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JOB DESCRIPTION Title: Specialist Dietitian Directorate: Clinical Support Services* Board/corporate function: Medicine Board* Band: Band 6 Responsible to: Clinical Dietetic Services Manager* Accountable to: Head of Nutrition and Dietetics* Hours: 37.5 Location: University College London Hospitals NHS Foundation Trust (UCLH) UNVERSITY COLLEGE LONDON HOSPITALS NHS FOUNDATION TRUST University College London Hospitals NHS Foundation Trust (UCLH), situated in the West End of London, is one of the largest NHS trusts in the United Kingdom and provides first class acute and specialist services both locally and to patients from throughout the UK and abroad. The new state-of-the-art University College Hospital which opened in 2005, is the focal point of the Trust alongside six cutting-edge specialist hospitals. UCLH was one of the first trusts to gain foundation status. The Trust has an international reputation and a tradition of innovation. Our excellence in research and development was recognised in December 2006 when it was announced that, in partnership with University College London (UCL), we would be one of the country’s five comprehensive biomedical research centres. Alongside our relationship with the world leading UCL and Royal Free medical school, we enjoy close links with London South Bank and City universities offering the very best in training and education. CLINICAL BOARD The Medicine Board incorporates the specialties of Critical Care, Medical Specialties, Infection, Pathology, Emergency Services, Clinical Support Divisions lead by the Medical Director. DEPARTMENT JD/PS Trust Format – February 2007 Updated Mar 2010 1 The Nutrition and Dietetic Service at UCLH is a Trust-wide service providing an in and outpatient service from five sites; University College Hospital (UCH), the National Hospital for Neurology & Neurosurgery (NHNN), Elizabeth Garrett Anderson & Obstetric Hospital (EGA), The Heart Hospital (HH) and the Royal London Homeopathic Hospital (RLHH). Our team consists of 33 Dietitians and 2 assistant practitioners and 2 clinical dietetic support workers. We are a forward thinking department, committed to providing an efficient, clinically effective evidence based nutrition and dietetic service to our patients. The main department at UCH is based on the 3rd Floor East Wing in 250 Euston Road which is opposite the main hospital building. The Head and Neck Cancer Dietitians are based on the 1st Floor East Wing, 250 Euston Road. The wards are situated in the main hospital tower, across the road at UCH. Outpatients may be seen in the main UCH hospital podium, EGA or the Rosenheim Building. The department at NHNN is based on the 2nd floor of Albany Wing. Wards are situated in the Queen Mary Wing and the Chandler Wing. Outpatients may be seen in the NHNN. There are also offices at RLHH and HH from which sole practitioners provide an in and out patient service. JOB PURPOSE To provide assessment, management and education for patients requiring specialist dietetic and nutrition intervention by using evidence based practice and conforming to best practice guidelines To assist in the development of the specialist dietetic service and produce evidence based resources, policies and guidelines To assist in providing education and training to dietitians, dietetic assistants, student dietitians and other healthcare professionals (HCPs) in nutrition and dietetic specialities to facilitate continuous learning and development DIMENSIONS Responsible for the dietetic and nutritional management of patients under the care of the Multidisciplinary team. This service covers both specialist inpatients and outpatients, as required, at the designated site. Actions are in accordance with the service clinical guidelines, integrated care pathways and policies set out by the Trust. KEY RESULT AREAS Clinical To provide highly specialist nutrition advice to patients, their carers and HCPs through formulation of treatment and education plans and prescription of dietary intervention. This involves the collection and interpretation of anthropometry, requesting and interpretation of biochemistry, consideration of the financial implications and distress to the patient, their clinical profile and individual dietary information. JD/PS Trust Format – February 2007 Updated Mar 2010 2 To interpret this information and apply clinical judgement and reasoning to assess, evaluate and monitor nutritional status and implement appropriate evidence based changes to dietary interventions if indicated. To make recommendations to the medical staff regarding changes to medications for the nutritional management of patients based on interpretation of biochemical, physiological and dietary parameters. To use Trust policies, national guidelines, available research and the individual patient information in clinical decision making and reasoning with little supervision. To provide the catering department with expert advice on special diets and arrange the provision of specific dietary items or modifications to ensure patients nutritional needs are met. To practice within the Health Professions Council’s ‘Standards of conduct, performance and ethics’ and ‘Standards of proficiency for dietitians’, and the British Dietetic Association’s ‘ Professional Standards for dietitians’ and 'Code of Professional Conduct' and therefore have a clear understanding of issues such as consent, confidentiality and equal opportunities. To have responsibility for the planning and prioritisation of clinical caseload and non-clinical workload including provision of dietetic cover to other specialist areas in the events of planned and unplanned leave of designated cover partner. To establish safe practice through development of caseload management plans taking into account risk management and documentation, and reporting of critical incidents as outlined in Trust policy. To represent the dietetic service and/or individual patients at the multi-disciplinary team meetings, to ensure the delivery of a co-ordinated multi-disciplinary service, and integrate dietetic treatment into the treatment programme. This will include discussion of patient care, patient progress and involvement in discharge planning. To work as an autonomous practitioner working within clearly defined procedures/policies/protocols/guidelines, guided by precedent and advice from senior colleagues. To interpret, extract and analyse available patient information from a variety of sources e.g. medical notes, nurses record charts, communication with MDT members, patients and their carers and document information relevant to dietetic management in the medical notes and dietetic record cards within a reasonable timeframe. To initiate correspondence with general practitioners, consultants, community teams and feed companies by producing letters outlining dietetic management and dietary prescription requirements within reasonable timeframes. Education and Training To provide quality evidence based and appropriate nutrition and dietetics support and education to nursing, medical, catering staff and other health professionals as directed. To deliver patient education sessions To contribute to the training of pre-registration student dietitians, including contribution to the assessment process by completing standard assessment tools with individual students and direct clinical supervision as part of own caseload, acting as a mentor if required. JD/PS Trust Format – February 2007 Updated Mar 2010 3 Professional To ensure that own professional practice complies with the HPC Statement of Conduct. To take responsibility for updating personal dietetic practice portfolio of continuous professional development in line with national legislation for state registration. To participate in consulting with/involving patients/public in service development and delivery. To contribute to the Trusts’ and Departments Governance Agenda by participating in Clinical Governance Meetings, Practice Development Work, Appraisal System and complying with Risk Management requirements. To demonstrate continuous professional development through active participation in and facilitation of journal clubs, clinical effectiveness and clinical update sessions. Research and Development To participate in the measurement and evaluation of own clinical work and practice through the use of evidence based projects, practice development work, audit and outcome measures. To use research findings to inform practice. Communication To communicate complex information in a comprehensible way to patients and carers who may have significant communication and / or cognitive difficulties, language barriers requiring the assistance of interpreters or registered blind / deaf. To use advanced teaching and communication skills to educate a diverse and multicultural patient group/population on essential and highly complex specialised dietary adaptations needed for disease control/prevention. To use advanced communication, counselling and interpersonal skills when delivering sensitive information, breaking bad news to patients and/or carers, or dealing with aggressive behaviour and contentious situations. To use advanced cognitive behavioural therapy, reassurance and motivational skills to negotiate, motivate and counsel patients, their carers and other HCPs to help overcome barriers to change especially in situations of non-compliance. To adjust and individualise how dietary information and advice is delivered to patients and their carers by considering the social and medical circumstances, their level of intelligence and ability to understand the information provided. To access and operate a variety of computer data bases and information systems daily for purposes including electronic communication with an extensive range of staff and relevant professional bodies, researching specialised information, extracting patient information and creating documents for presentations, letters and audits. Supplementary Information To manage and prioritise workload in a flexible manner considering frequent interruptions and disturbances from bleeps and phone calls. JD/PS Trust Format – February 2007 Updated Mar 2010 4 To recognise and appropriately manage the emotional effort of being involved in the care of acute, chronic or terminally ill patients through clinical supervision. To manage the physical effort of working between hospital sites, frequently moving up and down stairs, standing for long periods of time and carrying heavy folders. To manage working in unpleasant conditions such as environments where there may be unpleasant sights, noises, smells and temperature fluctuations e.g. hospital wards General To adhere to the UCLH Service Commitment "Putting Patients First" and adopt a professional approach to customer care at all times. To comply with the Trust’s Equal Opportunities Policy and treat staff, patients, colleagues and potential employees with dignity and respect at all times. To take personal responsibility for promoting a safe environment and safe patient care by identifying areas of risk and following the Incident, Serious Incidents and Near Misses reporting policy and procedure. To take personal responsibility for ensuring that UCLH resources are used efficiently and with minimum wastage, and to comply with the Trust's Standing Financial Instructions (SFIs). To comply with Trust policies for personal and patient safety and for prevention of healthcareassociated infection (HCAI); this includes a requirement for rigorous and consistent compliance with Trust policies for hand hygiene, use of personal protective equipment and safe disposal of sharps. To be aware of and adhere to all Trust policies and procedures, the Health and Safety at Work Act and the Data Protection Act. To maintain confidentiality at all times. Other These guidelines are provided to assist in the performance of the contract but are not a condition of the contract. The job description is not intended to be exhaustive and it is likely that duties may be altered from time to time in the light of changing circumstances and after consultation with the postholder. All staff will be regularly assessed on their knowledge, skills and behaviour, and application of all aspects of the job description, in line with the Trust’s Personal Development Review (PDR) process. Staff will also be expected to abide by the relevant code of professional practice relating to their discipline. *PLEASE NOTE: “Directorate”, “Board”, “Responsible to” and “Accountable to” may differ for different posts, therefore please check in the post specific appendix for details. JD/PS Trust Format – February 2007 Updated Mar 2010 5 Post: Specialist Dietitian Dept: Nutrition & Dietetic Services HOW WILL CRITERIA BE ASSESSED? APPLICATION / TEST OR PRESENTATION / INTERVIEW / REFERENCES REQUIREMENTS ESSENTIAL / DESIRABLE* A Four year degree in Nutrition & Dietetics or equivalent E HPC registered E Member of the British Dietetic Association (BDA) or equivalent association D Post registration training in Cognitive Behaviour Therapy D Post graduate study in specialist area of dietetics e.g. PENG course, paediatric/renal modules D E T/P I Knowledge & Qualifications Experience Post registration clinical experience Knowledge of current issues relating to specialist area of dietetics Involvement in relevant specialist interest group E D E E Skills & Abilities Communication Sound verbal and written communication skills Experience of multidisciplinary teamwork Proven ability to communicate using a variety of methods to a range of professionals, non professionals and patients Flexible and adaptable to working alone or with different groups Awareness of need for confidentiality and issues of consent Personal and people development Ability to reflect/ question/evaluate own practice (evidence of CPD) JD/PS Trust Format – February 2007 Updated Mar 2010 6 E E E E R Experience of training student dietitians/other HCPs Proven organisational skills E Experience in the support and development of junior members of staff Teaching on degree (or higher level) / professional course Health, Safety and Security Experience of conducting audit and/or research, including the ability to analyse and interpret statistics Critical appraisal skills i.e. clinical and professional documents Computer literacy D E D E E E E E E E Equality and Diversity Awareness of equal opportunities and diversity Information collection and analysis including IT skills Anthropometry skills D Quality and service improvement Experience in project management E Knowledge & understanding of clinical governance and risk management and relevance to dietetics Other requirements To manage the physical effort of working between hospital sites, frequently moving up and down stairs, standing for long periods of time and carrying heavy folders. To manage working in unpleasant conditions such as environments where there may be unpleasant sights, noises, smells and temperature fluctuations e.g. hospital wards JD/PS Trust Format – February 2007 Updated Mar 2010 7 KSF Outline Core Dimensions Foundation Gateway ( Subset Outline) Level Second Gateway ( Full Outline) 3 (A-C) 3 (A-F) 2 3 1 (A-C) 1 (A-E) 4 Health, Safety and Security Service Improvement 2 (A-C) 2 (A-F) 5 Quality 2 (A-D) 2 (A-F) 6 Equality & Diversity 2 (A+B) 2 (A-D) HWB1 Promotion of Health and Wellbeing and Prevention of Adverse Effects on Health and Wellbeing Assessment and Treatment Planning Interventions and Treatments Information collection and analysis Learning and development 1 (A-E) 2 (A-G) 3 (A-J) 4 (A-J) 3 4 2 (A-C) 2 (A-C) 2 (A-F) 2 (A-F) 1 Communication 2 Personal and People Development 3 Specific Dimensions HWB6 HWB7 IK2 G1 JD/PS Trust Format – February 2007 Updated Mar 2010 8 Level