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INFORMATION FOR CANDIDATES POST OF: BASE: REF NO: Lung Cancer Clinical Nurse Specialist University Hospital Crosshouse N/499/13 Thank you for applying for the above post with NHS Ayrshire & Arran. This information sheet summarises the terms and conditions related to the post. Please note if you provide us with an email address on your application form any future correspondence regarding this post will be emailed to you. If you do not wish to receive this correspondence by email then please contact us as soon as possible. A job description and person specification for the post are attached. This post is Fixed Term/Secondment opportunity until 31st March 2014. The salary for the post is based on the Band 7 salary scale which is currently £30,764 to £40,558 per annum (pro rata for part time posts). The hours for the post are 37.5 per week. DISCLOSURE SCOTLAND PROTECTION OF VULNERABLE GROUPS (PVG) SCHEME The following provides information relevant to the post you have applied for and requires your attention and completion. PVG MEMBERSHIP The post you have applied for is considered to be in the category of “Regulated Work” as defined by the above scheme and successful candidate(s) will be required to be a member of the scheme prior to commencing employment. Membership currently costs £59.00. The cost of membership, if you are successful in your application, will be paid by NHS Ayrshire and Arran. EXISTING PVG MEMBER Applicants who are already a PVG member will require to confirm their membership and the regulated workforce this covers, eg, Adults, Children or both. Prior to employment, NHS Ayrshire and Arran will determine whether the current level of membership is appropriate for the post offered. If further membership to cover another regulated workforce is required, the conditions of membership as stated above will be applied. If however the level of current membership is appropriate, NHS Ayrshire and Arran will seek a Scheme Record Update (SRU) and will both pay and incur the costs associated with obtaining the update. Further information on the scheme can be found on the Disclosure Scotland website at www.disclosurescotland.co.uk PVG SCHEME MEMBERSHIP MANDATE (Please complete Sections 1+2 and return with your application) Section 1. Personal details (* circle as applicable) Name ____________________________ Post Reference Number: Post Applied for: ___________________ ___________ Are you currently a member of the PVG Scheme *YES/NO If YES, please provide Membership Number _________________ Date of Membership _______________ Date of last Scheme Record Update (if applicable) Member of which Regulated Workforce: *Adult __________________________ *Children *Both Section 2. Declaration I understand if my application for this position is successful, I will require to become a member of the scheme covering the appropriate regulated workforce. Signed: Name: ______________________________ ______________________________ Section 3 - For office use only Full membership required Yes/No Update only: Yes/No SPN: Date: _______________________ Post Ref no: _________________ Regulated workforce: Adult / Children / Both _____________________________ GENERAL CONDITIONS: Conditions of Service - The conditions of service are those laid down and amended from time to time by the appropriate negotiating bodies e.g. NHS Staff Council/NHS Pay Negotiating Council. Annual Leave – The leave year runs from 1 April to 31 March. Annual leave entitlement for full time staff on appointment is 202.5 hours (27 days), with 217.5 hours (29 days) upon completion of 5 years NHS service and 247.50 hours (33 days) after 10 years NHS service. Entitlements for part time will be pro rata. Public Holidays – Public holiday entitlement for full time staff is 60 hours based on the 8 designated Public Holidays per annum, and on a 5 day week working 7.5 hours per day. The 60 hours entitlement is due to all whole time staff irrespective of work pattern. For part time staff, this will be applied on a pro rata basis and also allocated in hours. KSF - The NHS Knowledge and Skills Framework is essentially a development tool but will also contribute to decisions about pay progression. It will promote equality for and diversity of all staff, having the same opportunities for learning, development and review. It will promote effectiveness at work – with managers and staff being clear about what is required within a post. It will support effective learning and development of individuals – with all members of staff being supported to learn throughout their careers. Pensions - Employees are automatically opted into the NHS (Scotland) Superannuation Scheme. Contributions are at the rate of 9%. Employees may opt out by obtaining and completing the relevant Opt Out form from the Scottish Public Pensions Agency website. Disabled Applicants - A disability or health problem does not preclude full consideration for the job and applications from people with disabilities are welcome. All information will be treated as confidential. NHS Ayrshire & Arran has been approved, by the Employment Services Department, as an Equal Opportunities employer with a positive policy towards employment of disabled people. NHS Ayrshire & Arran guarantees to interview all applicants with disabilities who meet the minimum criteria for the post. You will note on our application form we ask for relevant information with regards to your disability. This is simply to ensure that we can assist you, if you are called for interview, to have every opportunity to present your application in full. We may call you to discuss your needs in more detail if you are selected for interview. Asylum and Immigration Act 1996 and 2004 (Section 8) - The Asylum and Immigration Act 1996 and 2004 requires employment checks to ensure that all employees are legally employed in the United Kingdom. Candidates will be asked to provide relevant original documents prior to an offer of employment being made. Any offer of employment will only be made when the organisation is satisfied that the candidate is the rightful holder of the documents and is legally eligible for employment within the United Kingdom. Medical Examination - Any offer of employment is conditional upon a satisfactory medical report from our Occupational Health Services. You may be offered employment conditional on confirmation that you are medically fit for employment. A commencement date for employment will only be agreed following this confirmation. Policy Relating to Staff with Bloodborne Virus Infection - Candidates for posts which involve exposure prone procedures will not be allowed to commence employment until they have been assessed as fit to perform EPPs by Occupational Health. The pre-employment screening must be completed prior to any job offer being made. Where a candidate is not able to perform EPPs, Occupational Health will notify the appropriate manager that the candidate is ‘fit with restrictions’ and is unable to perform EPPs. The health status of the individual will not normally be notified to management. Where the restrictions recommended by Occupational Health are unable to be accommodated due to the clinical duties of any of the posts within the staff groups specified in the policy, an offer of employment to the post will not be made. Candidates who are not offered employment due to being deemed unfit to undertake EPPs as an essential requirement for a post, may be offered the opportunity to apply for another advertised vacant post and be considered with other applicants. The pre-employment screening for EPP posts above do not apply to staff undertaking non-EPP posts who could have direct contact with blood, bloodstained body fluids or patients’ tissue in the course of their work activities. These staff will be offered and strongly advised to be immunised against Hepatitis B in line with the Immunisation Policy including recall for boosters and further antibody checks. References - Two satisfactory written references must be obtained prior to any offer of employment being made. These should include current and previous employers as requested in the job application form. This is in line with the Recruitment and Selection Policy. YOUR APPLICATION: Informal Enquiries - Informal enquiries are welcomed by Sandra White, Nurse Consultant, who can be contacted on 01563826025. Closing Date - Your completed application form should be submitted by 05th September 2013 via the online application form on the SHOW website. Alternatively your completed application form can be returned to the address below or can be e-mailed to [email protected] Department of O&HR Development 63A Lister Street University Hospital Crosshouse KILMARNOCK Ayrshire KA2 0BE JOB DESCRIPTION 1. JOB IDENTIFICATION Job Title: Clinical Nurse Specialist – Lung Cancer Responsible to (insert job title): Clinical Nurse Manager Department(s): University Hospitals Ayr and Crosshouse Directorate: Integrated Care and Emergency Services Job Reference: N/499/13 No of Job Holders: 2 Last Update (insert date): 2. JOB PURPOSE 2.1 To improve the quality of health care provision for people with lung cancer and their carers throughout the cancer journey. 2.2 To act as the clinical nursing specialist within Hospital for lung cancer within the context of a widespread multi-professional team to provide co-ordinated care pathways. 2.3 To strengthen professional leadership within cancer care, influencing the implementation of evidence based practice in line with relevant local, regional and national strategies. 3. DIMENSIONS 3.1 Cancer services within Ayrshire and Arran are delivered in collaboration with the regional Managed Clinical Networks (MCNs). NHS Ayrshire and Arran and the MCNs agree cancer priorities and service developments. The CNS plays an integral role in the local implementation of MCN activity. 3.2 The provision of cancer services involves complex clinical pathways which require a system wide approach to care, including the NHS Ayrshire and Arran Divisions, the Regional Cancer Centre, the Local Authority, the Hospice and Voluntary Agencies. 3.3 The clinical pathway for cancer patients interfaces across departmental, organisational and geographical boundaries. Care is managed within the context of a complex and widespread multi-professional team. The CNS role is key to co-ordination and communication within the team in order to deliver structured supported care within the system. 3.4 Strategic direction of Ayrshire and Arran Cancer Nursing is in line with national and regional priorities and delivered under the auspices of the local Cancer Nursing Steering Group. The CNS is the designated lead for key projects set against these agreed priorities. 4. ORGANISATIONAL POSITION Associate Nurse Director Consultants Clinical Nurse Manager (Operationally) and Nurse Consultant for Cancer (Professionally) District Nurses/Charge Nurses Hospice Nurses/Practice Nurse Lung CNS CNS Colleagues Ward Nurses/Health Care Assistants 5. ROLE OF DEPARTMENT ROLE OF CANCER SERVICES Within Ayrshire and Arran, 2000 people are diagnosed with cancer each year and there are approximately 7000 individuals living with active disease. Of the patients diagnosed, around 300 will have lung cancer. The service objective is to provide good quality care for cancer patients and their carers from diagnosis to the disease terminal stage. To achieve this there are close links between primary care in the community, secondary care in hospital and the regional cancer centre, as well as voluntary, hospice and social services. The Cancer CNS role involves working across these links in terms of clinical and system management to produce structured pathways of care for a site specific cancer group. 6. KEY RESULT AREAS 6.1 To lead for lung cancer nursing within Ayrshire and Arran and influence the implementation of evidence based practice in line with local initiatives, regional priorities and national strategies. 6.2 To work in partnership with NHS colleagues, local authority and the voluntary sector to deliver structured pathways of care, including effective interventions at diagnosis, treatment, rehabilitation, palliation, and terminal care. 6.3 To lead on specific cancer nursing projects, developing guidelines and protocols in line with agreed national, regional and local priorities, including research, audit and practice developments 6.4 To act as an expert clinical resource to the multi-professional team, to proactively plan and deliver services. 6.5 To be responsible for the role development of nursing colleagues working to facilitate the integration of general and specialist cancer nursing developments in order to improve evidenced based practice across the whole system, ensuring that the code of professional conduct is adhered to at all times 6.6 To maintain communication structures by means of relationship building and use good quality appropriate documentation to ensure individualised patient focussed care 6.7 To lead and co-ordinate quality nursing provision which is based on research and expert clinical skills, including effective assessment, intervention and evaluation of physical, psychological, spiritual and social needs. 6.8 To develop cancer nursing educational programmes in conjunction with University establishments and undertake the delivery of education sessions to pre and post. registration nurses and allied health care professionals 6.9 To lead in the development and implementation of nurse led follow up for patients with lung cancer, in response to issues of service capacity in relation to medical staffing. 6.10 To collect quality of life patient outcome data, to ensure effective patient focussed interventions and provide direction for developing nursing practice 7a. EQUIPMENT AND MACHINERY The CNS in lung cancer is required to have a working knowledge of all the equipment used regularly: PC Pager & Answerphone Saturation monitor Inhaler devices Venesection equipment 7b. SYSTEMS Responsible for documentation within casenotes of clinical assessment and correspondence contained Orders supplies for own department using a paper based stock control system Completes weekly timesheet Completes expenses forms Maintains paper based patient record systems (case notes and specialist nursing notes) which can be accessed by the multi –professional team. Gathering of quality of life data 8. ASSIGNMENT AND REVIEW OF WORK 8.1 Assignment Receive direct referrals for assessment and management from: Consultants General Practitioners Nurses Social workers Allied health professionals Patients and family members Voluntary sector 8.2 Review 8.2.1 The postholder works autonomously and is required to make complex clinical decisions regarding patient management without direct supervision – this includes the discharge of patients post chemotherapy. Access to advice is available and a scheduled time is planned to discuss patients’ management at the weekly multi-professional meeting 8.2.2 Meetings are arranged bimonthly with the Lead Cancer Nurse to discuss progress against service developments and provide professional advice 8.2.3 Individual clinical supervision is provided bimonthly by an external organisation 9. DECISIONS AND JUDGEMENTS 9.1 The lung cancer CNS is clinically and professionally expected to make autonomous decisions on a daily basis in the clinical area or by telephone, including provision of advice to MDT staff including medical staff within and outwith Ayrshire and Arran . 9.2 The lung cancer CNS is able to assess the complex needs of patients and carers (physical, psychological, social and spiritual) to establish change in condition, inform clinical decision making, and plan care. 9.3 Is able to provide professional advice to registered / unregistered staff and students and an ability to recognise own limitations and the requirement for appropriate referral on to others. 9.4 Has the ability to assess and respond quickly to patient’s needs in an emergency situation for example – spinal cord compression, superior vena caval obstruction. 9.5 The CNS in lung cancer has discretion to work within agreed parameters including the application of human resource policies, health & safety policies, and risk management strategies. 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB 10.1 Communication within a complex, widespread, multi-professional team to provide structure and support for vulnerable patients and their families. 10.2 Ability to deal with highly emotive situations involving patients/carers and then participate in service development issues within a short period of time. 10.3 Time management in order to incorporate all expected aspects of the job when the pressure of clinical input is very high. Other aspects of the role include leading on: Audit and research Education Professional development Service management and development 10.4 Driving/ leading change to improve quality of clinical care for patients. 10.5 Recognising and responding to the needs and feelings of others 10.6 Has the ability to continually change and adapt to new situations and strategies 11. COMMUNICATIONS AND RELATIONSHIPS 11.1 People with cancer require information and support regarding diagnosis and complex treatment options. Individuals vary regarding their preference for amount and detail of information they want, and invariably it is the lung cancer CNS that they seek this information from. Therefore the postholder is required to utilise highly developed communication skills to assess and manage an individuals ongoing informational needs and occassionally deal with situations where patients do not easily understand their care packages due to cultural, language, physical or learning disability. 11.2 The postholder is required to communicate with a wide range of professionals to ensure seamless patient care and to improve knowledge and skills of staff caring for people with lung cancer. 11.3 In addition the postholder in leading organisational service developments is required to communicate and build relationships with clinical/managerial staff across NHS Ayrshire and Arran, whilst ensuring that he / she adhere’s to the Divisions policy on confidentiality including the requirements of the data protection act and the Caldicott guidelines. These include: Patients and their families/carers. Medical staff in Respiratory, Oncology, Radiology, Thoracic Surgery, Palliative Care and Psychology. General Practitioners Nursing staff in primary, secondary and tertiary care. Other CNS locally, regionally and nationally Lead cancer nurse Administration staff in primary, secondary and tertiary care. Allied health care professionals and social services in primary and secondary care. Local authority Voluntary sector Educational services locally and regionally Professional bodies locally, regionally and nationally IM&T staff 12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB WORKING ENVIRONMENT 12.1 PHYSICAL EFFORT/SKILLS: Occasional moderate effort Occasionally moves/manoeuvres patients Keyboard skills Office administration skills Drives regularly for business 12.2 MENTAL EFFORT/SKILLS: Frequent concentration Daily concentration on organisation of workload for example-patient assessment; schedule of Visits; expectation of others Participation in formal and informal education programmes. Answering queries from daily contacts with patients, relatives and other staff regarding lung cancer; diagnosis; treatment aim & possible side effects; symptom management including advice regarding medications. Maintaining motivation and enthusiasm while working alone and unsupervised Maintaining awareness of all aspects the job requires and planning time to accommodate these Maintains accurate documentation to ensure effective communication of clinical information 12.3 EMOTIONAL EFFORT/SKILLS: Frequent highly distressing circumstances The CNS in lung cancer frequently meets with patients and families who are extremely distressed. The CNS is present on most occasions when patients with lung cancer or mesothelioma are told their diagnosis, to provide support and advice to both the patient and their families. This continues throughout active treatment, palliation, rehabilitation and terminal care. The CNS is regularly contacted via the telephone to retrieve a crisis situation where patient/carer require support and advice, as they are no longer able to cope physically, psychologically, spiritually or socially. The way in which Lung cancer develops and progresses means that, at time of diagnosis, the majority of patients will have incurable disease. The CNS works in a highly emotional environment, frequently dealing with questions around prognosis and end of life issues. Patients and families/carers may go through an anticipatory grief process, manifested in a variety of complex emotions, which are often directed at the CNS e.g. anger. Excellent interpersonal skills are required to help them deal with these issues and to support bereaved relatives/carers both within the ward setting and in the community. In Scotland overall median survival for 50% of patients with lung cancer is 4mths, with survival at 1yr 21.5% and 5yrs 6.6%. Frequent provision of intense periods of care and support from diagnosis to terminal care on a recurrent basis can be emotionally draining for the lung cancer CNS and the degree of emotional investment that the CNS gives is impossible to quantify, but is a heavy burden of care. In order to manage this burden and enable her to fulfil the expectations of the job, the CNS equips herself through education and practice 13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB 13.1 Essential Registered nurse with current NMC registration First degree or relevant post registration/graduate qualification in cancer or palliative care/ Working towards masters degree by demonstrating completion of masters level short courses – e.g, management of breathlessness 5 years post registration experience. 2 years within speciality area Ability to work in complex clinical environment Excellent communication/interpersonal skills Experience in supervising junior staff Evidence of progressive professional development IT Skills Demonstrable written and oral communication skills Participation in service development projects Leadership skills underpinned by relevant training / experience 13.2 Desirable Master’s degree in relevant subject Experience in developing education programmes Supplementary prescribing Presentation skills NHS Ayrshire and Arran Person Specification Post Title Post Reference Number Lung Cancer Clinical Nurse Specialist N/499/13 Selection Factors (Person Specification) QUALIFICATIONS & TRAINING EXPERIENCE KNOWLEDGE COMPETENCIES & SKILLS Criteria Essential Registered nurse with current NMC registration First degree or relevant post registration/graduate qualification in cancer or palliative care Desirable Masters degree / equivalent eg. by demonstrating completion of masters level short courses –g, management of breathlessness Essential Significant relevant experience in acute care Desirable Previous experience within lung cancer nursing Essential lung cancer investigations and treatments Palliative care supportive measures Desirable Knowledge of local / organisational systems / processes / agencies Essential Ability to work in complex clinical environment Excellent communication/interpersonal skills Highly organised Use of basic IT Desirable PERSONAL CHARACTERISTICS AND OTHER Essential Desirable Compassionate and sensitive nature