Job responsibilities
Take responsibility for accepting
referrals (from GP, hospital doctor etc) within a defined specialty area, and
prioritise action appropriately.
Elicit clients concerns and
expectations, as well as a detailed family history.
Interpret medical, family and
psychosocial history and confirm diagnostic information about family members
Calculate risks of clients and
families being affected by various genetic disorders (including recurrence
risks and carrier risks). Identify changes of risk within the family and take
responsibility for communicating and applying new scientific information for
the benefit of the family over an open-ended time frame, through follow-up
systems and audit measures.
Communicate genetic information to
clients and their relatives at an appropriate level following assessment of
the individual situation. Identify and respond to emerging issues for the
client and family.
Receive, analyse and interpret
highly complex and frequently conflicting information, and use this to make
clinical judgments and manage the implications of this.
Make judgments about, order,
interpret and communicate normal and abnormal genomic (and other) test
results to patients and health care professionals. This may involve
performing phlebotomy in a variety of health care settings or clients homes.
Provide accurate information on the
range of options open to a client/family including reproductive and
risk-reducing options
Take a lead role in the provision
of predictive genetic test consultations with patients.
Organise and partake in joint
counselling with colleagues (e.g in cases of complex family dynamics), where
individual factors would indicate its utility.
Expertly communicate highly
sensitive and potentially psychologically damaging information, which may
cause high levels of distress e.g.
o breaking the bad news of positive predictive and confirmatory tests
for an untreatable condition such as Huntingtons disease, or a condition
that causes a high risk of developing various cancers.
o giving a couple an unexpected
abnormal prenatal finding, or news that their fetus is affected with a severe
condition where termination of pregnancy is an option
o counselling terminally ill patients
about the chances that their illness may be the result of an inherited gene that they have a high
chance of having passed it onto their children
Assess when clients have additional needs (e.g. therapeutic
counseling or psychiatric support, support group, social care services) and
mobilise resources and make onward referrals for this
Communicate with clients who are
bereaved and provide support e.g. around termination of pregnancy, death at
young age etc.
Initiate timely interventions,
sometimes acting as patient advocate e.g. in termination of pregnancy, timing
of risk-reducing surgery etc.
Use expert counselling skills and
techniques to counsel clients about various testing options and facilitate
decision-making. Manage clients who have great difficulty accepting a
clinical diagnosis or a genetic test result.
Identify and manage conflict within
families created by sensitive genetic/genomic information.
Manage conflict when clients
demands are incompatible with professional responsibilities and resources.
Use advanced counselling skills to
communicate sensitively and expertly in difficult and often unexpected
situations, e.g.;
o in the presence of language and/or
cultural differences or disability requiring the aid of an interpreter
o when dealing with cases where there
is antagonism and anger or in a highly sensitive atmosphere e.g. in complex
ethical cases where expectations differ
o in cases of psychiatric illness or
learning difficulties where expert communication skills are required
Assess an individuals ability to
understand the highly complex nature of genetics/genomics and adapt the
information, concepts and options to suit their individual needs, this may
mean devising visual aids, diagrams, models and skill in assessing language
and cultural needs etc.
Advise on factors that reduce risk
(e.g. risk-reducing surgery, high dose folic acid) and on factors that
influence risk (e.g. contraceptive pill, HRT).
Prepare letters to patients
summarising clinic consultations and giving test results using the
appropriate level of detail. This involves skilled use of dictation tools to
appropriately delegate work to secretarial staff.
Be aware of, and follow, accepted
protocols and policies on a departmental, local and national level.
Work independently and unsupervised
as well as in various multidisciplinary teams (MDTs) in a variety of health
disciplines. This may include lone home visiting and patient care in hospital
and other health care settings.
Manage own caseload; ordering
investigations and other procedures as required using departmental recall
policies. This will include interpreting genomics test results (as part of a
multidisciplinary team if necessary). The jobholder will take responsibility
for a particular area subspecialty.
Ensure that all clinical documents
are legible, up to date and accurate.
Possess the personal skills and
development that allows significant self-reflection and insight in order to
comprehend and utilise dynamic counselling processes.
Communication
with Colleagues
The
jobholder will:
Liaise with laboratory colleagues
to order and communicate about genomic tests and to discuss complex test
results which are difficult to interpret
Liaise with relevant colleagues
when arranging timely interventions e.g. a termination of pregnancy following
an abnormal prenatal result, invasive specialist investigations,
risk-reducing surgery etc.
Liaise regionally, nationally and
internationally with other laboratories, departments of histology, surgery,
screening, fetal medicine, midwifery, neurology, psychiatry, cardiology to
obtain and provide information
Liaise with colleagues in other
genomics centres to obtain and provide information and to establish
understanding and co-operation within the legal constraints of patient
confidentiality.
Write letters to referring
clinicians and other clinicians appropriate to that episode of care.
Liaise with medical colleagues
about issues that have diagnostic or clinical complexity. This may be as part
of a formal MDT.
Identify and discuss cases of
ethical complexity
Appropriately use databases and IT
packages/web applications in patient care.
Educating,
advising and contributing to service improvement
The
jobholder will:
Carry out audits and client
satisfaction surveys and present findings to departmental members.
Act as an educational resource,
including formalised teaching sessions and informally providing advice where
appropriate.
Take part in duty rotas for
providing advice to patients, colleagues and the wider healthcare system.
This can involve taking and acting on urgent referrals for clients in
distress or in a vulnerable situation.
Form part of MDTs (including
supporting patient care in the mainstream setting).
Develop and utilise patient
information leaflets.
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
genomics and related subjects to medical personnel, other health care
professionals and members of the public.
Prepare and present clinical,
psychosocial and scientific journal articles in departmental journal clubs,
supervision journal club and at departmental teaching sessions.
Act as an educational resource for
medical and other personnel attached to the clinical genetics/genomics team and associated organisations involved
with patients care e.g. voluntary bodies, patient support groups.
Work on a variety of managerial
working groups where specific tasks have to be undertaken influencing
departmental policy decisions. This will include dissemination to other
departmental members and to colleagues within a wider context.
Actively seek opportunities to be
involved in service development within the department, the Yorkshire, Humber
and North East region, and the Genetic/Genomic Counselling profession as a
whole. Identify areas where development or changes are needed and propose
alternatives
Be a valuable resource for
mainstream colleagues as genomic testing becomes more widespread within the
NHS.
Comply with LTHT health and
wellbeing policies to ensure staff and client safety, and ensure all
incidents are reported and documented.
Ensure any complaints (formal and informal) are escalated and
resolved appropriately following LTHT policies.
Training
and mentoring
The
jobholder will:
Support, mentor and provide
clinical supervision to a variety of personnel; e.g. MSc. students, Trainee
Genetic counselors and STP Genomic Counsellor Trainees.
Organise training packages and
induction for new staff members.
Contributing
to research
The
jobholder will:
Identify participants to take part
in clinical research organized through the departmental research team.
Take opportunities to contribute to
Genomic Counselling research locally, nationally or internationally.
