An Example of a Gastroenterology First Contact Dietitian

What we offer as an FCP Dietitian?

Kim Bowra, First Contact Dietitian. Bexhill Primary Care Network (East Sussex) 

• Enhanced Dietetic triage and assessment including dietary, physical and emotional well-being e.g. medications, physical activity, MECC, promoting screening, advice and signposting​

• Basic observations​

• Abdominal examination​

• Blood test requests: FBC, haematinics, LFTs, renal, bone, lipid, TFT, Hba1c, TTG, amylase and inflammatory markers​

• Sample requests: FIT, faecal cal, faecal elastase, h pylori and oral thrush swab/obs​

• National tool completion: Q risk cardiovascular v3, FRAX score, PHQ-4, GAD-7, 6CIT, GDS, Epworth sleep score​

• Direct onwards referrals: PCN services, triage point for dietetic services, HSCC / ASC, community services and bone DEXA scan ​

• Onward referrals for GP to approve: Gastroenterology, endoscopy, Colorectal 2ww

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Service Statistics

• 3 centralised GP surgeries, spread over 9 sites.​

• Bexhill patient population of 46,000​

• Total referrals last quarter = 142 (monthly referrals range 35 – 65)​

• 20% increase in total referral numbers compared to previous year​

• GPs main referrers ~60%. PPs, nurses and community teams increasing.​

• Self-referral, Engage Consult and receptionist referral low numbers, increasing.​

• Gastro referrals have doubled in past year (53 to 117)​

• 60% of referrals clinic based consults, 30% of referrals are home visits​

• Waiting times vary 1-6 weeks depending on capacity & clinical priority​

• Up to 82% of patients referred are seen by FCP Dietitians​

• 90% of patients are seen for 2 contacts or less​

Additional opportunities working as an FCD in Gastro​

• Frequent Attender project – The Gps have seen the benefit of our FCD work in gastro conditions, which has led to a pilot in FCD assessment and support of ‘frequent attender patients that have gastro conditions’ such as diverticular disease or IBS to offer enhanced assessment, advice and sign posting for patients with unmet needs and recurrent GP contacts. Initial project results show positive impact of FCD input including improvement in symptoms and quality of life.​

• Post Covid Assessment Service- PCN FCD actively engaged with pilot opportunity to improve patient care, self management and empowerment for the local population who have long term conditions such as fibromyalgia, chronic fatigue, EDS and chronic pain. These conditions often present with GI symptoms and so access to this service is beneficial for our gastro population. Project objective was to recruit 30 patients and required promotion of the service within the PCN and surgery teams, plus EMIS searches to identify potential patients for the FCD to contact and recruit. Without this work these patients, with complex conditions would not have access to such programs.​