Job responsibilities
JOB PURPOSE
- To provide a specialist SLT service within the Band 6 rotation to patients from stroke, acute (medical and surgical) and Critical Care wards at University Hospital Lewisham, Queen Elizabeth Hospital and those based in the community and those who are enterally fed and known to the Home Enteral Nutrition Team
- To assess, diagnose and manage adult clients with acquired swallowing and\or communication disorders, using sound theoretical knowledge to inform advice, support and therapy.
- To work closely with the Multidisciplinary Team (MDT) in the management and discharge planning of these patients in an acute setting
- To work as part of an integrated interdisciplinary Home Enteral Nutrition team
- To assist the Head of Speech and Language Therapy with service evaluation and development
KEY RELATIONSHIPS
Site Lead SALT
Home Enteral Nutrition Team Service Lead
Highly Specialist Speech and Language Therapist - Acute Care
Highly Specialist Speech and Language Therapist Stroke
Highly Specialist Speech & Language Therapist HEN Team
L&G Acute & Stroke Consultants
All Therapists/Leads in Occupational Therapy / Physiotherapy / Dietetics
All L&G Speech and Language Therapy Staff
L&G nursing staff
Referring Hospitals
Social Services
Community Services
Home Enteral Nutrition Team MDT & Community Head & Neck Team
GPs
Voluntary Services
Academic Institutions
Acute & Stroke Specialists external to L&G
Home Enteral Nutrition Team patients are seen in 2 additional London Boroughs: Southwark and Lewisham with equivalent key relationships
DUTIES AND RESPONSIBILITIES
1.0 Clinical
1.1 To use specialist skills to assess, differentially diagnose and manage complex patients with acquired swallowing and communication disorders from the stroke, acute and critical care wards at University Hospital Lewisham, Queen Elizabeth Hospital, and community services according to the rotation.
1.2 To manage and prioritise patient caseload independently, taking into account a complex range of clinical, practical and contextual factors, such as service availability and the need to carry out additional duties
- To further develop skills in the assessment, differential diagnosis and management of patients with tracheostomy who have swallowing and communication impairments and to provide input to these patients for tracheostomy weaning with support from senior colleagues.
- To be highly flexible to the demands of the environment including unpredictable work patterns, deadlines and frequent interruptions
- To demonstrate developing clinical skills for interpretative assessment techniques and interventions in the care of patients with tracheostomies, including those requiring ventilation on the Intensive Care Unit.
- To develop and demonstrate specialist clinical skills for interpretative assessment techniques and interventions involving instrumental procedures e.g. videofluoroscopy and FEES.
- To ensure effective joint working with the Multi-Disciplinary Teams in the management and discharge planning of patients within the caseload.
- To undertake training by the HEN Nutrition Nurses and Dietitians in order to meet the needs of home tube fed patients by carrying out multidisciplinary assessment and review of patients
- To collaborate with HEN team members and carry out extended, interdisciplinary roles including nursing and dietetics to ensure that patients receive care and advice on all aspects of tube feeding at home. Delegated tasks from nursing and dietetics are performed after competency based training and are within RCSLT scope of practice guidelines
- To negotiate therapy goals with patients, their carers and the multidisciplinary team (MDT).
- To provide information, support and training to relatives and patients
- To employ counselling skills with patients and carers with highly complex needs including those related to terminal illness, death and severe disability or disfigurement.
- To participate in MDT decision-making process around consent to treatment (e.g. PEG and non-oral feeding) taking full account of the legal and ethical considerations.
- To write therapy programmes to be carried out by the speech and language therapy assistant.
- To demonstrate specialist knowledge in the area of the current rotation, underpinned by current evidenced based practice.
- To attend relevant training and development in order to maintain and develop skills and knowledge required of a specialist therapist working in the respective fields. To maintain HPC and RCSLT registration and ensure it is up to date.
- To keep up to date with new techniques and developments for the promotion and maintenance of good practice in your clinical area.
- To write reports for other professionals reflecting your knowledge of communication and swallowing.
- To communicate complex condition related information from assessment and intervention to clients, carers, families and members of the multi-disciplinary team/other professions.
- To attend ward rounds, case conferences, rehabilitation meetings and other multidisciplinary meetings. To ensure a two-way exchange of information with these parties to help decide on the best course of intervention for each individual.
- To demonstrate empathy with clients, carers and families and colleagues, ensuring that effective communication is achieved, particularly where barriers to understanding exist.
- To demonstrate clinical effectiveness by the use of evidence based practice and outcome measures.
- To provide advice on speech and language therapy to non-specialists and other specialists/professionals within clinical field.
- To maintain up to date and accurate case notes in line with RCSLT professional standards and local trust policies.
- To participate in the development and delivery of training (formal and informal) to others in area of clinical expertise.
- To have due regard for your own personal safety and that of clients and carers, in particular to have regard to moving and handling regulations, restraining policies, lone working and ensure the safe positioning of self and others
- To monitor stock levels in own service area and request new equipment as appropriate
2.0 Organisational
2.1 To be aware of, adhere to and implement service and team plans and policies.
2.2 To use your specialist knowledge to inform service/policy developments as appropriate
2.3 To attend meetings at the request of the service manager.
2.4. To consult with service users regarding service developments wherever possible, within existing resources.
2.5 To participate in and develop innovations in areas of risk management, quality standards setting and clinical effectiveness within Speech and Language Therapy and the Trust in general.
2.6 To develop care protocols/packages informed by the evidence of your clinical specialism in liaison with your supervisor and/or service manager.
2.7 To develop Clinical Governance/audit projects within the speech and language therapy services.
2.8 To develop local clinical guidelines informed by the evidence of your clinical specialism.
2.9 To demonstrate the ability to reflect on your practice with peers and mentors and identify your own strengths and development needs
2.10 To participate in Personal Development Reviews ensuring that the objectives set reflect the Service and Trust plans, including specific objectives relating to the clinical specialty.
2.11 To keep accurate and complete records of the amount of time spent on clinical activities in order to monitor effectiveness and facilitate service delivery.
2.12 To contribute to interagency/multi-disciplinary team building
2.13 To assist with the identification of training needs within the team.
