Developing the Paediatric Dietitians’ Curriculum for Diabetes

The National Curriculum for the Training of Health Care Professionals who care for Children and Young People with Diabetes Mellitus was first published in 2013 (Allgrove and Waldron, 2013). This document is a series of knowledge-based statements relating to 14 different aspects of diabetes care, with five levels of increasing complexity in each category. It was created by a multiprofessional working group in the UK, incorporating international guidelines from many different countries. The whole curriculum is for any healthcare professional working with children and young people (CYP) with diabetes, including non-specialist ward staff, as well as specialist teams of nursing, dietetic, psychological and medical staff.

Content of the curriculum
The curriculum comprises 14 different subject areas encompassing the holistic care of CYP with diabetes. These subject areas include insulin therapy, hypoglycaemia and hyperglycaemia, individual long-term complications, education and psychological aspects of care.

Level 1 training should be completed by all staff and has been accessible by e-learning since 2014 (available at: http://bit.ly/1S5UwQX). The e-learning programme was written by clinical professionals, incorporating the knowledge statements from the original curriculum. Knowledge requirements of specialist staff depend on profession, grade or banding and responsibilities, and they may be at different levels for different aspects of care. A dietitian of any band may be expected to reach level 4 in the nutrition section, but maybe only level 1 or 2 in the eye complications section.

The dietetic version of the original curriculum has now been further developed specifically to define the knowledge expectations of paediatric dietitians in Agenda for Change (AfC) bands 5–8c, and is now titled A training, education and competency framework for Paediatric Dietitians working in Paediatric Diabetes. This has been developed specifically for paediatric dietitians working in children’s diabetes, using the same knowledge statements as the original document. Each knowledge statement has been graded as Essential (E), Desirable (D) or Non-essential (N) for different dietitians across the AfC bands.

The E/D/N classifications were decided by a working group of dietitians on the Paediatric Subgroup of the British Dietetic Association (BDA)’s Diabetes Specialist Group. The working group consisted of experienced dietitians from a diverse range of diabetes services across the UK. The document will enable clinical paediatric dietitians to demonstrate knowledge and competence, in compliance with Best Practice Tariff (BPT) and National Peer Review Programme requirements. Dietitians new in post will be able to use the document to demonstrate progression, while experienced dietitians will have a tool to consolidate existing knowledge.

This is the first document to detail knowledge and competency expectations across AfC bands. The information is particularly useful for lone dietitians within diabetes teams who have no peer to compare themselves with. It is intended to help consistency in dietetic input across diabetes teams in the UK. It emulates the existing Integrated Career and Competency Framework for Dietitians and Frontline Staff (Deakin, 2011) previously created for dietitians working in adult diabetes. The new document has been professionally endorsed by the BDA and its Diabetes Specialist Group.

Examples of the document are shown in Figure 1. Professionally, we (the Diabetes Specialist Group) would encourage all dietitians working in children’s diabetes either to use the curriculum to self-assess their knowledge or to use it as part of a training programme for new staff, supporting their knowledge progression. It could be used by managers to assist appraisal or Personal Development Plan processes to identify learning and training needs. Postgraduate training for healthcare professionals is available at several universities throughout England, which may combine learning for the diversity of diabetes knowledge beyond that of dietetics alone.

Future plans
The current document will be reviewed in 2019 and feedback from users will inform ongoing development, alongside evidence for clinical practice in the management of CYP with diabetes.

Accessing the curriculum
The curriculum has been made available electronically. It will not be published in print. It can be accessed either through the National Children and Young People’s Diabetes Network website: http://bit.ly/2iemz1U or via the BDA website (for BDA professional members only): http://www.diabetesdietitians.org.uk