A First Contact Dietitian (FCD) can diagnose medical conditions and then provide suitable dietetic treatment for those conditions. FCDs work in primary care (usually in GP surgeries and health centres). The title ‘First Contact’ points to the fact that patients can make or be given an appointment with an FCD without having to see the GP first.

There are specific conditions that are appropriate for FCDs depending on their knowledge, experience and scope of practice.

Conditions commonly seen include:

• Treating people living with overweight and obesity
• Diabetes
• Frailty
• Gastroenterology, i.e. IBS or coeliac disease

The roles may include other conditions, dependant on a dietitian’s scope of practice. Dietitians working with undifferentiated diagnosis in paediatric populations must have relevant masters level training and education in the management of nutrition and dietetic practice in paediatrics.

For more information please read NHSE Roadmap to practice and the BDA the Association of UK Dietitians :What is a First Contact Practice?

Further information can be found here.

The scope of practice for First Contact Dietitians is set out in the NHSE Roadmap to practice for First Contact and Advanced Practitioners. These roadmaps provide a clear educational pathway from undergraduate study through to Advanced Practice, detailing the knowledge, skills, and professional attributes required to work as an FCP or Advanced Dietitians in primary care. They also outline the supervision structures and clinical governance arrangements necessary to support safe and effective practice.

By defining the capabilities of FCPs and Advanced Dietitians the roadmaps help employers and workforce planners understand the value these roles bring to a multi-professional team, supporting high-quality, patient-centred care.

Here are examples of what a First Contact Physiotherapist can see, this may change dependent on the induvial Physiotherapists and their previous experience and training:

• Gastroenterology
• Diabetes
• Fragility
• Obesity
• Malnutrition
• Infant feeding difficulties
• Provide information on self-care and enable and support behaviour change
• Undertake social prescribing
• Refer to a course of treatment
• Request investigations
• Medicines optimisation

NHSE Dietitians in Primary care

Recruiting First Contact Dietitansthrough ARRS

Primary Care Networks (PCNs) can recruit First Contact Dietitans (FCPs) via the Additional Roles Reimbursement Scheme (ARRS). This scheme funds a range of roles to help build bespoke, multidisciplinary teams that meet local population needs. All PCNs are eligible for reimbursement, with funding allocation based on their weighted population share.

Through ARRS, PCNs can employ FCPs and be reimbursed for 100% of the specified salary and associated on-costs. This makes it a cost-effective way to integrate dietetic expertise into primary care teams, improving access and outcomes for patients.

More information can be found in:

• DES contract.
• Additional Roles at a Quick Reference Summary.
• CQC Mythbuster.

To practice as a First Contact Dietitian, clinicians must be registered with the Health and Care Professions Council (HCPC), which requires a BSc (Hons) dietetics degree or shortened postgraduate programme with a relevant first degree

Dietitians working at Advanced Practice level are generally expected to hold a Master’s degree or equivalent postgraduate qualification to support extended clinical decision-making, supplementary prescribing, and leadership responsibilities.

NHS England recommends that Dietitan have 3–5 years of post-qualification experience before entering primary care training to become a First Contact Practitioner. This ensures they have the clinical expertise needed to manage patients safely and effectively in a first-contact setting.

In addition, First Contact Dietitians should:

• Hold a Master’s-level qualification or demonstrate equivalent specialist knowledge, skills, and experience.
• Be able to demonstrate Level 7 capability in Dietetic practice, including advanced assessment, diagnosis, and treatment.

Further information ca be found here:

BDA :Dietitians in Primary care: A guide for general practice

NHSE Dietitians in Primary care

Dietitians can train to be a First contact practitioner via 2 routes:

University taught route – there are several fully funded courses available for Dietitians to attend:

Dietitians can also undertake the portfolio route, this route is aimed at individuals with previous post graduate training and / or primary care experience. 

Further Information on Education and Training can be found here.

BDA The Association of UK Dietitians; What Is First Contact Practice?

Job Description

BDA :Dietitians in Primary care: A guide for general practice

Dietetic Role in Primary care webinar

BDA Primary care Paper- The expert Generalist

Example of interview questions

Supervision under ARRS

The Network Contract DES specifies the minimum supervision requirements for staff hired through the ARRS. The table below outlines the recommended minimum frequency for supervision meetings and identifies who can provide this supervision. Each clinical supervision session should last at least one hour.

These recommendations are based on the Network Contract DES requirements, professional regulatory standards, and expert guidance.

More information can be found in NHS England’s’ supervision guidance for primary care network multidisciplinary teams.

Supervision of the MDT.

FCP Portfolios

• Agilio (Clarity)

Portfolio Blank Templates

• Audio COT
• Case-Based Discussion – Dietitian
• Clinical Supervisor’s Report
• Consultation Observation Tool – Dietitian
• FCP Verification Form
• Level 7 Module Performa
• Multi source feedback form
• Patient Satisfaction Questionnaire
• Personal Development Plan
• Patient survey questionaire and multi source feedback form via accuRx guide
• Tutorial Evaluation
• Tutorial Record