Job responsibilities
Duties and Responsibilities
Communication with patients and families
Elicit clients concerns and expectations and accurately document clients detailed family history.
Interpret medical, family and psychological history and confirm diagnoses.
Communicate genetic information to patients and their relatives, taking responsibility for communication and applying current or new scientific information for the benefit of the family and identifying changes of risk within the family.
Identify and respond to emerging issues for the client or family.
Interpret and communicate normal and abnormal genetic test results to patients and their health care professionals.
Organise, lead or partake in co-counselling with colleagues to provide predictive testing.
Expertly communicate highly sensitive and potentially psychologically damaging information, which may cause high levels of distress such as giving a positive predictive testing result for hereditary cancer.
Communicate with patients who are bereaved and provide support, e.g. around termination of pregnancy. Liaise with relevant colleagues to arrange termination of pregnancy following an abnormal prenatal result, referrals for risk reducing surgery and cancer surveillance.
Use advanced counselling skills to counsel patients about various testing options and to facilitate decision-making.
Identify and manage conflict within families created by sensitive genetic information.
Manage conflict when patients demands are incompatible to professional responsibilities and resource.
Deal with patients who have great difficulty accepting a clinical diagnosis or a genetic test result.
Use advanced counselling skills to communicate sensitively in the presence of language, cultural and/or medical issues. Work with interpreters.
Prepare and dictate letters to patients summarising clinic discussions and giving test results.
Develop and utilise patient information leaflets in the Departmental series.
Communication with Colleagues
Liaise with laboratory colleagues to order genetic tests and discuss complex test results that are difficult to interpret.
Liaise regionally, nationally and internationally with other laboratories, departments of histology, surgery, screening, psychiatry, and cancer care to obtain and provide information.
Liaise with colleagues in other genetic centres to obtain and provide information and to establish understanding and cooperation.
Prepare and dictate letters to referring clinicians and other health professionals.
Liaise and defer to medical colleagues about issues that have diagnostic or clinical complexity.
Obtain information from other cancer specialities to enhance patient care within genetics.
Discuss cases with ethical complexity with colleagues where appropriate.
Educational Activities
Duties and Responsibilities of the Trainee:
To learn and practise under supervision the values and principles of teamwork as a team member, supervised in each section of the training and on call rota.
To agree learning objectives and review performance with the supervisor in each section and meet the leaning contract requirements as agreed with the named supervisor and line manager.
To develop the required knowledge, skills and attitudes of a genetic counsellor eligible to register with the GCRAB in accordance with the GCRAB competency framework and code of conduct/ adhere to the HCPC standards of conduct, performance and ethics/ adhere to the AGNC code of ethics (as applicable).
To maintain practice within the stipulated GCRAB Scope of Practice document and seek timely advice from colleagues when needed.
To compile and produce a portfolio of evidence to meet the assessment requirements of the GCRAB in order to become eligible to submit an intention to register.
To produce a portfolio using genetic counselling practice work based evidence for assessment against the competency framework as stipulated by the GCRAB.
To learn and practice effective communication skills and attitudes towards patients, team members and all stakeholders.
To work collaboratively with and contribute to the daily routine of the genetic counselling team.
Present findings of research, audit and clinical practice to large groups of staff or members of the public, within the Trust, regionally, nationally, or internationally.
Participate in the teaching of genetics to medical personnel, other health care professionals and members of the public.
Actively contribute to and help develop the annual cancer genetics course for healthcare professionals which is delivered by the Consultant Genetic Counsellor in Cancer Genetics.
Prepare and present scientific articles in clinical and departmental journal clubs and study days.
Act as an educational resource for medical and other personnel attached to the clinical genetics team.
Patient/Client Care
Calculate risks of patients and families being affected by various genetic disorders, the risks of recurrence and the carrier risks, risk of further primary cancers and have a discussion about competing risk. This can involve making decisions where expert opinion differs or some information is unavailable. In order to do this; source and interpret complex scientific papers and genetic test results.
Assess patients to determine where there is need for referral to specialist therapeutic counselling, psychiatric assessment or screening, and make appropriate referrals.
Act as duty genetic counsellor for enquiries from patients and health professionals.
Take responsibility for accepting referrals from GPs, nurses, hospital doctors and other health care professionals and prioritising action accordingly.
Phlebotomy.
Order genetic and biochemical tests as clinically appropriate and in line with department policies obtain appropriate approvals for specific tests.
Planning & Organisation
Manage an individual caseload autonomously. Pre-registration Genetic Counsellors will be able to work towards this within a mutually agreed time frame.
Arrange for blood samples taken outside the Trust to be transported to Guys (or elsewhere) as appropriate.
Based upon each family members specific risk of developing/carrying a condition, develop a programme of care for the patient. This may involve referring to multiple specialities. Provide information on the care of other family members, to identify at-risk relatives and advice on how they could obtain genetic counselling or screening.
Act as named genetics supervisor to Breast, Bowel or Gynaecological-Oncology Care nurse(s) in Family History Clinic at local hospital(s) in the region.
Policy and Service Development
Within areas of speciality design protocols and polices with guidance from colleagues, Clinical Genetic associations and Department of Health Policies.
Information Resources
Ensure that all clinical documents are up-to-date, accurate, legible and appropriately filed.
Use available IT resources to accurately send standard and non-standard letters and other communications as appropriate.
Accurately record data on patient information systems and use the in-house databases.
Occasional requirement to create databases or spreadsheets using computerised systems.
Staff Supervision & Training
Contribute to clinical supervision and training of Specialist Trainee Genetic Counsellors and MSc students, Lab trainees and Visiting Professional Programme participants where appropriate. This will be based on level of experience.
Be the named Genetic Counsellor supporting our family history nurses and participate in the training and supervision of nurses new to the family history role.
Research and Development
Design and implement audit of clinical genetics to maintain clinical governance and audit profile of department.
Access and interpret literature reviews relating to clinical practice.
General Patient Care
See patients and their families in clinics at Guys and St Thomas Hospitals, or peripheral clinics elsewhere in the Region, in GP surgeries or in their own homes as appropriate.
Ensure that the views of patients, or those speaking on their behalf, are well received; and that complaints, both formal and informal, are received courteously and responded to promptly according to Trust guidelines.
Maintain a good working environment in which patients receive a high standard of care.
Ensure that standards of care are maintained and that effective procedures exist to assess and review the quality of services offered regularly.
Maintain the safety and well-being of patients and staff in accordance with the Health and Safety Policy, and ensure that all accidents/incidents are reported and documented.
Self Development
Take personal responsibility for continuing professional self-development (together with the Genetic Counsellor Team Lead) and keep up-to-date with changes in the practice of genetic counselling.
Attend monthly team counselling supervision sessions to discuss difficult cases with group and the supervisor taking a proactive approach.
Comply with the agreed department consultative supervision contract and the GCRAB/AGNC counselling supervision guidelines.
Actively utilise counselling supervision to develop psychosocial skills, self-awareness, reflective practice and for resilience building.
Actively contribute to lab clinic meetings, genetic counsellor internal CPD meetings and other educational events relevant to area of practice.
Pre-registration Genetic Counsellors will be expected to achieve GCRAB registration within 3-4 years of taking up post (based on skills, competencies and performance which will be negotiated with their line manager)
GCRAB Registered Genetic Counsellors will be expected to maintain their continuous professional development in line with AHCS renewal of registration guidelines and contribute to the professional development of pre-registration colleagues in conjunction with the Principal Genetic Counsellors.
