Unreliable access to clinically necessary dietetic assessment and support
First to latest report 14 Feb 2017 — 5 Jun 2026
Reports that mention this concern
6
Times this concern has been raised
6
Stated actions linked to this concern
25
What this concern includes
Includes failures of the dedicated dietetic service pathway affecting access to clinically necessary assessment or support, including inappropriate reliance on telephone assessment where face-to-face review is needed, inadequate appointment governance, delayed or unavailable specialist input, and insufficient out-of-hours coverage.
What is not included
Excludes generic staffing, communication, funding or governance deficiencies unless they directly impair access to clinically necessary dietetic assessment or support.
Excludes non-dietetic specialist referrals and appointments, including general clinical or mental-health assessment pathways.
Excludes failures limited to nutritional care delivery where no dietetic assessment or specialist-support access deficiency is identified.
Excludes the underlying nutritional condition or outcome when no dietetic service control failure is asserted.
Trends
Reports over time
Reports mentioning this concern, over time
Reports about this concern issued each year.
* 2026 is projected from reports observed to 7 Sep 2026.
Most frequent recipients
Most frequent recipients
Reports about this concern sent to each recipient.
Aneurin Bevan University LHB1
Brunswick Ward at Lindridge1
Department of Health and Social Care1
East Suffolk and North Essex NHS Foundation Trust1
Glangwili General Hospital1
NHS England1
NHS Nottingham and Nottinghamshire Integrated Care Board1
Sussex Partnership NHS Foundation Trust1
Velindre NHS Trust1
NHS trust3
Healthcare site2
Executive non-departmental public body1
Integrated care board1
Local health board1
Ministerial department1
Reports and published responses 6 reports
See individual reports that have raised this concern, and the actions taken in response
East Sussex
Concerns raised1
Lack of appropriately qualified dietitian provision for inpatients undergoing psychiatric care
Linked responses
Department of Health and Social Care
NHS England
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
NHS England
Develop safer staffing standards for Allied Health Professionals, including principles applicable to mental health services.
NHS England
Continue supporting multidisciplinary and integrated approaches to care through published specifications and guidance.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.3
NHS England
ICBs are responsible for commissioning appropriate nutritional care for psychiatric inpatients and should answer enquiries about local provision.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
NHS England
Providers and commissioners determine workforce models and local arrangements for dietetic provision.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Department of Health and Social Care
Individual NHS Trusts and employers determine staffing levels and workforce composition to meet patients’ needs safely.
Redirects responsibilityThe respondent said that another organisation was responsible for deciding or taking action.
Essex
Concerns raised1
Lack of out-of-hours specialist dietetic service or cover for patients at CGH
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked response
East Suffolk and North Essex NHS Foundation Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.2
East Suffolk and North Essex NHS Foundation Trust
Undertake a project to ensure relevant ward areas receive consistent, compliant dietetic-care-planning training.
East Suffolk and North Essex NHS Foundation Trust
Develop an out-of-hours escalation process for dietetic support and audit compliance regularly.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
East Suffolk and North Essex NHS Foundation Trust
Weekday dietetic support, robust care plans and enteral feeding starter regimes are considered sufficient outside weekday working hours.
Existing arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Gwent
Concerns raised1
Failure to govern and monitor decisions on face to face dietetic appointments
This report raised 2 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked responses
Aneurin Bevan University LHB
Velindre NHS Trust
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.9
Velindre NHS Trust
Strengthen dietetic governance through enhanced risk reporting, service-risk visibility and oversight of multidisciplinary clinical standards.
Velindre NHS Trust
Develop dietetic assessment standards and a Standard Operating Procedure for telephone reviews and face-to-face consultations.
Velindre NHS Trust
Finalise the dietetic Standard Operating Procedure and submit it for internal governance approval.
Velindre NHS Trust
Implement the approved dietetic Standard Operating Procedure across relevant Velindre Cancer Service teams.
Velindre NHS Trust
Audit the implemented dietetic Standard Operating Procedure and share learning through quality and safety governance.
Aneurin Bevan University LHB
Develop and update a dietetic assessment guideline defining criteria for face-to-face and remote consultations.
Aneurin Bevan University LHB
Adapt the ABUHB booking process to facilitate face-to-face review as an initial assessment.
Aneurin Bevan University LHB
Introduce a decision-making tool requiring clinicians to document the rationale for remote or in-person assessment.
Aneurin Bevan University LHB
Conduct annual joint audits of adherence to the transfer-of-care standard and assessment protocol, reporting findings through governance groups.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Velindre NHS Trust
The actions taken are considered robust enough to prevent future deaths related to dietetic support and provision.
Existing arrangements considered sufficientThe respondent said that existing arrangements were sufficient, so no further action was needed.
Nottinghamshire
Concerns raised1
Lack of commissioned specialist long-term dietetic support for ASD patients with ARFID symptoms
This report raised 1 other concern. They are not shown here because they do not form part of this recurring concern.
Linked response
NHS Nottingham and Nottinghamshire Integrated Care Board
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.8
NHS Nottingham and Nottinghamshire Integrated Care Board
Review clinical cases to identify current ARFID provision and service gaps.
NHS Nottingham and Nottinghamshire Integrated Care Board
Review current ARFID service provision.
NHS Nottingham and Nottinghamshire Integrated Care Board
Develop a preferred all-ages ARFID pathway with service-delivery recommendations.
NHS Nottingham and Nottinghamshire Integrated Care Board
Obtain approval for the preferred ARFID pathway and required resources.
NHS Nottingham and Nottinghamshire Integrated Care Board
Implement the agreed all-ages ARFID pathway.
NHS Nottingham and Nottinghamshire Integrated Care Board
Undertake a skills audit and training-needs analysis across specialist and non-specialist services.
NHS Nottingham and Nottinghamshire Integrated Care Board
Explore development of expanded ARFID-related roles within primary care.
NHS Nottingham and Nottinghamshire Integrated Care Board
Explore workforce competencies around ARFID with Health Education England.
Carmarthenshire and Pembrokeshire
Concerns raised1
Insufficient staffing of the acute dietetic service for timely referral response
This report raised 3 other concerns. They are not shown here because they do not form part of this recurring concern.
Linked response
Hywel Dda University LHB
Stated actions An action is something a respondent says it has done, is doing, or plans to do in response to the concern raised.4
Hywel Dda University LHB
Recruit substantive staff to fill acute dietetic vacancies while continuing efforts to maintain service capacity.
Hywel Dda University LHB
Use locum dietetic staff to support acute service capacity while substantive recruitment continues.
Hywel Dda University LHB
Prioritise high-risk patients for rapid dietetic referral and initiate an enhanced ward-based nutritional care pathway during staffing shortages.
Hywel Dda University LHB
Propose increased acute dietetic establishment through additional registered dietitians and unregistered dietetic support workers.
Respondent positions A position is what a respondent says about the concern when they do not describe a specific action.1
Hywel Dda University LHB
Low numbers of suitable applicants have prevented recruitment and adequate locum cover for acute dietetic vacancies, limiting staffing capacity.
Unable to actThe respondent said that a constraint prevented them from taking the relevant action.
Brighton and Hove
Concerns raised1
Failure to refer nutritionally deteriorating patients to dieticians
This report raised 25 other concerns. They are not shown here because they do not form part of this recurring concern.
No linked response statements
No respondent-stated action or position is linked to these concerns in the published data.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.
Actions and positions describe what organisations say in published responses. Implementation is not independently verified.