Job responsibilities
Communication and working relationships
To work as an integral member of the surgical MDTs including, but not exclusively the Colorectal Team, Upper GI team, stoma team
To communicate and establish working relationships with:
Nutrition Support Team and Nutrition Nurse Specialists
Surgical MDTs, rehabilitation teams, and nursing teams
Allied health professionals
Home Enteral Feeding (HEF) dietitians and HEF Team
Catering department
Other dietitians, locally and regionally to share best practice
Students dietetic and other professions
Other health and social care professionals
Planning and organisation
To manage own time and clinical caseload as an autonomous practitioner within the surgical gastroenterology service
To plan, organise and develop the dietetic service in surgical gastroenterology, with support from the dietetic team leads, head of service and gastroenterology teams
Actively evaluate the dietetic service provided, for example, identifying the strengths of service provision, patient activity statistics, health outcomes and patient satisfaction (e.g. Friend and Family Tests) and any areas for development.
To plan, organise, deliver, and evaluate training sessions to a variety of groups including health and social care professionals and patients. Training may be face to face or virtual platforms.
Responsibility and accountability
To be the nutritional lead in the surgical gastroenterology team to ensure patients have high quality nutritional care
To deliver Dietetic care to a caseload of complex adult patients in collaboration with the gastroenterology MDT and other MDTs as required
To provide a source of expert knowledge and advice on nutrition to the service
To be a lead liaison between the acute team and the catering team, partaking in monthly meetings and advising on menu content and special diets for patients
Responsibility for patients and client care
To provide referred inpatients and outpatients with evidence-based, individualised, disease specific nutritional care plans as part of the NST and surgical MDTs. Main responsibilities are:
To advise on commencing and continuation of parenteral or enteral nutrition, often transitioning between routes dependent on clinical situation, gut anatomy and function.
To be a key member of the Nutrition Support Team and surgical MDTs managing a caseload of both inpatients and outpatients receiving parenteral and/or other routes of nutrition support.
Regular review of this caseload, undertaking nutritional assessments to ensure efficacy of nutrition support, (this will include interpretation of nutritional status with comphreshensive nutritional assessment, calculatation of disease specific nutritional requirements using knowledge and evidence-based practice, requesting and interpreting biochemistry, measuring anthropometry, consideration of clinical situation, communicating with both local and national intestinal failure units details of care which may be shared. Discuss, agree and make clinical changes where necessary.
To use behaviour change and advanced communication techniques to support and aid compliance with recommended dietary/nutritional treatment plans
To explain treatment plans (verbal and or written) in an easily understandable way to patients, carers and relatives and other relevant individuals, to enable patients to make informed choices about their own health
To provide resources such as patient information leaflets, recipes and menu plans and to signpost them to other resources where appropriate (e.g. NHS patient webinars, relevant charities and support groups).
To provide dietetic care with empathy for people requiring long-term nutritional interventions (including those who may be in the end stages of their life) considering emotional, ethical and social developments in addition to clinical situation
To be pro-active in initiating appropriate dietetic treatment and/or referral, and to signpost to other appropriate services
To understand and be fully aware of the range of oral nutrition support products, enteral tube feeds, parenteral nutrition bags and associated equipment
To be a key member of relevant MDTs; providing a source of expert knowledge and advice on nutrition, being actively involved in MDT discussions (inpatient and outpatient settings) and decisions around nutritional care and feeding for patients, including medically, socially and ethically challenging situations (e.g. decision making around feeding routes, patients lacking mental capacity or being treated under the Mental Health Act, end of life care, best interest meetings and safeguarding).
To liaise closely with ward teams and catering staff to support the provision of appropriate diets
To ensure safe and timely discharge and ongoing care of patients from hospital to home receiving parenteral and/or enteral nutrition support, with the support of the NST, ward staff and home enteral feeding team/home parenteral nursing teams
To advise parenteral nutrition and off script enteral tube feeds for home use
To provide support where quality or safeguarding issues have been identified
Policy and service responsibility
To contribute to the writing of policies, protocols, resources and guidelines relevant to this role, with the support from MDTs and dietetic teams
To provide resources such as patient information leaflets, recipes and menu plans
To contribute to the wider service development of the dietetic service
To attend other relevant team meetings which may include related surgical MDT management meetings, dietetic meetings, local and national service provision meetings (virtually where possible)
To lead on advising developments and changes for hospital menus in line with national guidance eg BDA Digest and report into Nutrition & Hydration Steering Group
Responsibility for finance, equipment and other resources
The post carries no budgetary responsibility
To take anthropometric measurements to assess nutritional status, including the use of weighing scales, callipers, grip strength during patient assessments
To promote the clinical and cost-effective use of nutrition support products for example, when inpatients are discharged from hospital into the community
Responsibility for supervision, leadership and management
To provide nutrition expertise to relevant teams and across the trust
To provide clinical support and supervision to dietetic support workers and Band 5 dietitians, which may include monthly 121s and annual achievement reviews, supported by the Team Lead and with appropriate training
To delegate and supervise tasks to dietetic support worker and other members of the support team
To support and supervise other members of the acute dietetic team, providing cross cover as required
To participate in the training of student dietitians and students of other professions
To provide cover for specialist dietitians (with appropriate training) during periods of leave
To actively support own wellbeing, as well as to support the wellbeing of the other members of the team
Information technology and administrative duties
To use Attend Anywhere or equivalent for patient assessments, when clinically appropriate
To prepare own presentations, reports, and documents
Maintain clinical records including dietetic records and GP letters and in line with professional and departmental standards. Use electronic patient records where available
To work within the requirements of Data Protection legislation and access to health records
To communicate via email, social media and other internal IT systems
To use Microsoft Teams to attend meetings and deliver training and education virtually, and virtual patient education groups
Use IT to project manage and collect data for service evaluation
Responsibility for research and development
To be responsible for own continued professional development and be proactive within annual Achievement Reviews and monthly 121s with Team Lead
To liaise with other specialist dietitians
To work within the HCPC (Health and Care Professions Council) Standards of Conduct, Performance and Ethics and the BDA (British Dietetic Association) Code of Professional Conduct
To proactively identify and undertake project work to develop the service to provide high quality nutritional care to patients
Produce reports/summaries to monitor, evaluate and provide feedback about the service
To identify and participate in relevant audit and research projects to evaluate nutritional care with the support of team lead, NST and surgical MDTs.
