Specialist Intestinal Failure Dietitian

Job description

Job responsibilities

Clinical

Be professionally and legally accountable for own work and caseload.

Work autonomously as a lead clinical specialist, in the provision of a comprehensive nutrition and dietetic service to IF patients within the OUH.

Lead and coordinate dietetic provision to ensure a comprehensive specialised dietetic service is provided to IF patients. This will include:

• Providing a highly specialised clinical service to IF inpatients, including those requiring TPN within the OUH
• To support the multidisciplinary nutrition team in facilitating the planning and discharge of PN fed patients, coordinating and arranging appropriate follow-up remotely or at the consultant led multidisciplinary nutrition clinic for HPN and complex enterally fed patients being discharged both locally and out of area

Co-ordinate the dietetic service provided to OUH HPN patient and complex nutrition caseload for in and outpatients, and support the NST to assess and provide nutritional input, including requesting additional information, investigations, blood tests, vitamins and trace elements, review TPN prescription based on nutrient requirements and biochemistry

• Train other dietitians in this speciality (band 6s and band 5s on rotation and ward dietitians)
• Co-ordinate professional development, development of standards / protocols / guidelines for IF and TPN across the Trust (i.e. inclusive of cardiac and neuro ITUs).

To assess the nutritional status of individual patients based on anthropometric measurements e.g. weight, height, weight history as well as biochemical parameters, diet/ nutrition history and other validated methods of nutritional assessment as appropriate.

Obtain and analyse relevant information from different sources including: electronic patient records, medical notes, nursing notes, the patient and their carers, ward staff, homecare colleagues etc, in order to make a comprehensive assessment of the patients needs.

Provide hands on care to support nutrition as required, within scope of practice and clinical competency.

Attend regular NST MDT meetings regarding patient care, liaison meetings with other multi-disciplinary teams where patients joint care is planned and reviewed, case conferences, ward rounds and governance meetings.

Along with the team lead, to have responsibility for all organisation, liaison and monitoring of the dietetic aspects of the intestinal failure dietetic service.

To communicate effectively with patients, carers, family and health professionals. Skills of diplomacy, pragmatism, negotiation, motivation, explanation and gaining consent will be used in a wide variety of and, sometimes sensitive, situations. The ability to communicate complex information at an appropriate level to allow understanding is essential. Barriers to communication may require consideration and overcoming e.g. non-English language, loss of hearing, receptive and expressive problems with the formulation and understanding of language or difficulties with speaking. The use of communication aids such as letter/picture boards or games, liaison with other professionals e.g. LD nurses, interpreters may be necessary.

To assist in delivering a dietetic service to any clinical area when required, for example by covering other dietitians workload, etc.

Participate in research and audit undertaken by the NST and/or Dietetic team. Presentation of audit or research results at national or international conferences to promote practise and share expertise with colleagues.

To provide specialist advice, teaching and training to all members of the dietetic and multidisciplinary teams within the trust, regarding the dietetic management of IF patients. This involves regular participation in in-house training of clinicians and both specialist and ward nursing staff. Act as a resource for colleagues within and outside OUH on nutritional issues related to TPN and HPN.

Organisational

To collect data as required by the department, trust and outside agencies, in a safe and appropriate way.

Collation and sharing of audit data on the outcomes of IF patients managed in the dietetic/OUH IF service

To determine priorities for own work area based on clinical need and balance patient caseload with professional demands.

To maintain accurate and up-to-date documentation of patient interventions on electronic patient records.

To communicate any changes in IF care to appropriate agencies be that in patient ward teams, around the NST MDT, or to outside agencies for patients based in the in- or out- patient setting. In addition to electronic patient records, additional communication may be required via secure/appropriate email, formal letter, electronic homecare records, in house databases or national data repository.

Management and professional responsibilities:

Be accountable for own actions working within the professional, ethical and legal framework for dietetics set out in the Health Profession Councils Dietitians Standards of Conduct, Performance and Ethics and the British Dietetic Associations Professional Standards for Dietitians and Code of Professional Conduct.

To participate in audits and initiate/lead audits within own work area in order to monitor and evaluate existing practice and or whether local/ national standards are being met and make recommendations for change to improve service delivery and strive for excellence in patient care.

To remain up to date with the relevant literature and ensure that this contributes evidence-based practice knowledge which will contribute to optimising the long term outcomes for each individual patient.

Clinically supervise less experienced dietitians, and student dietitians during clinical placement.

Professional

To initiate and lead discussions on organisational, professional and clinical issues relevant to the service area. Along with the Service Managers, to be responsible for the dietetic service provided to their clinical area and its development.

To continue to develop own knowledge and skills and contribute to the development of colleagues within the MDT and the Dietetic Service. This involves:

• taking responsibility for own continuing professional development (CPD) and provide evidence for this by maintaining a CPD portfolio. CPD involves critical evaluation of scientific papers, attending professional development meetings, working as a reflective practitioner and attending relevant internal/external courses.
• Participating in own annual appraisal, identifying own development and training needs and setting personal development objectives with line manager.
• Undertaking all relevant statutory and mandatory training
• Involvement in the dietetic student training programme
• Providing specialist education and advice to dietetic colleagues in their clinical specialist area via regular departmental professional update meetings
• Attending and representing the department and lead area of work at the regional and national meetings as appropriate.

To be responsible for communicating effectively and working collaboratively with the Dietetic team, line managers, other health professionals within the MDT and other organisations to ensure a co-ordinated and evidence based approach to the delivery of dietetic care.

To have responsibility for and lead the development, promotion and delivery of the specialist dietetic service for patients with intestinal failure. This involves:

• Developing dietetic practice to ensure evidence based practice and an equitable service delivery
• Applying legislation, policies and procedures and making appropriate recommendations for service delivery
• Managing development projects relevant to the clinical area, the dietetic service and the NHS organisations involved
• Making recommendations and managing service improvement
• Evaluating own work and that of the team, including through clinical audit
• Recognising the need for and seeking appropriate support
• Active involvement in multidisciplinary team meetings and events, dietetic departmental meetings and discussions

To demonstrate risk management skills and a sound understanding of clinical governance and apply to the work situation.

Education and professional development:

To keep a portfolio providing evidence of continual professional development (C.P.D.). This may include critical evaluation of scientific papers, attending professional development meetings, working as a reflective practitioner and attending relevant internal/external courses.

Participate in annual appraisal, identifying own development and training needs and setting personal development objectives within an Annual Report.

Actively participate in the dietetic student training program, facilitating the development of skills and knowledge, being involved in the assessment process and acting as a mentor.

Person Specification

Qualifications

Essential

• Recognised Nutrition & Dietetic Degree or equivalent
• Registered with Health Care Professions Council as a Dietitian
• Evidence of successful completion of significant relevant specialist post graduate training equivalent to Masters level in this clinical area; for example PENG

Desirable

• Member of the British Dietetic Association
• Member of a relevant Specialist Interest Group
• Evidence of training as clinical supervisor
• Evidence of leadership training

Experience

Essential

• Evidence of a high level of specialist dietetic knowledge/skills in this clinical area as a result of experience and related CPD
• Comprehensive knowledge and understanding of artificial nutrition support, both enteral and parenteral
• Demonstrates excellent and up to date knowledge of national policies, guidelines relevant to whole service as well as to specific clinical area
• Evidence of leadership experience
• Evidence of research / audit / project work
• Demonstrates in depth knowledge of the principles of clinical governance
• Able to organise work load and manage time within conflicting agendas

Desirable

• Evidence of clinical service development
• Experience of development, planning, delivery and evaluation of education and training programmes
• Experience of student training including supervision, mentoring and assessment

Skills

Essential

• Evidence of exemplary complex decision-making skills
• Demonstrates empathy, compassion, persuasion, and proficient negotiation and diplomacy skills
• Demonstrates excellent communication skills, both written and verbal, particularly where barriers to communication exist
• Has personal traits and characteristics congruent with the Trust values
• Ability to work flexibly and prioritise clinical and non-clinical work to meet the needs of the service in conjunction with other members of the team
• Computer/IT literate

Other

Essential

• Able to easily and efficiently travel to clinical sites and training venues across the county, to provide a dietetics service and to support staff/colleagues

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.

Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

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

Oxford University NHS Foundation Trust

Address

John Radcliffe Hospital / Churchill Hospital

Oxford

OX3 9DU

Employer's website

https://www.ouh.nhs.uk/ (Opens in a new tab)