Detailed job description and main responsibilities

1. Managerial:

1. To provide operational, administrative and advanced managerial support associated with the day-to-day functioning of the Orthoptic Stroke service and general Orthoptic Service, particularly in the absence of the Head Orthoptist.
2. To provide representation in the absence of the Head Orthoptist.
3. To be highly effective at prioritising and managing own clinical case load and administrative tasks associated with ward-based patients and outpatient examinations. To oversee other staff clinics as necessary and to have responsibility for patient flow within the Orthoptic Stroke Service.
4. To take the lead in the evolution and management of the Stroke Service with responsibility for service maintenance, development and promotion.
5. To be responsible for managing own adult patient clinics and paediatric hospital or community clinics within the general Orthoptic service. To determine and action appropriate outcomes for every patient seen.
6. Ensure effective and efficient use of physical resources, making recommendations regarding equipment and supplies. To ensure clinical equipment and work areas are well maintained, cleaned regularly, and ensure all clinical equipment is stored appropriately.
7. To formally appraise staff members, and action personal development plans arising from own appraisal. To contribute to attendance management and recruitment of Orthoptic department staff.
8. To provide clinical supervision to staff members and provide support/mentorship and training to junior staff members, especially those working as part of the Orthoptic Stroke team.
9. To be a key trainer for Orthoptic medical devices and to ensure competencies of staff remain high.
10. To demonstrate own clinical practice to other professionals e.g., paediatric SHO’s GP trainees and pre –registered optometrists.
11. To be an Orthoptic Clinical tutor having significant input to the training and assessment of Orthoptic students.
12. To regularly attend and actively participate in staff meetings. To lead in-house training programmes, journal clubs and presentations to enhance own and department continued professional education. To present at other clinical meetings outside the Orthoptic Department when requested.
13. Undertake reflective practice.
14. To keep up to date with research and new developments in Orthoptics, to ensure best clinical practice is maintained within the department. To actively take part in local and national research and be the lead for some research projects within the department. Disseminate acquired knowledge within the department to uphold a high standard of patient care.
15. Regularly initiate and participate in formal clinical and non-clinical audit, as well as specific service evaluations. Be able to gather and analyse complex data, drawing conclusions, and presenting information to benefit Orthoptic and Ophthalmology departments. Actively participate in implementing service improvements.
16. Regularly communicate with medical, optometry, nursing, other health professionals and clerical staff to maintain a high level of patient care.
17. To be involved in the development. Instigation and review protocols and SOPs within the department/directorate and contribute to the planning and development of Orthoptic services including enhanced clinical pathways.
18. To help ensure trust policies and procedures are adhered to and Health and Safety regulations are complied with.
19. Develop and update relevant patient information including service user feedback.
20. Act as a role model for the department, exhibit professional behaviour and treat all staff with dignity and respect. Take appropriate action to address behaviour inconsistent with Trust policies.
21. To help promote the Orthoptic profession both within the Trust and to external partners.
22. To be an active member within relevant BIOS CAG and local networking groups.
23. To maintain own HCPC registration.

Clinical:

24. To be a Lead Orthoptic expert for Orthoptic Stroke Services.
25. To provide the orthoptic service as part of a multi-disciplinary team within stroke. To also liaise with consultants, optometrists, and other health professionals as necessary within the general Orthoptic service. To provide advanced expertise as clinical Lead to clinical colleagues from other specialities and to develop effective clinical partnerships.
26.  Utilise highly specialist level of anatomical and neurological knowledge to formulate accurate diagnoses, prognoses, and multidisciplinary discharge plans as necessary.
27. To have an awareness of national guidelines of care and national audit requirements specific to Stroke services.
28. To manage own Orthoptic case load being independently responsible for assessing, planning, and monitoring treatment in a wide range of highly complex conditions, using extensive knowledge of evidence-based practice. To instigate the onward referral of patients to the appropriate medical professional advising on further investigations.
29.  To perform a comprehensive range of relevant investigative and diagnostic orthoptic procedures including Octopus perimetry evaluations for DVLA driving advice.
30. To produce individualised treatment plan as an autonomous practitioner using advanced clinical reasoning and significant clinical experience of a wide range of treatment, for patients of all ages.
31. Communicate effectively using a broad range of verbal and non-verbal communication mechanisms with patients, parents, and carers to gain informed consent and to assess if treatment is being understood and adhered to.
32. To take the lead in arranging for individual patients to discuss the decision and timing of surgery or other ophthalmic procedures e.g., Botulinum Toxin injections.
33. To undertake pre-operative and post–operative measurements of motility defects and to discuss surgical options and treatment plans with the surgeon. Analyse and discuss post-operative risks with patients (parent/carer) and surgeon. Modify treatment plans post-operatively if required.
34. To assist the surgeon in post-operative adjustable sutures.
35. To have high levels of manual dexterity, speed, and concentration to ensure accurate results especially in infants, or complex adults who will be having eye surgery. To have good hand-eye co-ordination and be proficient when using Orthoptic/ophthalmic equipment.
36. Accurately assess patients’ glasses prescription using manual and automated focimeters.
37. To accurately perform Visual Field assessments on Humphrey Field Analyser (HFA), Octopus and Goldmann perimeters (including monocular and binocular Fields of B.S.V), for patients with complex sight altering conditions, such as those attending with neuro-ophthalmological conditions. To interpret the test results using advanced clinical knowledge and work pro-actively with relevant consultants to formulate and implement treatment plans.
38. Have an ability to interpret OCT scans.
39. To be responsible as an autonomous practitioner for the decision to instil eye drops, under patient group directions, for refraction test and diagnostic purposes and to give advice of side effects.
40. To provide support for SEN Special School Screening including associated administrative duties.
41. To provide support for LaVSS and Blackpool school vision screening and complete associated administrative duties.
42. To assess patients with learning disabilities, adapting communication skills and examination technique, using a variety of quantitative and qualitative examination methods.
43. To Lead in the triage of new adult patient referrals using highly developed judgement skills, prioritising urgent referrals as required and allocating appropriate appointments, based on clinical reasoning.
44. Maintain accurate patient records in patient file or within Medisight, recording diagnosis and management plans and provide summary letters to optometrists, G.P’s, or other relevant professionals in a timely manner.

Physical Effort

 To aid in manoeuvring those patients who have difficulty with positioning for their Orthoptic examination, such as patients with disabilities, children, the elderly.

Mental Effort

To remain patient and flexible whilst working in a busy department within a role prone to interruptions and additional demands on time and workload.

Emotional Effort

 To retain a professional and sympathetic attitude in stressful situations e.g., where patients, parents or carers become emotional or challenging.

To remain sensitive where there may be exposure to unpleasant working conditions e.g., body odour, transmittable diseases, lice, bodily fluids.

To have a sensitive/emotive approach to patients who may not wish to accept their diagnosis and possible detriment to their quality of life. 

Working Conditions

To apply occasional adaptation of working posture during the Orthoptic examination, e.g., during eye movement or vision assessment of children or adapting to ward patients. This may involve mild discomfort if kneeling, bending, or leaning.