| 8.1
Improving the Scottish diet is one of the priorities of
the NHS in Scotland. Health Boards, Trusts and primary
care teams all have important roles in the delivery of
dietary targets but the activity which offers the
greatest potential is the development by Boards of a
range of "health alliances" in their respective
areas with key organisations such as local authorities,
employers, schools, catering establishments and the
media. |
| 8.2 Within
these alliances, Health Boards are initiating a wide
range of local projects to bring the healthy eating
message more directly to the public. Activities include a
project in deprived areas on healthy eating which is
teaching young people basic cookery skills to enable them
to adopt a healthier diet, local healthy eating award
schemes, work with schools to develop healthy food
choices, opening healthy eating clinics and distributing
health promotion literature. In addition, Boards and
Trusts were required to have food and health policies for
NHS premises in place by March 1994. These policies
require dietitians to be consulted on menu planning for
both patients and staff. It is, nevertheless, important
that the NHS should ensure that its healthy eating
policies are consistent throughout the Service and that
NHS management should satisfy itself that the Service's
catering specifications reflect the guidance in the Model
Nutritional Guidelines for Catering Specifications for
the Public Sector in Scotland (see Annex to Section 6). |
| 8.3 The
Scottish Diet Report referred to "the current state
of ignorance and limited skills of the professionals
involved in providing consequent dietary advice in
Scotland". In the light of that criticism, which was
not disputed in The Scottish Office consultation on the
Report, it is clear that the NHS will need to take active
steps to ensure that its professional staff have an
adequate grounding in diet and nutrition and that they
are able to convey appropriate dietary advice and support
both to the general public and to their patients. In this
context, the recommendations of the Nutrition Task Force
Project Team and its Core Curriculum for Nutrition in the
Education of Health Professionals, "Nutrition in
General Practice", published by the Royal College of
General Practitioners, and "Nutrition for
Life", published by the English National Board for
Nursing, Midwifery and Health Visiting are all relevant
and helpful. |
| 8.4 The
provision of dietary advice will be particularly
important to pregnant women and to patients suffering
from coronary heart disease, diabetes, hypertension and
obesity and those with a family history of these
conditions. The independent Post-Graduate Nutrition and
Dietetic Centre based at the Rowett Research Institute
operates on behalf of Scottish dietitians to promote the
education of professionals in the Health Service in
Scotland. Health Boards, often through the combined
efforts of dietitians and health promotion specialists,
also provide locally based education and training
initiatives. Support for both national and local
opportunities should continue and the larger Health
Boards should consider the appointment of public health
nutritionists or suitably experienced State Registered
Dietitians. It will also be important for the Health
Education Board for Scotland to ensure that it has access
to expert nutritional advice. |
| 8.5 The
Group considers that Directors of Public Health have a
crucial role in this area of public health in terms of
identifying local need for action, co-ordinating local
health strategies and in ensuring appropriate delivery of
effective health promotion action in partnership with
health promotion specialists. They should specifically
include, in their Annual Reports, a summary of their
Boards' diet-related activity. |
| 8.6 The
medical profession has a crucial leadership role in most
areas of health care and health promotion. For this
reason, it is particularly important that Scottish
doctors should appreciate the extent to which dietary
inadequacies contribute to Scotland's dismal health
record and the potential role of dietary changes in
improving the health both of individual patients and of
the population as a whole. In the past, the importance of
diet and nutrition has not been sufficiently emphasised
in medical school curricula and this will need to change.
It will also be important for the Royal Colleges and the
Scottish Council for Postgraduate Medical and Dental
Education to ensure that appropriate emphasis is given to
nutritional and dietary issues in their programmes for
specialty training and continuing professional
development. It is equally important that appropriate
emphasis is given to nutritional and dietary advice in
educational programmes for nurses (particularly school
nurses), midwives, health visitors and members of the
professions allied to medicine and that the National
Board for Nursing, Midwifery and Health Visiting for
Scotland and the Council for Professions Supplementary to
Medicine respond accordingly. |
| 8.7 The
dietetic profession in Scotland has been working for
several years to promote the education of professional
groups within the Health Service. Scottish dietitians
should be encouraged to continue their educational
developments and to improve, through appropriately
audited procedures, dietetic advice and practice
throughout the NHS in Scotland. The dietetic service, in
conjunction with the Health Education Board for Scotland,
should also enhance their national strategy for
developing educational materials and should consider what
other methods of supporting their professional colleagues
may be possible in securing the necessary changes in the
diet of the Scottish population. Community dietitians
should be encouraged to develop their professional skills
by taking short courses and postgraduate degree training
in health promotion and dietetics and nutrition. Health
Boards have a role in promoting this professional
development. |
| |
| Action
Points |
- The NHS should ensure
that the Service's catering specifications take
account of the guidance in the Model Nutritional
Guidelines for Catering Specifications for the
Public Sector in Scotland.
- In their planning for
continuing professional education Health Boards
and Trusts should ensure that greater priority is
given to providing adequate dietary education and
counselling skills to enable health professional
staff, including primary care teams, to place
increased emphasis on giving dietary advice to
patients, both opportunistically and routinely.
- The larger Health
Boards should consider appointing public health
nutritionists or suitably experienced State
Registered Dietitians. The Health Education Board
for Scotland should ensure that it has access to
expert nutritional advice.
- Directors of Public
Health should include, in their Annual Reports, a
summary of their Health Boards' diet related
activity.
- Medical schools, the
Royal Colleges, the Scottish Council for
Postgraduate Medical and Dental Education, the
National Board for Nursing, Midwifery and Health
Visiting for Scotland and the Council for
Professions Supplementary to Medicine should
ensure that appropriate emphasis is given to
nutritional and dietary issues in their
respective education and training courses and
programmes.
- The dietetic service,
in conjunction with the Health Education Board
for Scotland, should enhance their national
strategy for developing educational materials and
should consider what other methods of supporting
their professional colleagues may be possible in
securing the necessary changes in the diet of the
Scottish population.
- Health Boards should
encourage community dietitians to develop further
their professional skills.
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