Job Description
We are seeking an innovative and compassionate Dietitian to work as a specialist clinician within Gloucestershire Hospitals NHS Foundation Trust’s cancer prehabilitation service. This is an opportunity to be at the forefront of establishing dietetics, using a preventative or early intervention model right at the beginning of the cancer pathway. The prehabilitation team is an AHP team consisting of Physiotherapy, dietetics and psychology, working alongside support workers to provide proactive and preventative interventions relating to physical, nutritional and psychological concerns for patients, undergoing a range of treatments for cancer, including surgery and systemic anticancer therapy (SACT). This post is fundamental to establishing and developing our existing service, keeping diet and nutrition at the forefront of our offer to patients.
The post holder with have close links and support from both the AHP cancer lead and the dietetic lead. They will have active engagement with the Trust cancer care Dietitians and the wider Trust dietetics service, as well as working closely with dietitians within the cancer rehab program.
This is a 1 WTE band 6 (37.5 hours).
For informal inquiries;
Contact Juliette, AHP Cancer Lead juliette.sherrington@nhs.net
or
Fiona Brown, Lead Dietitian Fiona.brown1@nhs.net
To work as an autonomous practitioner, providing nutritional assessment and treatment in the context of prehabilitation interventions in order to enhance and promote the nutritional status in patients newly diagnosed with cancer, prior to starting treatment. The post will require an experienced dietitian who is able to provide tailored nutritional advice and expertise alongside core dietetic skills. The post-holder will also need to demonstrate competence in: office skills, data management, preparing and delivering educational material, liaison and skilled communication with a wide range of healthcare staff and patients. Clinical interventions will be in the form of individual contacts with patients and within group/education sessions where appropriate and within the competencies of the post holder.
The post-holder must show willingness to work within an AHP team providing group interventions, including supporting patients within group classes.
The post is based within cancer services. Cancer Services work across all directorates within the hospital involved in a cancer patient’s care from suspicion of cancer through to oncology services. Working closely with a variety of services and professionals, involving, diagnostics, in-patient care though to community rehabilitation.
Cancer services offer opportunities for research and innovation and work closely to ensure the best care for patients throughout their cancer journey.
Gloucestershire Hospitals NHS Foundation Trust is the largest employer in the county and with over 8,000 staff, we are one of the largest NHS trusts in the UK. You will have access to Dietetic peer support and be actively engaged with the Trust Dietetic Service. We offer a generous annual leave allowance, excellent bank rates, access to the excellent NHS Pension Scheme, discounts for local shops, restaurants and services, access to our health and well-being hub, access to our two on-site nurseries, flexible working options, discounted public transport, reward and recognition schemes, exercise and activity classes and membership to our popular hospital choir.
Clinical
- To provide specialist dietetic intervention for the cancer prehabilitation service, acting as a resource for therapists, other allied health professionals (AHP’s) and healthcare professionals.
- To work as an autonomous specialist practitioner, working with the responsibility for assessing and directing the management of patients diagnosed with cancer into a relevant prehabilitation programme.
- To deliver nutritional intervention, acting as a specialist clinician in prehabilitation by delivering nutritional care in an integrated and client-centred way.
- To ensure an effective and evidence-based service through contributing to the assessing, planning and implementing treatment programmes.
- To work within a multi-disciplinary allied health professional team, supporting in the provision of education sessions and supporting patients within the prehabilitation exercise groups.
- To assist with the provision of stepped care interventions for patients recently diagnosed with cancer prior to starting treatment.
- To work as an expert practitioner in cancer prehabilitation and utilise highly specialist theoretical knowledge, clinical experience and clinical reasoning to support comprehensive patient management. This will include patients with diverse or complex presentations/multi-pathologies and those newly diagnosed or under investigation for cancer.
- To respond emphatically and sensitively to patients or family members in emotionally distressing circumstances. Working with patients receiving potentially life limiting diagnosis.
- To regularly deal sensitively with patients who have high levels of anxiety and distress caused by pain, fear or limited mobility and when they are unable to accept a diagnosis/prognosis
- To communicate effectively with patients and carers potentially complex, sensitive or distressing information; in order to provide patient centered care, to encourage self-management, maximise prehabilitation and rehabilitation potential and to ensure understanding of the condition. Patients may have communication, perceptual or cognitive/understanding difficulties.
- To regularly make decisions regarding complex case management.
- To maintain clear, accurate and concise patient records in line with departmental and professional standards and include relevant outcome measures. This will include writing patient reports for e.g. medical practitioners.
- To liaise closely with prehab team members, and work collaboratively with Cancer MDTs, medical, nursing, cancer support staff and other colleagues to ensure delivery of a co-ordinated multidisciplinary service.
- To exercise a high degree of professional autonomy, whilst actively creating and developing protocols/guidelines for the management of patients in line with the prehabilitation team.
- To provide education, support and guidance for therapy staff, undergraduate students, clinical nurse specialists and cancer support workers in order to develop clinical skills and to promote consistency of practice trust wide.
- To comply with Trust and Departmental policies and procedures e.g. Health and Safety at Work Act (1974), Manual Handling, clinical equipment competency, risk management, Data Protection Acts and patient confidentiality at all times. This will include demonstrating compliance with the terms of all safeguarding policies and processes relevant to the safeguarding of adults and children in the care of GHNHSFT and to undergo regular mandatory training concerned with safeguarding matters.
Service Development
- To actively contribute to the evaluation and service development in the clinical area of prehabilitation in line with national and local drivers.
- To assist in the design and implementation of the prehabilitation service and associated developments.
- To make recommendations regarding national guidelines, initiatives and research. Support best practice by the use of validated assessment tools and review of intervention outcomes, in order to ensure a high quality evidence based service is provided.
- To assume responsibility for personal development, and CPD (continuing professional development), linked to appraisal, supported by the Prehabilitation Lead, AHP Cancer Lead and Dietetic service Lead
- To actively contribute to monitoring and evaluating the performance of the team to support a high standard of evidence based clinical practice and patient safety, in order to fulfil clinical governance requirements.
- To participate in strategic planning, policy development and implementation in order to maintain and achieve national and local targets.
- To contribute to proposals for service development/improvement for presentation to the Trust Management Board.
- To be innovative and proactive in supporting change, in order to respond to the demands of the financial situation and the modernisation agenda.
- To promote effective communication with cancer services in order to agree an inter-professional approach to patient management and ensure equity of care.
- To contribute to the evaluation of the service using qualitative and quantitative methods and trust-wide practice in cancer prehabilitation, evaluating the results and recommending changes in clinical and service developments based on the outcomes.
- To attend meetings in which service developments are planned and discussed and contribute to progress updates as required.
- To keep information regarding patients and the data to evaluate the project as required.
- To liaise with organisations and agencies outside the trust as required.
Research and Service Evaluation
- To assist with clinical audit within the prehabilitation team.
- To undertake data collection, analysis, the production of reports and summaries, using IT and statistical programmes.
- To undertake searches of evidence-based literature and research to assist qualified staff in evidence-based practice and service development.
- To familiarise themselves with, and to comply with, the Trust’s requirements on research governance.
IT Responsibilities
- To maintain personal records including clinical observations, information, outcome measures and work records in accordance with trust policies.
- To enter undertake data entry and processing as required.
- To develop information governance systems for prehabilitation, shared with the wider cancer MDT and Nutrition and Dietetic service.
General
- To contribute to the development and maintenance of the highest professional standards of practice, through active participation in training and development programmes, in consultation with the postholder’s professional and team/operational manager(s).
- To maintain the highest standards of clinical record keeping and report writing in accordance with professional codes of practice and Trust policies and procedures.
- To perform other duties of a similar kind appropriate to the grade, which may be required from time to time.
- To attend and contribute to appropriate meetings for prehabilitation, Nutrition and Dietetics, and Cancer MDT meetings where appropriate.
- Managing a specialist clinical caseload.
- Frequent interruption from other staff requesting advice and clinical opinions
- 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 post holder.
CPD
- To gain wider experience of prehabilitation within an acute healthcare setting
- To develop skills and competencies that assist in the delivery of current duties including the development of skill sets within physical activity and psychological well-being.
- To participate in current Trust performance / development review systems (e.g. appraisal). Performance will be monitored against objectives set in appraisals.
- To remain abreast of recent developments in relevant areas of Dietetics and prehabilitation service delivery.
Physical Effort and Working Conditions
- Job requires sitting in restricted physical position, for substantial and prolonged periods of time during administrative tasks and appropriate clinical works, meetings etc.
- Job requires postholder to support the running of exercise classes on a weekly basis.
- Job may require exposure to distressing and/or highly emotional circumstances.
- Frequent daily manual handling of equipment; range of weights, sizes & shapes, and over varying distances
- Occasional manual handling of patients both with and without equipment; with a range of weights and disabilities
- Job may involve occasional exposure to unpleasant working conditions (e.g. body fluids, noxious odours, verbal aggression, visual exposure to treatment processes).
- Sometimes working in confined/cramped spaces e.g. space around beds on wards, or in patients own homes
- Occasional exposure to contagious conditions and bodily fluids
- Occasional management of patients who may become aggressive.
- Frequently working under pressure with heavy caseloads and time/staffing level constraints
- Frequent repeated concentration for sustained periods e.g. assessment, analysis and problem solving etc
- Work effectively and professionally with colleagues whilst maintaining emotional resilience.
- Maintain a positive and compassionate attitude.
- Create friendly, professional and welcoming interactions with patients, family members and colleagues across all aspects of the post.
- Job requires application of computer keyboard and IT skills.
- Frequent use of computers/ VDU equipment for long periods of time.
- The ability to drive or travel to community sites outside of GRH & CGH will be required.
- Work in areas where infection control policies must be observed.
- Constant interruption from other members of staff, medical professionals, including carrying a bleep, or mobile phone
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