Specialist Dietitian - Frailty and Malnutrition Service

Please note: appointment to this role is subject to completion of an ongoing internal redeployment process. Role Purpose This is an autonomous specialist dietitian role within a 12-month pilot service delivering evidence-based malnutrition and frailty care to adults in care homes and community settings across North Staffordshire. You will lead the clinical delivery of the service, working to GLIM (Global Leadership Initiative on Malnutrition) diagnostic criteria, NICE guidance, and food-first principles. Oral nutritional supplements are used appropriately as one component of a comprehensive nutritional care pathway, with clear initiation criteria, time-limited prescribing, and structured review. The role requires a high degree of clinical autonomy, sound professional judgement, and a strong focus on measurable outcomes. You will be responsible for demonstrating service impact through robust data collection and contributing to evaluation that will inform future commissioning decisions. Key Responsibilities Clinical Assessment and Management • Deliver autonomous, specialist dietetic assessments for adults with malnutrition and frailty in care homes and community settings • Apply GLIM criteria to diagnose malnutrition and determine severity, ensuring standardised and evidence-based practice • Develop individualised nutrition care plans prioritising food-first interventions, with ONS prescribed only where clinically indicated • Make independent clinical decisions on ONS initiation, continuation, step-down, and discontinuation based on patient response and clinical need • Conduct functional assessments including handgrip dynamometry to monitor muscle status and track outcomes • Assess and manage patients with nutrition-related pressure ulcers and wounds, coordinating with tissue viability services where appropriate • Manage a mixed caseload including care home residents and free-living adults with long-term conditions at nutritional risk Service Delivery and Working Pattern • Deliver care through a hybrid model: approximately 60% remote (video and telephone consultations) and 40% face-to-face • Conduct regular weekly visits to care homes within the PCN footprint for complex assessments and high-risk residents • Provide timely access to the service, working towards a target of less than two weeks from referral to first contact • Maintain flexibility to adjust working patterns to meet service needs and patient requirements Supervision and Team Working • Provide day-to-day clinical supervision and support to the Nutrition Assistant • Review and prioritise referrals, delegating appropriate tasks while maintaining clinical oversight • Work collaboratively within the MDT including GPs, practice nurses, community nursing teams, and hospital discharge services • Build effective relationships with care home staff and support their development in nutrition screening and food-first approaches Data, Outcomes and Service Evaluation • Maintain accurate, contemporaneous clinical records in line with professional and organisational standards • Collect and report outcome data including GLIM status, weight trajectories, functional measures, wound healing progress, and ONS utilisation • Contribute to quarterly service reporting and pilot evaluation • Develop anonymised case studies demonstrating clinical and service impact • Support the generation of evidence to inform future commissioning and service sustainability Training and Education • Deliver MUST screening training and food-first education to care home staff • Provide education sessions for PCN and practice staff on malnutrition identification and appropriate referral • Contribute to the development of patient and staff resources Reporting and Governance • Reports operationally and clinically to the PCD Clinical Lead • Participates in monthly clinical supervision and case review • Works within PCD's clinical governance framework including incident reporting, safeguarding, and professional standards • Maintains HCPC registration and adheres to professional codes of conduct • Contributes to service audits and quality improvement initiatives Working Pattern and Travel This role is 0.6 WTE (22.5 hours per week). The working pattern will be agreed with the successful candidate but must include capacity for regular weekly care home visits within North Staffordshire. Travel across the region is required. You must hold a full UK driving licence and have access to a vehicle for work purposes. Person Specification Essential • HCPC registered Dietitian • Degree or postgraduate diploma in Dietetics • Minimum 3 years post-registration clinical experience • Demonstrable experience in community, primary care, or care home dietetics • Strong clinical reasoning and autonomous decision-making skills • Knowledge of malnutrition screening (MUST), assessment, and management • Understanding of evidence-based ONS prescribing principles and food-first approaches • Experience of outcome measurement and data collection in clinical practice • Excellent written and verbal communication skills • Ability to build effective relationships with patients, carers, and multidisciplinary colleagues • Competent in the use of clinical IT systems and video consultation platforms • Full UK driving licence and access to a vehicle Desirable • Experience applying GLIM criteria for malnutrition diagnosis • Experience in frailty, older adult, or care home nutrition • Knowledge of wound care nutrition and pressure ulcer management • Experience supervising junior staff or support workers • Experience with service evaluation, audit, or quality improvement • Training or teaching delivery experience • Familiarity with EMIS or SystmOne clinical systems About Primary Care Dietitians Primary Care Dietitians is England's only national independent specialist PCN dietitian provider. We support NHS Primary Care Networks and GP practices to deliver high-quality, tech-enabled dietetic services. What We Offer • Flexible working arrangements • Monthly clinical supervision from experienced clinical lead • Access to PCD's national network of dietitians for peer support and best practice sharing • Attendance at ESPEN Congress (European Society for Clinical Nutrition and Metabolism) fully sponsored - a significant professional development opportunity • Opportunity to shape and evaluate an innovative pilot service with potential for future commissioning General Terms This role profile is not exhaustive. You may be directed to complete other reasonable tasks within the expectations of your position. All Primary Care Dietitians staff are expected to: • Ensure conduct meets the standards detailed in Primary Care Dietitians' Code of Conduct • Safeguard children and adults, acting on any concerns to ensure appropriate assessment and investigation • Adhere to all Primary Care Dietitians policies and procedures Job description Job responsibilities Please note: appointment to this role is subject to completion of an ongoing internal redeployment process. Role Purpose This is an autonomous specialist dietitian role within a 12-month pilot service delivering evidence-based malnutrition and frailty care to adults in care homes and community settings across North Staffordshire. You will lead the clinical delivery of the service, working to GLIM (Global Leadership Initiative on Malnutrition) diagnostic criteria, NICE guidance, and food-first principles. Oral nutritional supplements are used appropriately as one component of a comprehensive nutritional care pathway, with clear initiation criteria, time-limited prescribing, and structured review. The role requires a high degree of clinical autonomy, sound professional judgement, and a strong focus on measurable outcomes. You will be responsible for demonstrating service impact through robust data collection and contributing to evaluation that will inform future commissioning decisions. Key Responsibilities Clinical Assessment and Management • Deliver autonomous, specialist dietetic assessments for adults with malnutrition and frailty in care homes and community settings • Apply GLIM criteria to diagnose malnutrition and determine severity, ensuring standardised and evidence-based practice • Develop individualised nutrition care plans prioritising food-first interventions, with ONS prescribed only where clinically indicated • Make independent clinical decisions on ONS initiation, continuation, step-down, and discontinuation based on patient response and clinical need • Conduct functional assessments including handgrip dynamometry to monitor muscle status and track outcomes • Assess and manage patients with nutrition-related pressure ulcers and wounds, coordinating with tissue viability services where appropriate • Manage a mixed caseload including care home residents and free-living adults with long-term conditions at nutritional risk Service Delivery and Working Pattern • Deliver care through a hybrid model: approximately 60% remote (video and telephone consultations) and 40% face-to-face • Conduct regular weekly visits to care homes within the PCN footprint for complex assessments and high-risk residents • Provide timely access to the service, working towards a target of less than two weeks from referral to first contact • Maintain flexibility to adjust working patterns to meet service needs and patient requirements Supervision and Team Working • Provide day-to-day clinical supervision and support to the Nutrition Assistant • Review and prioritise referrals, delegating appropriate tasks while maintaining clinical oversight • Work collaboratively within the MDT including GPs, practice nurses, community nursing teams, and hospital discharge services • Build effective relationships with care home staff and support their development in nutrition screening and food-first approaches Data, Outcomes and Service Evaluation • Maintain accurate, contemporaneous clinical records in line with professional and organisational standards • Collect and report outcome data including GLIM status, weight trajectories, functional measures, wound healing progress, and ONS utilisation • Contribute to quarterly service reporting and pilot evaluation • Develop anonymised case studies demonstrating clinical and service impact • Support the generation of evidence to inform future commissioning and service sustainability Training and Education • Deliver MUST screening training and food-first education to care home staff • Provide education sessions for PCN and practice staff on malnutrition identification and appropriate referral • Contribute to the development of patient and staff resources Reporting and Governance • Reports operationally and clinically to the PCD Clinical Lead • Participates in monthly clinical supervision and case review • Works within PCD's clinical governance framework including incident reporting, safeguarding, and professional standards • Maintains HCPC registration and adheres to professional codes of conduct • Contributes to service audits and quality improvement initiatives Working Pattern and Travel This role is 0.6 WTE (22.5 hours per week). The working pattern will be agreed with the successful candidate but must include capacity for regular weekly care home visits within North Staffordshire. Travel across the region is required. You must hold a full UK driving licence and have access to a vehicle for work purposes. Person Specification Essential • HCPC registered Dietitian • Degree or postgraduate diploma in Dietetics • Minimum 3 years post-registration clinical experience • Demonstrable experience in community, primary care, or care home dietetics • Strong clinical reasoning and autonomous decision-making skills • Knowledge of malnutrition screening (MUST), assessment, and management • Understanding of evidence-based ONS prescribing principles and food-first approaches • Experience of outcome measurement and data collection in clinical practice • Excellent written and verbal communication skills • Ability to build effective relationships with patients, carers, and multidisciplinary colleagues • Competent in the use of clinical IT systems and video consultation platforms • Full UK driving licence and access to a vehicle Desirable • Experience applying GLIM criteria for malnutrition diagnosis • Experience in frailty, older adult, or care home nutrition • Knowledge of wound care nutrition and pressure ulcer management • Experience supervising junior staff or support workers • Experience with service evaluation, audit, or quality improvement • Training or teaching delivery experience • Familiarity with EMIS or SystmOne clinical systems About Primary Care Dietitians Primary Care Dietitians is England's only national independent specialist PCN dietitian provider. We support NHS Primary Care Networks and GP practices to deliver high-quality, tech-enabled dietetic services. What We Offer • Flexible working arrangements • Monthly clinical supervision from experienced clinical lead • Access to PCD's national network of dietitians for peer support and best practice sharing • Attendance at ESPEN Congress (European Society for Clinical Nutrition and Metabolism) fully sponsored - a significant professional development opportunity • Opportunity to shape and evaluate an innovative pilot service with potential for future commissioning General Terms This role profile is not exhaustive. You may be directed to complete other reasonable tasks within the expectations of your position. All Primary Care Dietitians staff are expected to: • Ensure conduct meets the standards detailed in Primary Care Dietitians' Code of Conduct • Safeguard children and adults, acting on any concerns to ensure appropriate assessment and investigation • Adhere to all Primary Care Dietitians policies and procedures