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INFORMATION FOR CANDIDATES POST OF: BASE: REF NO: Community Dietitian Ayrshire Central Hospital S/703/12 Thank you for applying for the above post with NHS Ayrshire & Arran. This information sheet summarises the terms and conditions related to the post. A job description and person specification for the post are attached. This post is Permanent. The salary for the post is based on the Band 5 salary scale which is currently £21176 to £27625 per annum (pro rata for part time posts). The hours for the post are 30 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 initially paid by NHS Ayrshire and Arran, but will require to be repaid by you through an agreed schedule of payroll deduction(s) once you start work. It will not be possible to progress a PVG membership application without your agreement to repay membership costs. 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 1-3 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 and agree to repay to NHS Ayrshire and Arran costs associated with membership. I understand that this agreement is only binding if I am subsequently offered and commence employment with NHS Ayrshire and Arran. In signing the undernoted, I hereby give my permission, on commencement of employment with NHS Ayrshire and Arran, to deduct from my salary, in accordance with the undernoted, membership costs initially paid on my behalf by the Board. I, __________________________, agree to repay the sum of £59.00 to NHS Ayrshire and Arran as reimbursement of fees paid to Disclosure Scotland for my membership to the PVG Scheme. Section 3 Mandate Reimbursement to be made as follows (please tick): 1. Single deduction of £59.00 from 1st month’s salary 2. Deduction of £20.00 from 1ST and 2nd months’ salary followed by further deduction of £19 from my third month’s salary Should my employment with NHS Ayrshire and Arran terminate within the repayment period, I agree to pay the full amount due at the time of termination either by way of final pay or production of a cheque/cash payment if there are insufficient funds available in final pay. Signed: Name: ______________________________ ______________________________ Section 4 - For office use only Full membership required Yes/No Update only: Yes/No For Payroll Use Only SPN……………………….. Period Actioned………….. Actioned by 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. Superannuation - Employees are automatically opted into the NHS (Scotland) Superannuation Scheme. Contributions are at the rate of 6.5%. Employees may opt out by completing Form SB34. 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 preemployment 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 preemployment 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: Applications - Please note that we no longer acknowledge receipt of applications therefore, unless you are shortlisted to attend for interview, you will not receive any further communication. Informal Enquiries - Informal enquiries are welcomed by Louise Gibson, Dietetic Lead who can be contacted on 01294 323130. Closing Date - Your completed application form should be submitted by Friday 11th January 2013 to the address below or can be e-mailed to [email protected]. Department of O&HR Development 63A Lister Street Crosshouse Site KILMARNOCK Ayrshire KA2 0BE JOB DESCRIPTION 1. JOB IDENTIFICATION Job Title: Dietitian Band 5 Responsible to (insert job title): Dietetic Lead Department(s): Nutrition & Dietetic Directorate: Integrated Care & Partnerships Operating Division: Allied Health Professions Job Reference: S/703/12 No of Job Holders: 1 Last Update (insert date): July 2010 2. JOB PURPOSE To provide a specialist dietetic service by interpreting and communicating the science of nutrition into practical dietary advice to promote nutritional well-being, treat disease and prevent nutritional related problems. Providing health promotion information in response to key government health targets. To offer advice and information about nutrition and health to health professionals, consultants, GPs, patients, carers and the public. To provide the nutrition and dietetic service to an in-patient population, Day Hospital services, general Outpatients, GP clinics and nursing homes. This involves the management, assessment and monitoring of nutritional treatment plans for patients/carers. To act as a source of professional advice on nutrition and dietetics for patients and members of the multi-disciplinary team. This service is provided in a variety of settings and may include acute and community Hospitals, GP practices, health centres, nursing homes and private and public sector. 3. DIMENSIONS To provide Nutrition and Dietetic service to the area designated by Dietetic lead/team leader. Can be hospital or community based. Develops dietetic care packages for specific groups of patients eg nutrition support ,diabetic Attend multidisciplinary meetings as required e.g. case conferences, discharge planning meetings. Attend and participate in Dietetic team meetings and professional development sessions as required Flying Start Programme to be completed within first 12 months of recruitment 4. ORGANISATIONAL POSITION Head of Profession – Nutrition & Dietetics Dietetic Lead – Integrated Services Dietetic Team Leader Dietetic Assistant Band 6 Dietitian Band 5 Dietitian │ 5. ROLE OF DEPARTMENT The Nutrition and Dietetic Department provides a comprehensive, evidence-based, professional, nutritional advisory service. This is achieved through the translation of the individual’s scientific information, with respect to the consequent treatment plan, giving practical dietary advice for the primary/secondary prevention of treatment of ill health or disease, and for the alleviation of symptoms through adaptation of nutritional intake throughout the illness/disease process. This would also take into account the individuals social circumstances and lifestyle patterns. The department also has a health improvement role in relation to national targets for health promotion. 6. KEY RESULT AREAS 1. Plan, prepare and deliver up-to-date, evidence based, quality dietetic advice for patients referred to the service, ensuring individualised advice, support and agreed treatment plans are developed, implemented, monitored and reviewed. Provision of nutritional care is aiming to improve clinical condition, reduce deterioration or incidence of medical complications, this will be achieved through the following: On receipt of referral, prioritise, and re-prioritise caseload based on dietetic need/urgency. Review case notes/EMISS system, selecting appropriate raw data using judgmental skills to interpret data and results. Analyse information and results using judgmental, analytical and problem solving skills to inform methodology of treatment, for example, consideration of medical, biochemical, pharmaceutical lifestyle and social patterns. Where appropriate, calculate body mass index, % weight loss and individual estimated nutritional requirements. Consider all potential drug/nutrient interactions e.g. diabetic medication, statins, phenytoin Where necessary, suggest further biochemical tests when the outcome may inform or indicate modification of the dietetic treatment plan Decide, discuss, agree and implement the treatment plan in consultation with the patient/carer and members of the multi-disciplinary team to ensure individual needs are met using a holistic approach. When necessary, communicate routine, complex and/or sensitive information in an understandable form, which may include giving unwelcome or difficult to accept information e.g. long-term adherence to restricted diets. Having gained informed consent, educate patient/carer through use of interview and counselling skills in conjunction with appropriate resources to aid and support understanding of individual dietary treatment. Monitor the progress of the treatment plan, re-evaluating outcomes based on any relevant changes, modifying the plan (as appropriate) to ensure optimal patient care Arrange appropriate provision of therapeutic diets and the prescription of ACBS listed dietetic products, enteral and parenteral nutrition; ensuring nutritional adequacy of dietary intake is provided. Ensure cohesive patient discharge/transfer through optimal communication with patient/carer and all relevant members of the multi-disciplinary team, adhering to local systems in place. For example enteral feeding transfer form, prescription letters and referral procedures. To meet regularly with supervising dietitian to discuss caseload. To be professionally and legally accountable and responsible for all aspects of own work, including the dietetic management of patients, and to maintain notes for each patient in accordance with the BDA Guidance on Standards for records and record keeping ,ensuring they are accurate, comprehensive, legible and up to date documentation in line with legal and departmental requirements 2. Maintain CPD through registration and completion of the Flying Start Programme; which includes self-study, work shadowing, training courses applicable to remit, service needs and budgetary constraints maintaining HPC registration and ensuring practice is up-to-date and evidence based. 3. Participate in the local implementation of standards of nutritional assessment and diet therapy for patients in collaboration with members of the uni and multi-disciplinary team in line with local/national guidelines to ensure consistency of practice and evidence based care throughout the organisation. For example, Managed Clinical Networks; QIS standards; SIGN Guidelines; Local Dietetic Care Pathways. 4. To provide cover for annual/sick/study leave, across a variety of clinical areas both medically and dietetically, ensuring priority patients are dealt with timeously without compromising patient care. 5. To provide dietetic advice, teaching and training to dietetic colleagues, other members of the multidisciplinary team and other external agencies e.g. Nursing Home staff, Social Care staff etc as required 6. Ensure evidence-based best practice, review and update as necessary in line with new research, audit findings, professional and clinical standards. For example cardiac/pulmonary rehabilitation; tissue viability; induction etc. 7. Participate in the implementation of clinical/non-clinical standards, policies and procedures through collaboration with team members ensuring up-to-date evidence based care and continuity of practice. 8. Participate in clinical/non-clinical audit in relation to nutritional aspects of care to establish best practice as appropriate. 9. To collect and submit appropriate data and statistics for the use of the department/organisation. 10. Adhere to professional and departmental standards acknowledging individual responsibilities through compliance with Divisional/Departmental policies. For example Health and Safety, Data Protection, Confidentiality ensuring safety of practice and information. 7a & b. EQUIPMENT/SYSTEMS IT – To be competent in the use of current documentation systems with a working knowledge of relevant IT systems and software packages. Equipment/Systems Use/Purpose Computers, printers, Patient appointments and clinic administration, scanners and software Patient management systems e.g. EMISS, FACE, PMS packages. Correspondence, report writing (Word). Data Collection/Statistics .- provide accurate monthly activity data Nutritional Analysis(Comp-EAT). Intranet/internet; Division and Clinical information. Email: internal, Scottish, national, international and professional correspondence. Presentations, teaching aids and health promotion tools Presentations (Powerpoint/projector). Overhead projectors. Display boards, flipcharts. Food models, use of catering equipment. TV, video player, laptop, photocopier. Food, drinks for demonstrations. Telecommunications; Internal and external communication. telephone (landline & mobile), pagers and fax Nutritional Assessment/Support Equipment : To understand and ensure safe use of Dietetic and additional patient care equipment. Anthropometric equipment Assessment of nutritional needs. - Scales; stand-on, chair & - Weight and height measurements necessary for wheelchair calculation of Body mass index or % weight loss. - Stadiometer, , height sticks, - Measuring tape for alternative method of finding measuring tapes patients height also for waist circumference - Height and weight conversion - Calipers for measurement of body fat stores charts, BMI calculator - Skinfold calipers Administration of enteral feed. Enteral Feeding Pumps To support and reinforce verbal advice. Dietary Information Sheets. Stand alone information which requires no explanation General Nutrition Advice Sheets. To ensure items required to support the recommended dietetic treatment plan are delivered to the patient. Catering systems Clinical systems Risk Management system Documentation necessary to support MCNs etc Incident reporting via Datix to ensure the safety of patients, staff and visitors. 8. ASSIGNMENT AND REVIEW OF WORK Area of work is assigned by the Dietetic lead/team leader. The majority of the post-holders work is demand led. Referral is generated through the completion and/or review of the nutrition risk score or the perceived risk. Also through the admission/diagnosis of patients with medical conditions requiring dietetic intervention e.g. Diabetes. Referrals are made by telephone, written, electronic or verbal processes. The postholder is clinically responsible for the effective self-management of their assigned caseload on a day-to-day basis within agreed parameters and the confines of their dietetic team and/or senior colleague for supervision. Performance is assessed through the departmental system of performance appraisal & personal development on an annual basis, with 3 monthly reviews. The post-holder can assign and review work delegated to Secretarial colleagues and Dietetic support workers Should a situation out-with your experience arise, advice can be sought from a dietetic peer/ senior/manager and/or professional body or appropriate member of the multi-disciplinary team dependent on the nature of the problem. The postholder should anticipate/ report any problem in relation to remit to senior colleagues/line manager, appropriate member of the multi-disciplinary team as the situation dictates. 9. DECISIONS AND JUDGEMENTS The postholder makes decisions and judgements with respect to the proposed treatment plan having monitored, reviewed and interpreted the following:- Patient condition, biochemical results; medication, need for onward referral to other health professionals. This ensures their duty of care towards the patient is achieved as per HPC standards of proficiency for Dietitians. Recommendations for prescription of ACBS listed products, for example sip feeds, enteral feeds, dietetic specialist products based on the product information and prescribing categories. Make professional judgements in relation to continuation/discontinuation of treatments initiated have drawn on available knowledge and skills in relation to the up-to-date evidence based approach to nutritional care. Exercise decision making skills and professional judgement concerning the appropriateness of specific dietary treatments due to the conflicting nature of clinical pathologies (as necessary). Decisions and judgements in relation to the prioritisation and re-prioritisation of assigned caseload. Decisions and judgements in relation to the cost-effective, efficient use of organisational/departmental resources e.g. dietetic products; own time; supplies. Actions are legal and personal accountability for them is accepted by the postholder. 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB Managing conditions where dietary assessment, methodology and treatment is complicated by multiclinical, social and psychological pathologies. Effect behavioural change through counselling, motivational and educational skills to gain acceptance for suggested treatment plan and persuade patients to comply where there may be significant barriers to understanding/success. Time management in relation to regular changes in workload priorities. Frustration related to the reliance on other members of the multi-disciplinary team members in achieving dietetic outcomes. Making time to cover assigned caseload ; attend necessary meetings and meet CPD requirements. Adapting communication styles to suit a diverse range of patient and professional needs. 11. COMMUNICATIONS AND RELATIONSHIPS Patients/carers – to involve them in therapeutic decision-making and treatment planning. All appropriate members of the multi-disciplinary team, for example Nurses, Doctors, GP’s, Practice staff, Care home staff, Speech & Language Therapists etc with respect to professional and clinical standardisation of approach in relation to the proposes treatment plan. Specific liaison, on a daily basis, with departmental secretary, to ensure timeous requests for prescription of ACBS listed dietetic products, appointment scheduling and communications with all appropriate members of the multi-disciplinary team re progress. Specific liaison, Dietitian to Dietitian, when arranging planned annual/study/maternity leave cover. Dietetic lead/Team leader with respect to problem solving and planning in professional personal and departmental issues. Monitor on-going practice reporting any change in established routine to senior colleagues, for example in relation to protocols, guidelines, safety action notices etc. Contract feeding company representatives/nurse re training of home enteral feeding patients/carers/staff. Members of the public giving general nutritional advice. Other health professional groups/agencies within and outwith the Division to improve clinical knowledge and enhance development. Barriers to Communication. Patients/carers with significant barriers to understanding such as dementing illness, poor levels of consciousness, cognitive impairment, hearing or sight impairment and memory loss, behavioural problems, mental illness, depression, language difficulties etc. Patients/carers unwilling/unable to accept ongoing compliance to necessary treatment plan to the short/long-term nature/permanence of suggested lifestyle changes due to strong cultural/religious beliefs, resistant attitude to change; and/or social circumstances. Patients/carers not aware of/coping with managing their diagnosis. 12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB Physical Driving skills Requirement to walk/climb stairs to department/clinical areas on a daily basis. Potential to stand for a cumulative period of 1-2 hours, 1-2 times per day. Assistance of patients onto scales either from a sitting or standing position. Carrying scales e.g. 8kg Carrying patient records and written dietary information e.g. 1-2kg, 2-3 x per day Carrying dietetic supplies to wards or clinic areas/care homes e.g. 1-2kg, 2-3 x per week Frequent bending down to patients level at the bedside Exposure to offensive smells and unacceptable level of cleanliness. When working in the community, a significant part of a day can be spent driving to patients’ homes across a wide geographical area. This is often done in inclement weather. Break times are frequently taken in isolation in the car outwith your base. Mental Mental effort is the predominant demand of the job, requiring concentration for the majority of the working day. This can be interrupted/disrupted with frequent enquiries/problems of varying duration, relating to service provision and delivery. The workload is unpredictable requiring frequent re-prioritisation, on a daily basis. Emotional Maintaining professionalism when dealing with the following: Conveying unwelcome/distressing news for example diagnosis, unknown prior to consultation. Dealing with bereaved relatives/carers. Dealing with chronically ill patients. Dealing with palliatively ill patients. Dealing with difficult/demanding/aggressive patients/carers/staff. Environmental Exposure to body fluids and odours in ward environment. Inclement weather on home visits/walks to wards and other bases. Exposure to verbal and potential physical aggression. Temperature variations. Hazardous chemical/materials. Exposure to communicable diseases 13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB Minimum required to undertake the role: Honours degree/postgraduate diploma in Nutrition and Dietetics. Registered Dietitian with the Health Professions Council (HPC). Working knowledge and understanding of the HPC Standards of proficiency for Dietitians/standards of conduct, performance and ethics. Time management & organisational skills. Presentation skills. Basic computer literacy. Car driver/owner essential for travel to other sites NHS Ayrshire and Arran Person Specification Post Title:band5 Dietitian Post Reference Number: S/703/12 Selection Factors (Person Specification) QUALIFICATIONS & TRAINING Criteria Essential Degree in Nutrition and Dietetics or equivalent degree with Post Graduate certificate Registration with HPC Desirable EXPERIENCE KNOWLEDGE Essential None required Desirable Some experience desirable Essential A robust knowledge of Dietetic Guidelines/ Recommendations on current Practice Desirable COMPETENCIES & SKILLS Essential Desirable PERSONAL CHARACTERISTICS AND OTHER Essential Desirable Excellent communication skills Excellent team working skills Excellent organizational skills Excellent time management Car/owner driver Innovative Flexible Motivated Enthusiastic Proactive Able to be reflective on own performance