27 Feb 2025 80,000 accredited practitioners available to bolster the NHS
So why can’t patients access nutrition advice as an integrated part of NHS primary care?
Health and care services are delivered by a mix of professions and practitioners working in different roles. Some of these roles are subject to statutory regulation while others are not. Practitioners can, however, voluntarily join a register and demonstrate their commitment to maintaining professional standards (1).
What is less known is the politicking and professional slandering that goes on behind the scenes with regards to those health and care practitioners on voluntary registers. Despite choosing to make themselves accountable and meeting the professional standards required to register to protect the public, we have witnessed BANT practitioners subject to continual dismissal by the wider healthcare community as well as the parliamentary system that oversees these registers.
There is currently an 80,000 strong workforce of qualified practitioners on accredited registers, overseen by the PSA (2). The PSA accredits registers that meet PSA Quality Standards. This provides patients, the public and employers with assurance about the standards and competence of registrants.
Accredited Registers were established to ensure that those who work in roles not regulated by law, are still held to high standards. They set the same high standards for practitioners working in unregulated health and care occupations as those in statutory regulated professions.
How Voluntary Registration works for BANT Nutritional Therapists
The British Association for Nutrition and Lifestyle Medicine (“BANT”) mandates registration by all its members engaged in clinical practice with the Complementary and Natural Healthcare Council (“CNHC”) PSA-accredited voluntary register.
The CNHC was set up with government support to protect the UK public by providing a voluntary register of health practitioners. CNHC’s register has been approved as an Accredited Register by the Professional Standards Authority for Health and Social Care (“PSA”) an independent body accountable to the UK Parliament.
Through mandated voluntary registration BANT Nutritional Therapy Practitioners are required to:
- adhere to the CNHC code of professional conduct for the Nutritional Therapy Profession.
- be properly qualified and insured, having met the professional standards to register, in this case a BSc (Hons) in Nutritional Therapy
- pay an annual registration fee (in addition to their professional body membership), committing financial resources and intent to adhere to these standards.
- meet the minimum 30 hours per year of Continual Professional Development (“CPD”), ensuring they are working in-line with the latest evidence-based approaches.
- make themselves accountable if a complaint is made against them to CNHC, thus conferring trust and confidence and ensuring members of the public are protected. The same as statutory registered practitioners.
The PSA accredits both the statutory and voluntary registers, overseeing ten health and social care regulators that Parliament has said must be regulated, including the General Medical Council (GMC), General Pharmaceutical Council (GPhC) and Health & Care Professions Council (HCPC).
CNHC as PSA-accredited register, set up with government support and accountable to Parliament, set the same level of standards for practitioners working in unregulated health and care occupations as those in statutory regulated professions.
Voluntary registers were created to facilitate collaboration within health and care
A joint report from the Royal Society for Public Health and the Professional Standards Authority, Untapped Resources: Accredited Registers in the Wider Workforce, stated that:
“Practitioners registered with CNHC support public health by encouraging their clients to make a range of lifestyle changes. These include improvements to diet and nutrition, support with giving up smoking and losing weight, support with reducing stress, improving sleep, managing pain and other symptoms, as well as overall enhancements to wellbeing. All CNHC registrants are committed to enhancing the UK public’s health and wellbeing.”
This provides the perfect backdrop for Nutritional Therapists on an accredited register to support public health as part of an integrative team of professionals. However, three quarters of practitioners surveyed by the Royal Society for Public Health and the PSA felt they were ‘under-utilised in promoting the public’s health’ (2).
It is first worth noting that on paper NHS regulation guidance recognises both statutory and voluntary registers (3). In practice most General Practitioners and Primary Care Networks are unaware of the ability to refer to practitioners on an accredited register. The report identifies the top two factors hindering access to accredited practitioners were:
- Lack of awareness of accredited register practitioners / workforce among other healthcare professionals and the ability to refer on to these practitioners
- The financial obstacle faced by many people to privately fund their own healthcare, as most accredited register practitioners work outside of the NHS in private practice
The solutions put forward to address these barriers were:
- NHS employers to subsidise access to the services of an accredited register occupation, or provide in-house specialists, such as nutritional therapists. This would enable more NHS patients to access these services.
- Accredited register practitioners to have more authority to make direct NHS referrals, in appropriate cases, thereby reducing the administrative burden on GP surgeries.
Where the system fails Nutritional Therapists on the accredited register
Despite the assurances that the accredited PSA register provides, there is evident disparity between how practitioners in ‘statutory’ and ‘voluntary’ professions are viewed.
Former Parliamentary Under-Secretary of State for Public Health and Prevention, Andrew Gwynne MP, referred to Nutritional Therapists as ‘alternative’ stating in a correspondence that “Complementary and alternative medicine is not usually delivered within mainstream NHS healthcare”. The use of ‘alternative’ could be perceived to unfairly undermine the professional credibility of Nutritional Therapists.
This is in marked contrast with the PSA definition of ‘other health and care professionals that are not legally required to be on a statutory register’; clearly defined as practitioners delivering other health services where there is no legal requirement for regulation.
Nutrition is a very broad area of clinical practice; concerning food and its impact on health. Nutritionist is not a protected title in the UK and therefore anyone working in the field of nutrition may be thought of (and think of themselves) as a nutritionist, even if there are other more specific titles that may also apply to them. Nutritionists can generally be found working in industry (particularly the food industry), public health settings (giving advice at a population level about nutrition and health for people or animals), or giving personalised advice in clinical settings (nutritional therapy).
Dietitians are currently the only nutritionists in the UK with compulsory regulation and a protected title. Dietitians are regulated by the Health and Care Professions Council (HCPC). Dietitians give advice on nutrition in the management and treatment of disease and tend to work within the NHS.
Nutritionists can also work in the NHS under the supervision of dietitians, but most nutritionists work in private clinical practice with people seeking to improve overall health and wellbeing. Members of the public would tend to understand “nutritionist” as being someone who provides clinical advice.
Nutritional therapy is a complementary discipline which can and should sit alongside allopathic care. To categorise nutritional therapy as ‘alternative’, as often happens, discredits the validity of providing nutrition recommendations in a clinical setting.
Extending the HCPC Dietetics register to include Registered Nutritional Therapy Practitioners is the requisite next step
In response to the Labour government’s NHS 10-Year Health Plan, The British Association for Nutrition and Lifestyle Medicine (BANT) submitted its response unanimously calling for an extension to the Health and Care Professions Council (HCPC) register to include Registered Nutritional Therapy Practitioners (4).
As previously noted, both Dietitians and Nutritionists can work in the NHS giving personalised advice in clinical settings.
Dietitians are statutorily regulated by the Health and Care Professions Council (“HCPC”) and Registered Nutritional Therapists are voluntarily registered by the Complementary & Natural Healthcare Council (“CNHC”), both of whom are accredited by the Professional Standards Authority (“PSA”).
Incorporating Registered Nutritional Therapists into the HCPC Dietetics register would bring all nutrition health professionals under the scope of a single register. A single register for nutrition covering the wide scope of dietetic nutrition clinical practice is both necessary and expedient for the purpose of securing and improving the regulation of the profession and the services that the profession provides, in acute, chronic and preventative healthcare settings.
Secondly, a single regulator is consistent with fundamental principles of fairness, equality, non-discrimination and competition in the practice of nutrition whilst ensuring that high standards of consumer/patient protection are maintained.
Extending the HCPC dietetics register would foster collaborative ways of working in clinical practice, for the benefit of the NHS and the patients it serves, allowing skilled Nutritional Therapy professionals to play a vital role working in primary care, community and neighbourhood settings where the NHS most needs strengthening.
This singular regulatory change would augment the NHS workforce and get straight to the issue of tackling chronic disease through prevention-led care, thus relieving the strain on NHS resources and instantly increasing General Practitioner capacity to address GP wait lists.
In the interim, BANT requests that:
- practitioners on accredited registers are recognised by members of parliament and the healthcare community as adhering to the same level of standards as those on statutory regulated registers.
- members of parliament refrain from defining nutritional therapy as ‘alternative’ when the service provided is a complementary discipline which compliments allopathic care to improve overall health and wellbeing.
- BANT members are treated with principles of fairness, equality, non-discrimination and competition in the practice of nutrition.
For further comment or information contact BANT Communications Manager, Claire Sambolino [email protected]
References:
- Professional Standards Authority, https://www.professionalstandards.org.uk/organisations-we-oversee/find-a-register?&page=1&sort=relevance
- Report from the Royal Society for Public Health and the Professional Standards Authority, Untapped Resources: Accredited Registers in the Wider Workforce, https://www.cnhc.org.uk/uploads/asset/file/12/Untapped-Resources_0.pdf, accessed 27/02/2025.
- NHS Employers, https://www.nhsemployers.org/articles/professional-regulation
- BANT Press Release and Feature Article, 09/12/2024, https://bant.org.uk/change-the-nhs-bant-calls-for-nutritional-therapy-practitioners-to-work-within-primary-care/
NOTES TO EDITORS:
BANT is the leading professional body for Registered Nutritional Therapy Practitioners in one-to-one clinical practice and a self-regulator for BANT Registered Nutritionists®. BANT members combine a network approach to complex systems, incorporating the latest science from genetic, epigenetic, diet and nutrition research to inform individualised recommendations. BANT oversees the activities, training and Continuing Professional Development (CPD) of its members.
Registered Nutritional Therapists are regulated by the Complementary and Natural Healthcare Council (CNHC) that holds an Accredited Voluntary Register (AVR) for the Professional Standards Authority for Health and Social Care (PSA). A report by the Royal Society for Public Health and the Professional Standards Agency made a key recommendation that AVR practitioners have the authority to make direct NHS referrals, in appropriate cases, to ease the administrative burden on GP surgeries. BANT nutrition practitioners are the key workforce asset to harness 21st century lifestyle medicine to tackle the rising tide of stress-related fatigue, obesity, Type 2 Diabetes, dementia and other chronic diseases.
To find a BANT nutrition practitioner, please click here
BANT WELLBEING GUIDELINES:
The BANT Wellbeing Guidelines are specifically designed to provide clear, easy to understand general information for healthy diet and lifestyle when personalised advice is not available.
Alongside these guidelines, the BANT “Food for your Health” free open-access resources are available to educate and guide the public towards healthier food choices in prevention for diet-induced disease. Download a wide range of food and lifestyle guides, recipes, infographics, planning tools and fact sheets and start making healthy choices today.
