MAIN DUTIES:
1. Clinical 1.1. To be professionally, legally accountable, and responsible for all aspects of your work.
1.2. To work autonomously to provide expert dietary advice to patients, carers, nurses, clinicians, dietitians and other health professionals/agencies within and across the Trust regarding nutritional support and the appropriate use of nutritional products.
1.3. To assess and diagnose nutritional problems including malnourishment, taking anthropometrical measurements, interpreting blood biochemistry results, analysing dietary intake, and calculating nutritional requirements.
1.4. To develop, deliver and review complex treatment plans.
1.5. To be responsible for ensuring appropriate authorisation/prescribing of nutritional sip feeds and enteral feeds for patients and recommend products to GPs and medical staff.
1.6. To communicate complex scientific and sensitive medical information in an understandable form to patients from a wide range of backgrounds, carers and families, tailored to their needs, gain consent, ensure understanding of the condition, treatment options, risks, acceptance and compliance with dietary treatment, which may include unwelcome or difficult to accept information e.g. lifetime adherence to artificial diet or limitations of treatment in terminal illness.
1.7. To apply highly developed communication, negotiation and counselling skills to facilitate behavioural changes, investigating and accommodating emotional, physical, social and psychological barriers as well as strong influences on change e.g. depression, dementia, language difficulties, resistant attitudes, aggression, behavioural problems, mental illness, and loss of speech after stroke or oral surgery. To effectively use interpreters, sign language, Information Technology or other means of communication appropriate to the client's requirements.
1.8. To be an expert source of information and advice to patients/carers and nursing staff on the use of artificial feeding, care of feeding equipment, stoma site, complications and problem-solving. To discuss and challenge complex ethical issues or decisions with service users and health professionals e.g. whether to continue feeding or not.
1.9. To promote multi-disciplinary/multi-agency collaborative working to ensure continuity of care. Attend multi-disciplinary team meetings and case conferences. To provide timely and informative patient progress reports/discharge summaries to secondary, primary care and local authority/social services.
1.10. To refer to other health professionals/social services when appropriate.
1.11. To network and work in partnership with established clinical networks e.g. nutritional support, diabetes, paediatric specialist groups and mental health dietitians. To work with other disciplines/agencies e.g. public health department, prescribing leads, nurse leads, falls service and Palliative Care service to support prevention as well as treatment.
1.12. To keep contemporaneous, accurate and comprehensive notes and records for each patient using electronic patient systems (SystmOne)
1.13. To support, advise and provide clinical supervision to your team members regarding complex patients
2. Professional
2.1 To review, critique, develop and advise on up-to-date, accurate nutrition education materials
for use by the dietetic team, other health professionals and the general public. To use critical appraisal skills and pilot resources with user
2.2. To work as a team member and attend and contribute to regular departmental meetings, clinical updates and practice supervision.
2.3. To work under minimal supervision, as a lone worker in the community including at a clinic or, patients homes, hospitals, community and primary care sites, and nursing and residential homes.
2.4. To be responsible for managing time effectively, planning, prioritising, assessing risk and organising your own workload, and balancing professional demands, pressures and deadlines.
2.5. To lead in the area of dietetic prescribing development for Ealing
2.6. To respond accurately to nutritional enquiries from the Media and other non-NHS organisations.
2.7. To be accountable for the effective use of oral nutritional supplements in Ealing, monitoring spend and ensuring cost effective prescribing practices of the whole team across hospital and community
3. Teaching/Nutrition Education 3.1.To lead in identifying, assessing, planning and coordinating the delivery of nutritional support training/education (screening, food fortification, dietary modification and appropriate use of supplements) to professionals working in Ealing, e.g. nurses, medical staff, Residential and nursing homes, catering staff, allied health professionals, pharmacists, Social Services.
3.2.To induct new members of the nutrition support team, Diabetes Education Service and dietetic team.
3.3.To plan, assess and deliver student training to student dietitians and to other students e.g.
nursing, AHP and medical.
3.4.To plan, deliver and evaluate health promotion sessions to prevent malnutrition in vulnerable community groups e.g. Help the Aged. To engage in service user feedback in the community to ensure service users needs are focused upon.
3.5.To provide peer supervision, training and development for your team members and dietetic staff in nutritional support
4. Management
4.1.To develop, implement and oversee compliance with the local standard operational procedures (SOPs) within the Department.
4.2.To lead the Nutrition and Dietetic service, and line manage the Diebetes education service to develop, establish and monitor systems of patient review including setting up clinics in various locations across the borough, domiciliary visits and telephone reviews. To allocate clinics to nutritional specialists and ensure the service runs efficiently.
4.3.To recruit, select and retain your team members including specialist dietitians, nutritional, support workers and administrative staff.
4.4.To provide clinical leadership, supervise, train and develop nutritional support specialist dietitians and nutrition assistants in the area of nutritional support. Ensure the team has annual appraisal, job plans and personal development plans.
4.5.To provide support to the wider CNWL dietetic teams, as appropriate and agreed with the Head of Service. To ensure role development and competency guidance and assessment are in place for lower banded roles to include support workers.
4.6.To work in conjunction with the Ealing Service leads to develop the strategic direction for the service in line with Trust objectives, commissioning intentions and national modernisation initiatives.
4.7.To be accountable for the effective use of oral nutritional supplements in Ealing, monitoring spend and ensuring cost-effective prescribing practices of the whole team across the rehab unit and community.
4.8.Where required, to order equipment and feed for patients and authorise invoices for the nutrition support service.
4.9.To contribute to the development of programmes for cost improvement, income generation and proposals for monitoring the effective use of resources.
4.10.To be responsible for the leadership, development, clinical performance and day-to-day operational management of members of the team.
4.11.To monitor absence, and sickness monitoring and deal with performance issues for the Team members.
4.12.To work with other dietetic leads including the Head of Profession (HOP) within CNWL to deliver the Trust AHP strategy.
5. Clinical Governance 5.1.To lead in the development of audit and research activity within the nutrition support service. To communicate and publish the results, make recommendations for changing clinical practice and ensure changes are implemented and reviewed. To measure and evaluate service activities to ensure evidence-based practice and reflective learning.
5.2.To lead dietetics with other band 8 dietetic posts, NWL and trust-wide or across Trust multidisciplinary working group meetings around nutritional support.
5.3.To produce and establish updated, evidence-based packages of care, protocols/policies/guidelines/standards/resource materials for the management of nutritional support.
5.4.To ensure multi-disciplinary groups and carers/patients are consulted. To be a member of working parties e.g. Nutritional Support Lead Dietitians across NWL and nationally to share and instigate best practices. To produce statistical information as determined by the Departmental and Trust objectives and key performance indicators.
5.5.To be responsible for equipment in your care e.g. scales, tape measures, Callipers, laptops, enteral feeding equipment and feed samples, and maintain an asset register.
5.6.To be responsible for allocating operational and clinical governance tasks to the team and supervising delegated tasks.
5.7.To contribute (through analysing, reviewing and commenting) to the development and implementation of evidence-based departmental nutrition and dietetic clinical and nonclinical standards, policies, procedures and guidelines.
5.8.To contribute to the implementation of national and local agreed strategies, initiatives and NICE guidance e.g. National Service Frameworks, Nutrition support Policies and guidelines.
5.9.To deal with complaints, manage risk investigate incidents and ensure patient satisfaction with the service is high.
5.10.To and act in accordance with the Code of Professional Conduct of Health Care Professionals Council, Dietetic standards and Trust policies and procedures.
5.11.To develop and maintain highly specialist knowledge and skills required to practice in the area of nutritional support and in managing staff.
