Dietetics workforce report

This report provides an overview of the dietetics workforce in Victoria in 2017. It is based on survey responses from 1,422 individual dietitians (approximately 38 per cent of Victorian dietitians registered with the Dietitians Association of Australia (DAA) in February 2018 (DAA, 2018)) four focus groups involving 17 participants, and surveys from 89 employers and managers of organisations that provide dietetic services in Victoria. When contrasted with 2018 membership data from the DAA, the respondent cohort included an over-representation of individuals who were female, employed in the public sector, and those living in regional and rural areas. The age breakdown of respondents was comparable to the DAA membership data.

The dietetics workforce in Victoria is a young, female-dominated and growing profession. Dietitians worked across public, private and not-for-profit and sectors, with the majority employed in the hospital inpatient setting (40 per cent). Nutritional support and chronic disease management were the most common primary areas of practice for dietitians. Advanced roles were carried out by 53 per cent of dietitians, most commonly percutaneous endoscopic gastrostomy, home enteral nutrition management and total parental nutrition. Formal multi-disciplinary team structures were wide spread with the majority of dietitians (69 per cent) working with adults and older adults. Participants in this research reported good job satisfaction. Key contributors to this satisfaction included work-life balance, the type of work and the clients they worked with. The vast majority of dietitians (72 per cent) intended to stay within the dietetics profession for six years or more. Across their careers, dietitians are moving away from rural and remote areas towards metro and regional areas and from other states to Victoria.

Key areas of concern were inadequate resourcing to meet population needs such as the increasing prevalence of obesity and diabetes. Lack of funding and changes in funding models has resulted in dietitians not providing services to all of those who would benefit from seeing them. A recurrent theme was an absence of career development opportunities and difficulty in securing permanent employment. Career pathways are not clear and a lack of post-graduate training pathways and opportunities were highlighted. Although dietitians had the skills to complete their work, there was evidence of a need to improve non-clinical skills, particularly in management and communication, and marketing skills. Dietitians working in the private sector reported a need for business skills to be included in degree courses. Dietitians wanted to develop more innovative evidence-based practices, particularly in prevention and early intervention activities.

The dietetics profession in Victoria has experienced high-level growth with an increase of 95 per cent in student completions from Victorian universities between 2010 and 2016. Difficulty in gaining employment was reported by recent graduates and also more experienced dietitians wishing to move positions, particularly those who want to move from the community sector to the acute setting. Despite working in a clinical role 30 per cent of dietitians had no clinical supervisor. Dietitians were concerned with post first-year supervisory structures in the private sector and highlighted the need for early career graduates to be supported. Dietitians perceived the understanding of their role to be low within the general population and with other health professionals. To support the development of the dietetic professions there was a desire for mandatory registration similar to other allied health professions. In addition, corporate sponsorship of dietetics activities was considered to discredit the profession.

Key areas of consideration for the dietetics workforce going forward include: (1) Ensuring there are enough publicly-funded, secure positions, and other funding options, to meet the growing demand of an ageing population with increasing prevalence of chronic conditions such as obesity and diabetes, and to address the need for increased prevention and early intervention; (2) Need to strengthen the evidence and knowledge base of the profession to improve referrals and develop business cases for optimal staffing levels to help improve patient outcomes; (3) Provide more opportunities for career development and a clear career progression pathway, taking into consideration the need for secure employment and balancing parental responsibilities; (4) Developing post-graduate training pathways to provide a broad range of skills to support dietitians in developing practice areas. As well as supporting clinical practice, such as extended scope of practice, this should include developing non-technical skills of professionals particularly management and communication skills. Business skills should be included into existing dietetics training pathways; (5) Review the supply of dietitians from Victorian universities to ensure supply does not outstrip demand. This is particularly important due to a potential increase in the number of Victorian universities delivering dietetics training in the near future; (6) Consider the availability and appropriateness of supervision and support structures within the profession and ensure these can be utilised across all sectors; and (7) Improving the understanding of the profession amongst the community and other health professionals and consideration of issues that would support the professional status of dietitians.

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