Grading Manager, Band 6- Diabetic Eye Screening
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Job summary
Grading Manager, Band 6- Diabetic Eye Screening (25 hours a week)
We looking to recruit an experienced Grading Manager to join the Gloucestershire Diabetic Eye Screening Programme.
The Gloucestershire Diabetic Eye Screening Programmes (GDESP) provides diabetic eye screening to patients registered in GP practices located in the county of Gloucestershire. GDESP currently has over 38,000 patients registered with the service and employs around 30 members of staff. GDESP works closely with the Ophthalmic Imaging Team, the Gloucestershire Retinal research Group and the Gloucestershire Retinal Education Group.
Main duties of the job
- To assist the Programme Manager in delivering a high standard of systematic screening and grading services as part of the Diabetic Retinopathy Screening Programme for the whole of Gloucestershire against National Service Framework and National Quality Assurance Standards, to ensure the early detection of sight-threatening diabetic retinopathy and the reduction of blindness.
- To support the activities of the department to ensure that National Quality Standards and the Priorities and Planning Framework and other targets are met. To maintain the reputation of the department as an award-winning enterprise, which is high-profile being under the overall direction of the National Coordinator for the Diabetic Retinopathy Screening Programmes in England.
About us
Gloucestershire Hospitals NHS Foundation Trust is the largest employer in the county and with over 8,000 staff, we are one of the largest NHS trusts in the UK. We offer a generous annual leave allowance, excellent bank rates, access to the excellent NHS Pension Scheme, discounts for local shops, restaurants and services, access to our health and well-being hub, access to our two on-site nurseries, flexible working options, discounted public transport, reward and recognition schemes, exercise and activity classes and membership to our popular hospital choir.
Gloucestershire Diabetic Eye Screening Programme has the purpose of ensuring the early detection of sight-threatening diabetic retinopathy and the reduction of blindness. We are an award-winning team with an excellent professional reputation.
Details
Date posted
21 August 2024
Pay scheme
Agenda for change
Band
Band 6
Salary
£37,338 to £44,962 a year pa pro rata
Contract
Permanent
Working pattern
Part-time
Reference number
318-24-SUR-R12720
Job locations
Trustwide
Gloucestershire
GL1 3NN
Job description
Job responsibilities
KEY RESULT AREAS
Management of the Grading team
- Monitor performance of grading staff to ensure national and local policies are achieved to a high standard.
- Contribute to providing training to the GDESP department.
- To write, implement and update grading protocols
- Monitor the overall grading performance of the GDESP in relation to relevant Key Performance Indicators.
- Design and Implement initiatives to ensure the service achieves grading relevant KPIs.
- Manage and co-ordinate the grading of patient images for diabetic retinopathy as part of a multi-disciplinary team including Administrators, Screener/Graders, Medical staff and Optometrists.
- Referral Outcome Grading (ROG) of patients requiring referral to the Ophthalmology and Vascular team.
- Co-ordinate and liaise with colleagues and patients in the event of arranging for a screening patient to attend for urgent appointments in Ophthalmology.
- Monitoring of referrals completed by team members to ensure national and local requirements are adhered to and to maintain a high standard.
- Provide Test and Training feedback.
- Provide specialist advice to the GDESP team and other relevant professionals about diabetic retinopathy, grading and diabetic retinopathy screening.
- Provide information to patients contacting the screening service of their screening results and any other information they require.
- Maintain up-to-date knowledge of diabetic retinopathy, other relevant non-diabetic retinopathy ophthalmic diseases, current diabetic retinopathy screening and grading protocols and guidelines as well as local trust protocols.
- Participate in research projects, service audits and service reviews undertaken by GDESP.
- Undertake performance management of Grading Team members.
General Grading Manager
- Proven competence to work autonomously and effectively. Ability to plan travel time appropriately and to plan and organise own clinic time. To maintain a good throughput of patients in the event that workflow practices change. Capacity to work accurately whilst maintaining intense periods of concentration and competing claims on time. To be accountable and make clinical decisions involving patients within local guidelines, without direct supervision.
- Proven competence in digital retinal photography, to recognize and diagnose and refer to clinic, advanced cases of diabetic retinopathy that requires urgent treatment. Retinal photographs should be of sufficient quality to meet the National Quality Assurance Standard.
- Competence to grade unsupervised, sustaining high levels of concentration over extended periods, to analyse and interpret diabetic retinopathy, accurately identifying details of diabetic disease and other ocular lesions and ensuring timely referral to Ophthalmology when appropriate, grading a minimum of 1000 patient image sets per annum as directed by National Screening Committee
- Responsibility for maintaining internal quality assurance processes for grading during primary, secondary, arbitration and Referral Outcome Grade (ROG) level grading
- To remain calm and focused during screening clinics in particular during adverse conditions such as IT failure.
- To communicate effectively with health professionals and patients, sometimes in distressing and sensitive circumstances, using empathy and reassurance in the management of information regarding diabetes management, diabetic retinopathy, diabetic eye disease and loss of sight.
- To safely administer mydriatic eye drops within the Procedure for the Ordering, Prescribing and Administration of Medication Guideline and following department Patient Specific Protocols.
- Proven competence to deliver effective one-to-one patient education, using their retinal images as a teaching tool, in a motivating and persuasive manner so as to encourage effective diabetes management and reduction in the risks of diabetic eye damage whilst encouraging annual screening attendance.
- Competence of accurate image and data handling, including image capture and retrieval, to ensure timely image grading and generation of results to GPs and referral to an Ophthalmologist for treatment as appropriate.
- Carry out proficiently and safely the frequent movement of a digital fundus camera (87kgs) and equipment between county-wide surgeries, being aware of and acting in accordance with Trust manual handling protocols.
- Adhere to all Trust policies and procedures and maintain accurate patient records.
- Competence to train new screener/graders in all aspects of the job, present at an annual Preservation of sight Training Workshops for 60 UK professionals and to develop and maintain professional links with colleagues at all levels in both the primary and secondary care setting.
- Proactively seek and maintain up to date information and training to ensure that professional skills are sustained to a high standard.
- Training of new graders the fundaments of diabetic retinopathy grading:
To analyse and interpret diabetic retinopathy, accurately identify details of diabetic disease and other ocular lesions.
Use of protocols/pathways for image grading and outcome management.
The use of grading software and other relevant software systems used by the department.
- Provide ongoing support and training to the GDESP team within the field of diabetic retinopathy grading.
Clinical
- Demonstrates autonomy as well as the ability to collaborate within a multidisciplinary healthcare team in identifying and meeting the needs of the patient and family during various stages of the healthcare continuum.
- Ensures the patient is treated according to the schedule set out in the protocol
- Assists in the development and maintenance of databases as appropriate
- Coordinates and monitors the care of patients on clinical trials
- Collaborates with staff involved in clinical trials
- Systematically documents patient information
- Uses enhanced levels of dexterity and accuracy pertaining to clinical skill including the use of diagnostic equipment i.e., fundus cameras and OCTs.
- Independently use the OCT machines to obtain digital retinal scans to facilitate in the record keeping, assessment, diagnosis and management of a variety of retinal/ocular pathologies.
- Recognise when OCT and invasive procedures appropriate to attempt on certain patients.
- To be able to recognise a range of ocular pathologies and relevant diagnostic tests for diagnosis and assessment, including:
Diabetic Retinopathy
AMD
Retinal vascular pathologies
- Detailed understanding of the anatomy and physiology of the eye.
- Experienced in conducting DS clinics; including retinal imaging, obtaining OCT scans and the subsequent review and assessment/grading of these results.
- To be able to independently perform high quality tests patients. Clinical imaging duties include:
Fundus photography
Fluorescein fundus/iris angiography and Indocyanine Green angiograph
Slit-Lamp imaging
Stereoscopic imaging
Optical Coherence Tomography
- Recognise when OCT, FFA and ICG are not appropriate to attempt on patients.
- Understand data management, archiving, importing and exporting of data from relevant software.
- Efficiently become proficient in the use of new equipment and technology.
- Maintain an up-to-date knowledge of relevant scientific and technical developments.
Research and Development
- To work with the Gloucestershire Retinal Research Group (GRRG), Clinical Lead, Programme Manager and Ophthalmic Imaging Manager to implement research and development studies into GDESP
- In collaboration with relevant stakeholders ensure research projects are conducted to study protocols and adhere to statutory standards and requirements.
- Ensure the grading team members working on research studies are trained, qualified and practicing to the required standards relevant to individual research studies.
Professional
- Adheres to policies, procedures, standards and protocols.
- Remains up to date professionally including nursing registration.
- Provide supervision to the Grading Team, ensuring staff meet statutory professional requirements for their roles in terms of qualification and CPD.
Professional Development
- Demonstrate self-direction in facilitating continuing education and acquiring related experience
- Maintains own professional development in conjunction with the objectives of the Service and those identified at appraisal.
- Assume responsibility for continuing education by attending related workshops, rounds, seminars, conferences and courses as well as keeping up to date on current publications
- Contribute to educational initiatives within GDESP.
- Keep up to date with research-based practice and participate in audit.
COMMUNICATION & WORKING RELATIONSHIPS
- To develop and maintain communication and commitment with all members of the immediate team.
- Regular communications with the administration manager Ophthalmologists, Diabetologists and other members of the Healthcare team.
- Patients.
- General Practice staff
- Trust IT department
- Outside agencies for IT, camera and software support.
MOST CHALLENGING PART OF THE ROLE
To teach, promote and maintain safe and patient centred working practices and to ensure continuity in service provision by ensuring all staff are trained to the same high standard. Ability to work autonomously and unsupervised in General Practice, often under pressure, in the absence of guidance from department and clinical managers, whilst maintaining a high standard of patient care, education and time management. Responsibility for handling patient images and data and prioritising time to ensure timely and effective grading of retinal images in accordance with QA Standards. To remain focused and resourceful in adverse working conditions. Time management: in order to balance areas of responsibility with competing timescales.
Job description
Job responsibilities
KEY RESULT AREAS
Management of the Grading team
- Monitor performance of grading staff to ensure national and local policies are achieved to a high standard.
- Contribute to providing training to the GDESP department.
- To write, implement and update grading protocols
- Monitor the overall grading performance of the GDESP in relation to relevant Key Performance Indicators.
- Design and Implement initiatives to ensure the service achieves grading relevant KPIs.
- Manage and co-ordinate the grading of patient images for diabetic retinopathy as part of a multi-disciplinary team including Administrators, Screener/Graders, Medical staff and Optometrists.
- Referral Outcome Grading (ROG) of patients requiring referral to the Ophthalmology and Vascular team.
- Co-ordinate and liaise with colleagues and patients in the event of arranging for a screening patient to attend for urgent appointments in Ophthalmology.
- Monitoring of referrals completed by team members to ensure national and local requirements are adhered to and to maintain a high standard.
- Provide Test and Training feedback.
- Provide specialist advice to the GDESP team and other relevant professionals about diabetic retinopathy, grading and diabetic retinopathy screening.
- Provide information to patients contacting the screening service of their screening results and any other information they require.
- Maintain up-to-date knowledge of diabetic retinopathy, other relevant non-diabetic retinopathy ophthalmic diseases, current diabetic retinopathy screening and grading protocols and guidelines as well as local trust protocols.
- Participate in research projects, service audits and service reviews undertaken by GDESP.
- Undertake performance management of Grading Team members.
General Grading Manager
- Proven competence to work autonomously and effectively. Ability to plan travel time appropriately and to plan and organise own clinic time. To maintain a good throughput of patients in the event that workflow practices change. Capacity to work accurately whilst maintaining intense periods of concentration and competing claims on time. To be accountable and make clinical decisions involving patients within local guidelines, without direct supervision.
- Proven competence in digital retinal photography, to recognize and diagnose and refer to clinic, advanced cases of diabetic retinopathy that requires urgent treatment. Retinal photographs should be of sufficient quality to meet the National Quality Assurance Standard.
- Competence to grade unsupervised, sustaining high levels of concentration over extended periods, to analyse and interpret diabetic retinopathy, accurately identifying details of diabetic disease and other ocular lesions and ensuring timely referral to Ophthalmology when appropriate, grading a minimum of 1000 patient image sets per annum as directed by National Screening Committee
- Responsibility for maintaining internal quality assurance processes for grading during primary, secondary, arbitration and Referral Outcome Grade (ROG) level grading
- To remain calm and focused during screening clinics in particular during adverse conditions such as IT failure.
- To communicate effectively with health professionals and patients, sometimes in distressing and sensitive circumstances, using empathy and reassurance in the management of information regarding diabetes management, diabetic retinopathy, diabetic eye disease and loss of sight.
- To safely administer mydriatic eye drops within the Procedure for the Ordering, Prescribing and Administration of Medication Guideline and following department Patient Specific Protocols.
- Proven competence to deliver effective one-to-one patient education, using their retinal images as a teaching tool, in a motivating and persuasive manner so as to encourage effective diabetes management and reduction in the risks of diabetic eye damage whilst encouraging annual screening attendance.
- Competence of accurate image and data handling, including image capture and retrieval, to ensure timely image grading and generation of results to GPs and referral to an Ophthalmologist for treatment as appropriate.
- Carry out proficiently and safely the frequent movement of a digital fundus camera (87kgs) and equipment between county-wide surgeries, being aware of and acting in accordance with Trust manual handling protocols.
- Adhere to all Trust policies and procedures and maintain accurate patient records.
- Competence to train new screener/graders in all aspects of the job, present at an annual Preservation of sight Training Workshops for 60 UK professionals and to develop and maintain professional links with colleagues at all levels in both the primary and secondary care setting.
- Proactively seek and maintain up to date information and training to ensure that professional skills are sustained to a high standard.
- Training of new graders the fundaments of diabetic retinopathy grading:
To analyse and interpret diabetic retinopathy, accurately identify details of diabetic disease and other ocular lesions.
Use of protocols/pathways for image grading and outcome management.
The use of grading software and other relevant software systems used by the department.
- Provide ongoing support and training to the GDESP team within the field of diabetic retinopathy grading.
Clinical
- Demonstrates autonomy as well as the ability to collaborate within a multidisciplinary healthcare team in identifying and meeting the needs of the patient and family during various stages of the healthcare continuum.
- Ensures the patient is treated according to the schedule set out in the protocol
- Assists in the development and maintenance of databases as appropriate
- Coordinates and monitors the care of patients on clinical trials
- Collaborates with staff involved in clinical trials
- Systematically documents patient information
- Uses enhanced levels of dexterity and accuracy pertaining to clinical skill including the use of diagnostic equipment i.e., fundus cameras and OCTs.
- Independently use the OCT machines to obtain digital retinal scans to facilitate in the record keeping, assessment, diagnosis and management of a variety of retinal/ocular pathologies.
- Recognise when OCT and invasive procedures appropriate to attempt on certain patients.
- To be able to recognise a range of ocular pathologies and relevant diagnostic tests for diagnosis and assessment, including:
Diabetic Retinopathy
AMD
Retinal vascular pathologies
- Detailed understanding of the anatomy and physiology of the eye.
- Experienced in conducting DS clinics; including retinal imaging, obtaining OCT scans and the subsequent review and assessment/grading of these results.
- To be able to independently perform high quality tests patients. Clinical imaging duties include:
Fundus photography
Fluorescein fundus/iris angiography and Indocyanine Green angiograph
Slit-Lamp imaging
Stereoscopic imaging
Optical Coherence Tomography
- Recognise when OCT, FFA and ICG are not appropriate to attempt on patients.
- Understand data management, archiving, importing and exporting of data from relevant software.
- Efficiently become proficient in the use of new equipment and technology.
- Maintain an up-to-date knowledge of relevant scientific and technical developments.
Research and Development
- To work with the Gloucestershire Retinal Research Group (GRRG), Clinical Lead, Programme Manager and Ophthalmic Imaging Manager to implement research and development studies into GDESP
- In collaboration with relevant stakeholders ensure research projects are conducted to study protocols and adhere to statutory standards and requirements.
- Ensure the grading team members working on research studies are trained, qualified and practicing to the required standards relevant to individual research studies.
Professional
- Adheres to policies, procedures, standards and protocols.
- Remains up to date professionally including nursing registration.
- Provide supervision to the Grading Team, ensuring staff meet statutory professional requirements for their roles in terms of qualification and CPD.
Professional Development
- Demonstrate self-direction in facilitating continuing education and acquiring related experience
- Maintains own professional development in conjunction with the objectives of the Service and those identified at appraisal.
- Assume responsibility for continuing education by attending related workshops, rounds, seminars, conferences and courses as well as keeping up to date on current publications
- Contribute to educational initiatives within GDESP.
- Keep up to date with research-based practice and participate in audit.
COMMUNICATION & WORKING RELATIONSHIPS
- To develop and maintain communication and commitment with all members of the immediate team.
- Regular communications with the administration manager Ophthalmologists, Diabetologists and other members of the Healthcare team.
- Patients.
- General Practice staff
- Trust IT department
- Outside agencies for IT, camera and software support.
MOST CHALLENGING PART OF THE ROLE
To teach, promote and maintain safe and patient centred working practices and to ensure continuity in service provision by ensuring all staff are trained to the same high standard. Ability to work autonomously and unsupervised in General Practice, often under pressure, in the absence of guidance from department and clinical managers, whilst maintaining a high standard of patient care, education and time management. Responsibility for handling patient images and data and prioritising time to ensure timely and effective grading of retinal images in accordance with QA Standards. To remain focused and resourceful in adverse working conditions. Time management: in order to balance areas of responsibility with competing timescales.
Person Specification
Qualifications
Essential
- Nursing Registration
- Completed Diploma in Diabetic Retinal Screening.
- Completed CertHE in OCT Capture.
- Hold a driver's licence / Willing to travel to various county and national locations as required.
Experience
Essential
- Extensive experience in working in Grading Manager Position
- Considerable experience in the grading of retinal images for the presence of diabetic retinopathy and other eye conditions, including grading at Arbitration and Referral Outcome Levels.
- Experience in the training and provision of on-going support to new and current Grading Team members.
- Experience and understanding of NDESP service quality standards, plus extensive experience in working with a multidisciplinary team to improve programme performance standards.
- Able to discriminate between high and low quality OCT scans and understands the correct procedure for reporting failures.
Knowledge/ Skills
Essential
- Detailed knowledge of all aspects of diabetic retinopathy disease, sufficient to enable post-holder to make accurate diagnosis both of disease and level.
- Able to recognise a range of ocular pathologies that in some circumstances may need urgent treatment and therefore need to be brought to the attention of an ophthalmic consultant.
- Good all-round knowledge of diabetes and risk factors.
- Enhanced IT skills including Windows based software, capture and grading software for diagnostic purposes, plus Microsoft Word.
- Up-to-date knowledge and understanding of key professional developments and recommended good practice.
Person Specification
Qualifications
Essential
- Nursing Registration
- Completed Diploma in Diabetic Retinal Screening.
- Completed CertHE in OCT Capture.
- Hold a driver's licence / Willing to travel to various county and national locations as required.
Experience
Essential
- Extensive experience in working in Grading Manager Position
- Considerable experience in the grading of retinal images for the presence of diabetic retinopathy and other eye conditions, including grading at Arbitration and Referral Outcome Levels.
- Experience in the training and provision of on-going support to new and current Grading Team members.
- Experience and understanding of NDESP service quality standards, plus extensive experience in working with a multidisciplinary team to improve programme performance standards.
- Able to discriminate between high and low quality OCT scans and understands the correct procedure for reporting failures.
Knowledge/ Skills
Essential
- Detailed knowledge of all aspects of diabetic retinopathy disease, sufficient to enable post-holder to make accurate diagnosis both of disease and level.
- Able to recognise a range of ocular pathologies that in some circumstances may need urgent treatment and therefore need to be brought to the attention of an ophthalmic consultant.
- Good all-round knowledge of diabetes and risk factors.
- Enhanced IT skills including Windows based software, capture and grading software for diagnostic purposes, plus Microsoft Word.
- Up-to-date knowledge and understanding of key professional developments and recommended good practice.
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).
Additional information
Disclosure and Barring Service Check
This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
UK Registration
Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).
Employer details
Employer name
Gloucestershire Hospitals NHS Foundation Trust
Address
Trustwide
Gloucestershire
GL1 3NN
Employer's website
Employer details
Employer name
Gloucestershire Hospitals NHS Foundation Trust
Address
Trustwide
Gloucestershire
GL1 3NN
Employer's website
Employer contact details
For questions about the job, contact:
Details
Date posted
21 August 2024
Pay scheme
Agenda for change
Band
Band 6
Salary
£37,338 to £44,962 a year pa pro rata
Contract
Permanent
Working pattern
Part-time
Reference number
318-24-SUR-R12720
Job locations
Trustwide
Gloucestershire
GL1 3NN
Supporting documents
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