Job responsibilities
Patient Care
As a key member of the Multidisciplinary Wound care team, you will be a lead clinician in the management of a complex wound care caseload. Taking responsibility for all patients in that caseload and direct duty of care for the most complex and challenging patients in that caseload,
You will undertake regular review of the wound care caseload, ensuring timely transfer and referral of patients along the wound care pathway, as the wound progresses or deteriorates
To provide clinical support to other caseload leads as required, during planned and unplanned absences
Working in the acute foot service as part of the multidisciplinary team, you will take the lead role in the advanced assessment, diagnosis and treatment of patients who have complex pathology which puts their lower limb at increased risk of ulceration, infection and/or amputation, in a timely manner, to help avoid unnecessary emergency admissions
To act as a source of clinical expertise (in the advanced assessment, diagnosis and treatment and management of patients who have lower limb risk pathology) and lead co-ordinator of care to all other Lewisham Healthcare Trust professionals (including medical consultants, GPs and nurses) involved in the management of people with complex foot wounds and other complex pathology (e.g. charcot arthropathy).
To utilise advanced podiatric skills in the care of the patient with a lower limb wound/ulcer site. To review aetiology and pathology of the site, determining diagnosis, rationale for treatment, care plans and appropriate referral.
To carry and respond to a bleep for emergency assessment of patients in other locations e.g. A&E
To administer appropriate drugs and medicines in line with legal requirements and the Society of Chiropodists and Podiatrists code of professional conduct, recognising contra-indications and relevant risk factors in each individual patient.
To competently use advanced wound care knowledge to aid the selection of the most appropriate choice from a range of specialist dressings.
To utilise enhanced, evidence based, wound healing techniques such as Negative-pressure wound therapy (NPWT) and larvae therapy to promote safe and efficient healing techniques.
To competently use knowledge of advanced and customised pressure relieving strategies used in the management of diabetic foot disease and foot wounds
To use fibreglass casting techniques for the redistribution of plantar pressure by manufacturing casted pressure-relieving boots and total contact casts.
To have and use in depth knowledge of conditions that can impact on the feet such as diabetes, rheumatoid arthritis, peripheral vascular disease and dermatological conditions to support assessment, diagnosis and treatment planning,
To have and use in depth knowledge and skills to support the diagnosis and treatment of foot pathologies related to diabetes, rheumatoid arthritis, peripheral vascular disease, neuropathy and all other medical conditions that impact on tissue viability of the feet. Identifying when the diagnostic and treatment skills are outside the scope of practice of an advanced Podiatrist, referring on to an appropriate clinical specialist in a timely manner
To communicate all necessary information, and provide expert knowledge, efficiently and effectively with relevant colleagues, carers and with the patient.
To promote a patient centred approach to patient care.
To work autonomously, and to work collaboratively, with multidisciplinary teams and across other health care providers/agencies, and where necessary, to refer on appropriately for other specialist care such as vascular opinion, biomechanical assessment, orthopaedic intervention etc.
To undertake health promotion activities when required.
Where indicated, to assess, explain and obtain consent to carry out nail ablation surgery using local anaesthesia to achieve digital nerve block.
To maintain accurate, comprehensive professional case notes of all direct and indirect patient contact.
To be professionally and legally responsible for all aspects of the post holders own work.
To effectively communicate with Foot Health Departments of other Trusts to support the transition of care, or joint management, of individual patients.
Educational Role
You will use your wound care caseload lead position and expert clinical knowledge/skills to provide clinical support, supervision and direction to other Podiatrists undertaking clinical placements in the acute foot service.
To participate in theoretical and clinical teaching of the high-risk foot to colleagues within the Foot Health Service to ensure that staff can attain high levels of knowledge and provide quality care to patients.
To participate in the education and development of health care professionals from other disciplines within the hospital and community, with the aim of increasing staff awareness of the care required and the risks involved with foot ulceration and improving the quality of foot care provided by other health care professionals.
To act as a source of clinical expertise and advice, and as a resource for other team members, providing clinical leadership within the team.
Service Development
To work collaboratively with the Principal Podiatrist for wound care and the Lead Podiatrist for Diabetes, with an aim of continually improving clinical practice within the Foot Health Service. This may influence service delivery, clinical protocols, business planning and strategic reviews to support the delivery of the foot health plan.
To actively participate and contribute to the development of the service operational and development plan, leading on delegated projects.
To attend multidisciplinary team and educational meetings as directed by the Principal Podiatrist for wound care
To achieve effective daily management of the departments patient caseload, prioritising and balancing responsibilities for both patient related care and other professional duties.
To participate in the development, ratification and application into practice of guidelines, policies and procedures in relation to foot ulcer care.
To propose, develop and follow through to ratification changes to departmental protocols and procedures.
To evaluate treatment outcomes utilising such information to support both research and audit pathways.
To support the team in developing and implementing specialised clinical training programmes and in service training for podiatric staff and other professionals.
To implement a training programme for staff in Lewishams Community Foot Health Services.
Workforce
To be able to work autonomously at times, and at other times whilst work collaboratively as an integrated team player, within the hospital multidisciplinary teams and across other health care providers/agencies where necessary
To provide guidance, supervision and performance management to all podiatrists within the Foot Health Service in relation to wound care and the management of the high risk foot.
To lead and provide support to band 6 podiatrists undertaking wound care within your caseload
To undertake annual appraisal and objective setting of up to 3 band 6 Podiatrists, ensuring the objectives are in accordance with the service and Trust clinical governance and business plans and the individuals CPD and career development requirements.
To ensure that all line managed staff have an individual development plan, which is updated at least annually and is reported in a timely manner to the Foot Health Manager and Trusts workforce development team.
To hold regular 1:1 meetings with team members, to review progress, giving support and guidance where necessary.
To provide effective guidance, supervision and performance management, including education of students on observational placement and community staff on practical placements.
To ensure team member absences are reported in line with the Trusts sickness and absence policy.
To evaluate and interpret clinical information from diverse sources and make informed judgements about its quality and the appropriateness for disseminating it to colleagues.
To provide treatment that is consistent with evidence-based practice and legislation, yet using ones own expert knowledge, experience and judgement to identify the best and most appropriate treatment for patients that frequently present with complex co-morbidities. At times this will require analysis of the benefits and risks of any planned treatment
Main patient groups dealt with are people with complex co-morbidities (e.g. diabetes, peripheral vascular disease, end of life,) with active foot ulceration and at high risk of infection/amputation
