.

What to expect

• Dietitians working in the NHS are usually based in a hospital, health centre or clinic and will have a private consultation room. Community dietitians may have to travel locally to meet clients. If you're involved in research, you may work in laboratories.
• You'll work as part of a multidisciplinary team that can include nurses, doctors, consultants, psychologists, speech and language therapists and occupational therapists
• Jobs are available in most towns and cities throughout the UK.
• Self-employment and freelance work are possible within a clinical setting, sport and private health sectors, as well as in the food industry, public relations companies and the media.
• Being a dietitian can be an extremely rewarding career as you're able to make a significant contribution to improving patients' health. Patient caseloads can be challenging and require working closely with other healthcare professionals.

Qualifications

To practise as a dietitian you must be registered with the Health & Care Professions Council (HCPC). To achieve this, you must complete an HCPC-approved programme in dietetics, either an undergraduate degree or, if you have a degree in a relevant subject, an approved postgraduate course. Programmes are also accredited by the British Dietetic Association (BDA).

You'll usually need three A-levels (or equivalent), including biology and often chemistry (or another related subject), as well as at least five GCSE passes at grade C/grade 4 (or equivalent) or above, including English and maths, to get a place on a degree course. Courses last three years or four years and applications are made via the Universities and Colleges Admissions Service (UCAS).

To be accepted on to a two-year postgraduate course (either a Postgraduate Diploma or a Masters in dietetics) you must have a health or life sciences degree, often a 2:1 or above, that contains an adequate level of human physiology and biochemistry. Relevant degree subjects may include:

• biochemistry
• biological sciences
• biomedical science
• health sciences
• human biology
• human nutrition
• nutritional science
• physiology
• sport and exercise science.

Entry requirements vary between courses, so check with individual providers for exact details.

Both routes are full time and include a mix of theory and practical work placements in a hospital or community setting. Subjects covered include biochemistry, human nutrition, human physiology, diet therapy, pharmacology and nutritional medicine, as well as skills such as communication, professionalism, data analysis and research.

It's also possible to take a dietetic degree apprenticeship, which combines paid work as an apprentice in a dietetic setting with academic study at a university to complete the degree programme. Find out more about dietetic apprenticeships.

For a list of qualifying courses, search HCPC - Approved Programmes.

All eligible pre-registration undergraduate and postgraduate dietetic students studying at a university in England can receive funding support of at least £5,000 per year through the NHS Learning Support Fund (LSF). You don't have to pay it back and are still able to access funding for tuition and maintenance loans from the Student Loans Company. For more information, see Health Careers.

For details of financial support available to students in Scotland, Wales and Northern Ireland, see:

• Student Awards Agency Scotland (SAAS)
• Student Awards Services (Wales)
• Northern Ireland Direct Government Services

You'll also need satisfactory occupational health clearance and a criminal records check.

Entry into the profession without an approved degree or postgraduate qualification is only possible at the level of dietetic assistant or dietetic support worker. From here, your employer may support you in studying for an approved degree to then become a dietitian.

Skills

You'll need to have:

• an interest in the scientific aspects of food
• an interest in working in a care-based setting
• strong verbal and written communication skills
• the ability to explain complex ideas simply
• excellent interpersonal skills to develop relationships with patients/carers
• teamworking skills to work effectively as part of a multidisciplinary healthcare team
• the ability to prioritise your work and manage a caseload
• time management skills and the ability to work under pressure
• IT skills to record and access patient records
• a positive attitude and the ability to motivate others
• understanding and tact to deal with sensitive issues
• negotiation skills to help patients overcome barriers and create positive change
• a caring and compassionate approach
• willingness to keep up to date with current nutrition information and research.

You may also need a driving licence to travel to patients' homes or between hospital sites.

Work experience

Try to arrange a visit to a dietetic unit at your local hospital before applying for a course so you can get an idea of what the work is like and whether it would suit you.

You could also try to get some voluntary or paid work experience within a dietetic department to show your interest and understanding of the area. Contact the dietetic manager at your local hospital to ask about opportunities.

Working as a dietetic assistant practitioner or as a dietetic support worker provides a valuable insight into the role and shows your commitment. Experience in care work, with a nutrition-related charity or as a healthcare assistant is also useful.

Find out more about the different kinds of work experience and internships that are available.

Employers

The NHS is the major employer of dietitians. Many work in hospitals or in the community, in GP surgeries and clinics for example. There are also vacancies available in the private healthcare sector. You may also work for:

• local authorities
• catering companies
• care homes
• the food industry and food and drink manufacturers
• supermarket chains
• trade associations and promotional groups
• schools, universities and research establishments
• pharmaceutical companies
• the media
• prisons
• public relations companies
• publishing companies
• government and non-governmental organisations (NGOs)
• professional gyms, sports clubs and Olympic camps.

Other opportunities exist in the workplace and in the voluntary sector and with international relief agencies.

If you want to work abroad, check with the country's dietetic professional body to see what the requirements are for registration to practise.

With experience, you may choose to undertake freelance work or set up in private practice.

Look for job vacancies at:

• Dietitians Jobs
• HealthJobsUK
• NHS Jobs
• NHSScotland Jobs

Specialist recruitment agencies such as Pulse and Your World Healthcare also advertise vacancies.

Professional development

Continuing professional development (CPD) is an important part of being a dietitian and is an essential requirement of continued registration with the HCPC.

As a registered dietitian you can become a full member of the BDA, which runs regular post-registration training. Sessions are usually organised by special interest groups within the association and focus on areas of expertise.

Courses in professionalism skills and leadership and management are also available. Food manufacturers also offer courses for dietitians about new products, and these are sometimes run via BDA branches. For more details, see BDA - Continuing Professional Development.

You could also do post-registration postgraduate study in your area of specialism. Masters modules are available in areas of dietetic practice, which can be taken either as stand-alone or Masters programmes. Search for postgraduate courses in dietetics.

It's also possible to get involved in mentoring and teaching.

Career prospects

There is a clearly defined route for career progression in the NHS, starting with a basic grade dietitian (band 5), moving on to a dietitian specialist role (band 6) and then roles such as advanced dietitian or dietetic team manager (band 7). With the right combination of qualifications, skills and experience, you can progress to roles such as consultant dietitian or division lead (band 8).

The path you choose will depend on your career interests, for example working in a community-based role in patients' homes or at a GP clinic. You may decide to specialise in an area such as gastroenterology, diabetes or cancer, or with a specific group of clients, such as children, minority ethnic groups, athletes or elderly people. You may also choose to progress into a management role with responsibility for a team, department and budget.

Dietitians in the food and drink industry can move into product development and marketing roles. You may choose to do further training and move into teaching and research. Alternatively, there are opportunities in sport, health education, public relations, scientific research and journalism.

Self-employment is also an option, providing the flexibility to choose how your career develops according to your interests. This might involve combining freelance work for organisations such as the NHS with other activities such as writing for health publications.