Download 1. Job Identification - NHS Scotland Recruitment

Working together to achieve the healthiest
life possible for everyone in Ayrshire and Arran
Candidate
information pack
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Post Title:
Associate Practitioner
Job Reference Number:
T/711/15
Informal Enquiries:
Informal enquiries are welcomed by: Fiona McMillan, Head of Clinical
Physiology who can be contacted on 01292 617102
Closing Date:
Monday 29 February 2016
Process for Submitting Application Form:
You can apply using the online application form on the SHOW website –
www.jobs.scot.nhs.uk Alternatively your completed application form can be
returned to [email protected] or to the Department of O&HRD,
63A Lister Street, University Hospital Crosshouse, Kilmarnock, KA2 0BE
Please note: if applying using the online application facility on the SHOW
website, the text in the supporting statement section is limited and overlong
statements may be cut off. Please try to limit this section to the length of two
A4 pages.
All correspondence will be sent by email. We have experienced some issues
with personal email addresses and there is no guarantee correspondence will
be sent to your inbox. It is therefore your responsibility to check all email
folders, including your junk folder, as we have no control over which folder the
correspondence will be sent to.
Section one: Why work in Ayrshire?
Ayrshire is situated in the south-west of Scotland on the Firth of Clyde, and is
characterised by 80 miles of varied coastline, picturesque beaches, rolling green hills
and islands.
Just a 30-minute drive from Glasgow city centre, Ayrshire is an ideal location for
those who want to enjoy city life, with all the benefits of living in a semi-rural area.
Ayr, Irvine and Kilmarnock are the largest towns. However, there are many rural
towns, villages and communities throughout the area should you wish to relocate to
Ayrshire. Whether you decide to locate to Ayrshire or a neighbouring area, you will
find that property prices are more affordable than in other parts of the UK.
Alternatively, working in Ayrshire provides an easy commute from both Glasgow and
the wider central belt. There is an excellent network of both rail and bus links
throughout Ayrshire to Glasgow and beyond. There are UK and international flights
available from Glasgow Airport, as well as a range of services from Glasgow
Prestwick Airport.
Ayrshire provides a wide range of excellent recreational activities: whether you are
interested in history and heritage, outdoor pursuits, events and festivals, or simply
food and drink, there is something for everyone.
Ayrshire boasts more than 40 quality golf courses, including two Open
Championship courses at Turnberry and Royal Troon.
For more information on the range of recreational activities in Ayrshire, visit
www.visitscotland.com/ayrshire-arran
Local educational standards are very high at primary and secondary level. However,
private education is also available in the area. See below for more information on
local authority services:
East Ayrshire Council – www.east-ayrshire.gov.uk
North Ayrshire Council – www.north-ayrshire.gov.uk
South Ayrshire Council – www.south-ayrshire.gov.uk
Section two: NHS Ayrshire & Arran as an employer
NHS Ayrshire & Arran recognises that our staff are vital to delivering our purpose,
values and commitments and to achieving our strategic objectives.
Our purpose
Working together to achieve the healthiest life
possible for everyone in Ayrshire and Arran
Our values
Caring
Safe
Respectful
Our aim is to create an organisation where people want to work and strive to deliver
excellence each day; where staff wellbeing and personal resilience is supported;
where careers are interesting and developed; where staff are encouraged to reach
their full potential; and where staff feel their contribution is recognised and valued.
To do this, we need to attract, develop, support and retain our staff and enhance
their work experience. This will directly contribute to our aspiration to deliver
excellent high quality services to every person every time.
We believe the unique factors that help to define us as an employer are:
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our friendly and supportive environment;
our commitment to staff engagement and effective team working;
our track record in creativity and innovation and our ability to successfully
implement change and redesign;
our track record in supporting our staff’s learning, development and career
aspirations, from an initial comprehensive three-day corporate induction
programme to the availability of a wide range of internal training programmes;
our commitment to supporting flexible working through a wide range of family
friendly policies; and
our commitment to support and improve our staff’s health, safety, wellbeing
and resilience. We do this by implementing our Staff Health, Safety and
Wellbeing Strategy, and in our work towards achieving and maintaining the
Health Working Lives Gold Award. In addition, our Staff Care and
Occupational Health Service provide a range of support and interventions to
our staff.
The organisation has a statutory responsibility to ensure the Staff Governance
Standard is embedded and adhered to as part of the governance framework –
staff, financial, information and clinical governance – in which NHS Boards
operate. The Staff Governance Standard requires all NHS Boards to
demonstrate that staff are:
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well informed;
appropriately trained and developed;
involved in decisions;
treated fairly and consistently, with dignity and respect in an environment
where diversity is valued; and
provided with a continuously improving and safe working environment,
promoting the health and wellbeing of staff, patients and the wider
community.
During 2013, we consulted with our staff to select the key values and behaviours
which they believed were essential to create a safe, effective and person-centred
working environment which benefits patients, staff and carers. This allowed us to
develop our purpose, values and commitments. We passionately believe in creating
a culture which is open, fair and just.
Section three: Delivering our services
Acute Services
Emergency and elective hospital services are provided by our acute services, which
includes inpatient, outpatient and day case care. There are two district general
hospitals within Ayrshire: University Hospital Ayr and University Hospital
Crosshouse. These hospitals provide a wide range of acute services:
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University Hospital Ayr
University Hospital Ayr provides medical and surgical services on an inpatient,
day case and outpatient basis. It is the main Accident and Emergency service
for South Ayrshire. It provides a number of Ayrshire-wide services including
Vascular Surgery, Ophthalmology and Audiology.
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University Hospital Crosshouse
University Hospital Crosshouse provides medical and surgical services on an
inpatient, day case and outpatient basis. It is the main Accident and
Emergency service for East and North Ayrshire. Inpatient paediatrics, the
Ayrshire Maternity Unit and the main Laboratories for Ayrshire are on the
Crosshouse site.
Community, mental health and learning disabilities services
Following the introduction of Health and Social Care Integration, the operational
delivery for the range of community healthcare services and mental health and
learning disabilities services is through the newly created Health and Social Care
Partnerships and the Integrated Joint Boards:
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East Ayrshire Health and Social Care Partnership
North Ayrshire Health and Social Care Partnership
South Ayrshire Health and Social Care Partnership
Community Services
General medical and dental services are provided throughout Ayrshire and Arran by
general practitioners, dentists, community pharmacies and optometry practices.
Community nurses, health visitors and Allied Health Professionals are all involved in
providing care within our local communities.
Out-of-hours general medical services are provided by Ayrshire Doctors On Call
(ADOC) within the community.
Mental health and learning disability services
Inpatient mental health services, including the Intensive Psychiatric Care Unit, are
largely delivered at Ailsa Hospital in Ayr with further mental health inpatient services
provided at University Hospital Crosshouse
Learning disability services are provided from Arrol Park in Ayr. Elderly mental
health inpatient services are provided from Ayrshire Central Hospital in Irvine, and
East Ayrshire Community Hospital in Cumnock. Community based services are
provided throughout Ayrshire for the range of clinical groups: adults, child and
adolescent, elderly and addiction services.
For more information on the full range of clinical services provided by NHS
Ayrshire & Arran, visit our website www.nhsaaa.net
Section four: Investing for the future
There are two major capital developments underway within NHS Ayrshire & Arran to
ensure safe, effective and person centred care:
Building for better care
We are investing £27.5 million to provide fit for purpose front door services for
University Hospitals Ayr and Crosshouse, in order to improve emergency and urgent
care for patients who come to hospital for anything other than a scheduled
appointment.
North Ayrshire Community Hospital – Woodland View
We are investing £47 million to provide a 206 en-suite bedroom integrated mental
health and community facility, including older people’s long term care and
rehabilitation. This development will bring together a full range of outpatient and
inpatient facilities.
Section five: Post Details
1. Job Identification
Job Title:
Associate Practitioner- Clinical Physiology
Responsible to:
Head of Clinical Physiology
Department(s):
Cardiac ,Respiratory ,Vascular
Directorate:
Medical Specialities
Operating Division:
General Hospitals
Job Reference:
T/711/15
No of Job Holders:
Last Update :
May 2009
2. Job Purpose
The post holder will undertake a 2 year Academic and Clinical Training course leading to a
University Diploma in Clinical Physiology and Associate Membership of the Society for
Cardiological Science and Technology.
Upon successful completion of training the post holder will be competent to undertake:
Investigative diagnostic services to assess the functioning of the Cardiovascular and
Respiratory systems within the Clinical Physiology service ,
To provide Diagnostic services within Cardiology
To provide diagnostic services within the area Vascular services
To provide diagnostic services within Respiratory Physiology.
To provide diagnostic services within out reach Spirometry Clinics
3. Dimensions
The service provides acute health care for the local population of Ayrshire and Arran. The post
holder covers two locations, Ayr Hospital and Crosshouse hospital with out reach services to
other hospitals within Ayrshire and Arran and to primary care facilities
Location types include Coronary Care, Medical in-patients, Surgical in-patients for anaesthetic
assessment and post op. A&E , Theatre reception and recovery, Day surgery and Endoscopy
suite and theatre. Medical/Surgical out-patient, G.P. open access, Paediatric in-patients and
out-patients High dependency and I.T.U ,Psycho-geriatric patients, Vascular In and Out
patients.
The patients would include Acute high dependency, terminally ill, high risk, severely
traumatised, infectious, those with learning difficulties both paediatric and adults, mental illness
(pre ECT.) acute stroke and stroke rehabilitation, post head injury, drug and alcohol
dependants, chest patients, Acute Medical receiving. vascular patients, pre and post amputee,
Within the remit of the post holder a proportion of the following investigations are carried out:
45,000 ECGs
1,000 Lung function tests
1,350 Peripheral Dopplers
1000 Ambulatory 24 Hour ECG recordings
500 Ambulatory BP recordings
4. ORGANISATIONAL POSITIONHead of
Clinical
Physiology
Services
Area Highly
Specialist
Physiologists
Operational Lead
Clinical Lead U/S
Operational
Manager/
Clinical Lead
U/S
Crosshouse
Clinical lead
Devices- Ayr
Ayr
Highly
Specialist
Physiologists
Specialist
Physiologists
Physiologists
This Post
Assistant
Practitioners
5. ROLE OF DEPARTMENT
The department provides an investigative diagnostic service within the acute hospital setting for
patients with known or suspected Cardiac Vascular or Respiratory disease.
Within the department the post holder works across a range of diagnostic investigative
procedures. The work may be undertaken in either or both Acute hospitals or in a community
setting
The procedures undertaken are used to diagnose the level of Cardiac, Vascular or Respiratory
disease in a patients and optimise their treatment or management. For some patients this may
be over a period of time by monitoring the progress or deterioration of the disease pattern
Patients may be investigated on an emergency or elective basis.
During periods of high patient activity , Clinical Physiology staff have to respond to the increased
demand for investigation to ensure rapid patient diagnosis, treatment and subsequent prompt
discharge on appropriate therapy and prioritise their clinical work appropriately
The department works closely with clinicians in all specialities and provides Open Access
service to
General Practitioners.
The department is instrumental in achieving Health Board targets Set by the Executive for
Coronary Heart Disease and Stroke and in delivering the Managed Clinical Networks for CHD
and Stroke
6. Key Result Areas
As an independent practitioner 70% of the role:
Recording and first line reporting of resting ECG , Peripheral Dopplers and Ambulatory BP
recording
Multi Modality Cardiac Arrhythmia monitoring and hook up
Provides diagnostic Respiratory function assessment within acute and primary care
Independently produces accurate records of clinical & technical data across Cardiology,
Respiratory and Vascular Physiology services.
Ensures correct patient identification, maintains an accurate procedure log for audit purposes
Analyses data, formulates preliminary report for review by senior physiologist or physician.
Recognises Life threatening data and acts with the required level of urgency
Ensures diagnostic results are available for dispatch without delay.
Carries emergency page at evenings and weekends for A&E and the acute wards and is the
lone provider of the service at these times
Responds to the emergency page during normal working hours and as part of the Cardiac
Arrest team.
Participates in Cardioversion Therapy , monitors and advises clinicians of changes in heart rate
and rhythm.
Deals with enquiries regarding investigation results.
Recognises the requirements for patient confidentiality, determines the identity and status of the
enquirer before divulging information
Organises own workload within clinical sessions to ensure that patients are treated in an
efficient and timeous manner
Recognises and reports equipment malfunctions promptly ,where possible rectifies faults or
removes equipment from service.
Recognises faults with the equipment used and the effects this will have on data recorded.
Responsible for safe use of equipment within their remit and for cleaning and sterilising
equipment on a daily basis.
As an Assistant working in support of Specialist, Highly Specialist Physiologists and
Medical Staff
Patient preparation & assisting lead physiologist during exercise tests
Patient preparation and assisting lead physiologist during Tilt Table procedures
Analysis of Ambulatory Monitors with supervision from lead physiologist
Monitoring of physiological data during procedure, recognises variations to normal and informs
lead physiologist.
Contributes to the training and education of Assistant practitioners, trainee physiologists, clinical
support workers and other HCPs.
Performs general administrative duties, deals with patient and staff enquiries, retrieves results
and conveys in appropriate language to HCPs
Attends and contributes to multi disciplinary audit meetings
7a. Equipment and Machinery
Hand held peripheral Doppler equipment used for the measurement of arterial function.
Sphygmomanometer for the measurement of arterial blood pressure.
Electrocardiograph machine used for recording patients’ heart rate and testing for any rhythm
abnormalities.
Hand held spirometer used for basic lung function volumes.
Nebulisers used for the administration of Salbutamol.
Blood pressures monitoring equipment used for the recording of blood pressure over a twenty
four hour period.
Cardiac monitoring equipment used for the recording of heart and rhythm over twenty four hours
or more.
PC based analyser for ambulatory ECG and BP clinical data
Monitoring equipment during Exercise testing and Tilt testing
Oxygen Saturation monitors
Lung Function equipment for diagnosis of pulmonary disease using special gases such as
Acetylene, Carbon Monoxide and Methane
Defibrillator- for Cardiac arrest and Cardioversion of heart rhythm
7b. Systems
Clinical data bases to input, amend, retrieve ,collate, audit patient diagnostic data
Maintenance of manual patients records
Patient administration system for making /amending appointments, tracking of clinical requests
and reports
All machines are PC based and therefore VDUs are used constantly
8. Assignment and Review of Work
The majority of the post holders’ workload is referred by consultants and senior and junior
doctors on a daily basis.
The post holder conducts the workload autonomously within departmental protocols. Only if a
complex non routine problem occurred would the post holder refer the matter to the senior chief
of the department.
Test required is clearly indicated on the referral slip, although the post holders has autonomy to
review clinical details and expand information when appropriate and amend investigation as
appropriate.
Manipulate timings of investigation to accommodate additional investigation due to emerging
clinical data.
Apply time management skills to facilitate seamless patient pathway at one stop clinics
Have a flexible way of working to dovetail additional assessments into finite time slots
Post holder rotates through a range of diagnostic procedures in different Physiology specialities
on a weekly/daily basis.
Post holder undertakes these procedures in line with national , professional, hospital policies
and guidelines.
9. Decisions and Judgements
Analysing EGS and informing medical staff of significant/ life threatening changes
Example: Recording an ECG with acute heart attack changes in A&E ensuring that medical staff
are informed immediately to action thrombolytic therapy Analyse 24 hour recordings
for significant abnormalities or life threatening arrhythmia and inform appropriate
person with the correct degree of urgency
Amending investigation in the light of emerging clinical data
Example: Administering Bronchodilators /nebuliser during lung function test to relieve patients
Symptoms / asses changes in clinical results due to drug therapy
Example: Exercising a patient with normal arterial pressures to provoke symptoms to
provide diagnosis
Repeating Investigations due to equipment malfunction /electrode displacement
Assess and analyse the functioning of complex equipment prior to proceeding with investigation.
Example: recognition of spurious data and calibration drift which can cause inaccurate results
Once recognised, post holder must re calibrate and repeat investigation.
Compare patients results and interpret using respiratory knowledge to determine onward
investigation pathway according to patients’ individual clinical status.
Chooses appropriate pathway and interpret patient compliance, assesses level of compliance
and interpret results accordingly to clinician.
Take patient history, identify and categorise Doppler sound waves, measure arterial pressures,
determine if normal or abnormal.
Decide on next appropriate step , undertake further measurements and assessment.
Record patient symptoms, walking distance and pain distance , record in medical case notes.
10. Most Challenging/Difficult Parts of the Job
Working across physiological specialities.
Maintaining skills and clinical knowledge across specialities.
Communicating instructions effectively to patients to achieve the optimal results- this is also the
most rewarding part of the work
Managing workload to shifting and competing demands
11. Communications and Relationships
The post holder communicates with patients throughout the working day. This may be to explain
the procedure to be carried out, by talking the patient through the process, explaining in clear
language what is to be information is to be gained from the procedure.
Post holder encourages the patient to participate fully in the investigation to the best of their
ability.
Patients frequently require persuasion to continue with the investigation or require re assurance
that they are acting appropriately.
Patients are often unwilling/reluctant to undergo some investigative procedures, the post holder
has to use good communication skills to establish a relationship of trust and empathy with the
patient
Post holder will deal with patients who have varying degrees of mental and or physical disability
and use language that is appropriate to each patient.
When dealing with children post holder must adapt language to explain the investigation ,
reassure patient and carer and encourage patient to be fully compliant
The post holder communicates with a variety of health care professionals when arranging
timings and conditions of the investigation
Example: Arranging with ward staff to with hold bronchodilator for a set period prior to lung
function test
Post holder will communicate with colleagues throughout the day advising them of investigation
results, informing them of any steps to be taken as an outcome of investigation results
Post holder will explain to other medical/nursing staff investigation results, explain to medical
staff results/procedure for training and education purposes.
Contacting medical/nursing staff to clarify clinical information on patient referral.
Communicating vital diagnostic information with the multi disciplinary team the a cardiac arrest
Liasing with staff in other areas to arrange multi disciplinary sessions eg Cardioversion sessions
in Day surgery
12. Physical, Mental, Emotional and Environmental Demands of the Job
Physical skills /effort
The post holder provides a service to many disparate areas within the organisation i.e. A&E
Theatre reception and recovery, Endoscopy theatre, out-patient clinics, all wards both medical
and surgical, secure psycho/care of the elderly wards,
Post holder in carrying out duties will necessitate walking between the wards ,department, A&E
and clinics.
Running to cardiac arrests anywhere within the hospital
Repetitive movements- inputting data via keyboard to clinical data bases , all equipment is now
PC based.- 10 sessions
Making fine movements with no margin for error
Example: placing multiple electrodes within anatomically defined positions with no margin for
error
Pushing patients in wheel chairs,
Pushing Cardiac machines around the hospital , working in confined ward areas.
Manoeuvring of patients into position for investigation, many of whom have restricted mobility
Mental Effort/skills
Check that correct referral has been received and that procedure is carried out on correct
patient
Check that patient has followed advice on stopping drugs prior to procedure
Maintaining high levels of concentration on large amounts of physiological data for prolonged
periods.
Example: Undertaking acute heart attack screening in acute medical wards, analysing each one
for pathological changes from previous recording and alerting medical staff when appropriate
Emotional effort/skills
Dealing with traumatic situations
Example: Cardiac Arrest in A&E or on treadmill
Communicating with patients who have hereditary disease during screening process
Working Conditions
Post holder is exposed to bodily fluids
Post holder will deal with patients who are MRSA +ve , HIV+ve, Hepatitis B&C+ve
Post holder will working with patients with extensive leg ulcers which are malodorous
Post holder will work with patients who may be abusive, aggressive, confused , agitated
because of their medical condition.
13. Knowledge, Training and Experience Required to do the Job
Entrance Level for trainee : 3 “A” Levels at Band D or 3 “H “ levels at Band C including Science
subject(s) or equivalent pointage or an HNC in a Science subject.
Academic and professional training in post will lead to:
CARDIOLOGY
Foundation degree or University Diploma in Clinical Physiology
Associate Membership of the Society for Cardiological Science and Technology
Knowledge and understanding of the affects of acquired or congenital disease on the diagnostic
investigations undertaken within the department
Specific knowledge and understanding of ECG interpretation and the effects of drugs and other
therapies upon that interpretation.
Trained to UK Resuscitation Council Immediate Life Support standard .
Knowledge and understanding of the effects of co morbidity on investigations undertaken within
the department
RESPIRATORY
Additional KTE is acquired through a combination of in house study days,
Short courses arranged through the Association of Respiratory Technology and Physiology
To include Master classes in Spirometry, Diffusion, Lung Volumes Interpretation and Quality
Assurance
Theoretical training and education equivalent to HNC level
Knowledge and understanding of the effects of drugs on the Respiratory system
Administration of therapeutic drugs to confirm diagnosis by analysis of changing lung volumes
Knowledge and understanding of the effects of co morbidities (neuro muscular, ischaemic heart
disease, surgery ) on investigation results
Knowledge and understanding of complex gases and the administration thereof in the patient
pathway.
Competency in a range of complex respiratory investigations
Ability to operate independently in the Acute or Primary care setting
To undertake Community Spirometry clinics on a lone worker basis
VASCULAR
A combination of in house study days and short external courses through the Society for
Vascular Technology leading accreditation
Theoretical education and training in vascular anatomy and pathology
Competent in a range of vascular investigations
Operates independently within acute clinic and ward areas as part of the area vascular service
Knowledge and understanding and implementation of appropriate aseptic techniques/ infection
control
GENERAL
Knowledge understanding and training in Manual handling
Knowledge and understanding of COSHH regulations
Valid driving licence
Person Specification
Qualifications & Training – Essential Criteria
 Completed 1st and 2nd year of BSc in Clinical Physiology or equivalent
Qualifications & Training – Desirable Criteria
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Computer literate
Experience – Essential Criteria
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Working with people in a caring environment
Experience – Desirable Criteria
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Team player
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Ability to work alone and prioritise workload
Knowledge – Essential Criteria
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Understanding of the care environment
Knowledge – Desirable Criteria
Competencies & Skills – Essential Criteria
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Ability to work with health care professionals at all levels
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Good communication skills
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Excellent interpersonal and communication skills
Competencies & Skills – Desirable Criteria
Personal Characteristics and Other – Essential Criteria
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Driving licence
Personal Characteristics and Other – Desirable Criteria