Job responsibilities
JOB
PURPOSE
To
take a clinical lead role in the Foot Health team taking responsibility for
the advanced assessment, diagnosis and specialist treatment of high risk
patients within the hospital environment. These will include all consultant
based referrals. The post holder will provide specialist podiatry advice to
any appropriate hospital or primary health care professional. The post holder
will have the ability to make a clinical diagnosis and provide treatment to
ensure appropriate patient care within their scope of professional practice.
3. JOB DIMENSIONS
To provide clinical leadership to a
highly motivated team, providing a high standard of clinical care to all its
users with a priority for specialising in the areas of musculoskeletal (MSK)
services, wound management (acute and chronic) and as a key member of the
surgery MDT(s).
To act as a specialist liaison
between referring agents with regard to clinical finding, proposed
treatments, outcomes and further investigations along with communication of
such findings to primary care workers, multi disciplinary teams and other
health care professionals.
To conduct clinical and diagnostic
ultrasound assessments, vascular ABPI assessments, triage of surgical cases
in conjunction with the orthopaedic foot and ankle surgery team and under
take the appropriate treatment of all lower limb pathology in out-patient
clinics including preoperative clinical clerking and post-operative care to
meet service demands.
To provide advanced clinical
assessment, diagnosis and treatment of in and out patients as well as Leeds
Teaching Hospital NHS staff.
To identify, develop and implement
strategies to improve patient care through the development and adherence to
Foot Health Department and Leeds Teaching Hospitals NHS Trust (LTHT)
policies, protocols, strategies, objectives
in conjunction with departmental and Trust business plans. Adherence
to Health & Care Professions Council, Society of Chiropodists and
Podiatrists, DOH, NICE guidelines and Health and Safety guidelines.
To provide mentorship, training and
supervision to students and colleagues from Podiatry, Physiotherapy and other
health care professionals.
To be familiar with the
administrational and clerical duties of the FHD.
To lead and provide strategic
planning and development in the delivery of clinical services.
To use advanced theoretical and
practical knowledge to know when and how to seek further advice and/or
diagnoses from other specialties in LTHT.
To be able to prioritise, organise,
allocate, delegate and triage referrals to optimize patient care.
Actively participate in the
planning and delivery of staff meetings and co-ordinate in-service training.
KNOWLEDGE,
SKILLS AND EXPERIENCE REQUIRED
Diploma/Degree in Podiatry.
Local anaesthesia certificate.
Supplementary or independent
prescribing qualification
Post graduate specialist training
to Masters level qualification
Maintain comprehensive case notes
in accordance with the Legal requirements set down the Society of
Chiropodists and Podiatrists, LTH Trust policies, DOH NICE guidelines and
departmental protocols/policies.
Adhere to the Society of
Chiropodists and Podiatrists, DOH, NICE and Health and Safety guidelines. To
keep registered with the HPC and adhere to their guidelines.
Highly complex clinical skills in
the management of musculoskeletal diseases, wound care and surgery should be
evidence based and updated using relevant identified means e.g. appropriate
journals, courses, portfolios, professional guidelines etc.
To be responsible for the podiatric
assessment, diagnosis, planning, implementation, delivery and evaluation of
highly complex conservative and surgical podiatric interventions which may
include:-
Initiating
biomechanical/musculoskeletal treatment and provision of orthoses/exercises
and referral to other hospital specialists or community podiatrists as
appropriate.
Administering
local anaesthetics and other drugs subject to approved Patient Group
Directives (PGD), supplementary prescribing clinical management (CMP) plans
or as an independent prescriber.
Developing,
using and updating PGDs.
Generate
or be involved in the development of new LTHT guidelines e.g. Rheumatology
pathways, antibiotics etc
Where
appropriate undertake soft tissue surgery to the foot.
Nail
surgery using where appropriate incisional or excisional techniques.
Tissue
closure using sutures where appropriate.
Undertake
neurological and vascular assessments.
Provide
foot care and footwear advice or referral to appliance department for
appropriate footwear.
Independent
requesting of diagnostic x-ray, ultrasound imaging or CT, MRI, Bone scans
after consultation with a consultant radiologist as to the relevance.
Undertake
diagnostic ultrasound imaging and interpret the findings in conjunction with
a consultant rheumatologist.
Independent
requesting of Nerve Conduction studies.
To
make comprehensive clinical judgement on whether Podiatry or surgery would
benefit the highly complex patient.
Direct
triage and referral of highly complex patients needing surgery to the complex
foot and ankle clinic with the patients General Practitioners knowledge.
To undertake the assessment of
patients prior to nail surgery and where applicable soft tissue and joint
surgery. This may include:-
Obtaining
a full medical and social history with particular emphasis on risk factors
pertaining to surgery. This will include risk factors specifically attached
to rheumatology and diabetes patients e.g. biologic therapies and other
immunosuppressive drugs, and vascular pathologies.
Requesting
diagnostic tests such as blood tests, thrombophylic screening and liaison
with Haematology departments with regards to INR values. Blood glucose
tolerance tests and HbA1c.
Undertake
lower limb vascular assessment using doppler, ankle brachial pressure indexes
and blood pressure analysis.
Interpretation
of advanced test results and there clinical significance.
Requesting/prescribing
appropriate pre/post operative antibiotics.
Co-ordination
of wound care with community patient services.
To undertake post operative patient
care which may include:-
Post
op assessment/progress and monitor for signs of complications including
infection, deep vein thrombosis and complex regional pain syndrome.
Acute
and chronic wound and wound dressings management.
Suture
removal where appropriate.
Advice
on post operative care.
Provide
support and leadership in managing discharge of the patient.
Be aware of Health and Safety,
Trust and Departmental policies.
Be able to give comprehensive
lectures to Podiatry and other Health Professionals, promoting quality
evidence based practice.
To have the ability to lead audit
and research and support other members of the team in conducting audit and
research.
Advanced professional knowledge
acquired through Podiatry degree and HCPC registration and post graduate
training.
Extensive experience in
musculoskeletal diseases, wound care, and surgery services and procedures.
Highly experienced in assessing,
diagnosis, interpretation and treatment of complex high risk patients.
To have highly developed physical
skills, precision hand eye co-ordination for prolonged periods in the use of
local anaesthetics, scalpel work, surgical procedures and techniques.
Be able to communicate highly
complex medical information or gain consent when dealing with high risk
patients. These include patients with complex conditions or multiple
pathologies. This includes patients with emotional, physical and
psychological conditions which will require the expertise of verbal and non
verbal communication tools.
Be responsible for maintaining
personal and clinical hygiene. This includes maintenance of sterile fields
where necessary.
To participate in the
identification and trial of new equipment and products.
To be actively involved in the
provision of foot health education and advice to patient, relatives, carers
and to participate in foot health training where appropriate.
To provide clinical leadership to
podiatrists working in this field and act as a source of clinical expertise,
providing highly specialist support to other clinicians and healthcare
professionals both from within and outside of the organisation.
To be able to provide specialist
knowledge for the development of local, regional and national guidelines and
to use specialist knowledge to support local, regional and national care
organisations.
6. CORE VALUES
The
post holder will be honest and be able to demonstrate good learning outcomes
from any given situation whether guided or unguided. This will include
outcomes from audit, research, reflective practice, PDP, appraisals,
disciplinaries, benchmarking.
7. CORE BEHAVIOURS AND SKILLS
The
post holder should be able to demonstrate calm rational behaviour when
dealing with any patients or employees of LTHT. There will be the ability to
check quality performance either by self or in conjunction with other
parties. This will allow for case conferences, care pathway investigations
and results to maximise learning outcomes. There should be the ability to
converse at local levels of Health Professionals and Management with regards
to listening, reflective practice and self analysis. Highly developed
physical skills for scalpel, surgical and dexterity purposes are required.
Specific
behaviours will include
Established
clinical expertise
Professionalism
Smartly
dressed
Responsible
Appropriate
time keeping
Be
polite at all times
Communicate
problems effectively and appropriately
Self
motivated
Be
able to work in partnership within the department
