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Detailed job description and main responsibilities

Job Summary:

1. Specialist Dietitian in the provision and the service development of the paediatric dietetic service provided by the HEN team across Lewisham, Lambeth and Southwark.
2. To autonomously assess and treat a specialist dietetic caseload of children receiving HEN, liaising with their families, carers, acute and community staff. This could be in the patient’s own home, clinics, nursery or school
3. To provide specialist paediatric dietetic advice and training to patients, carers and all other health professionals
4. To write, update, disseminate and implement policies and procedures related to Paediatric Home Enteral Feeding. These policies would impact all Health Care Professionals involved in Home Enteral Nutrition
5. To regularly undertake research and audit in specialist area

Key Result Areas & Performance:           

Clinical Duties and Responsibilities

Communication and Relationship Skills 

• To provide expert, specialist, evidence based, dietetic advice and care to paediatric patients and their carers regarding home enteral nutrition. Communicating highly complex and sensitive information on nutrition using negotiation, counselling and behavioural change skills.

• To work autonomously when assessing patients, making clinical decisions, selecting treatments and evaluating outcomes of dietetic interventions.
  
  
• To collaborate with team members to ensure the patient receives care and advice on all aspects of tube feeding at home. This will require particularly close liaison with the Children’s Community Nursing Team and Speech and Language therapists.

• To develop and maintain close communications with all health care professionals (Consultants, GPs, Acute Dietitians, Children’s Community Nurses, SALTs, School Teachers, School Nurses, Social workers, Portage workers), private sector companies and other agencies as necessary in order to provide co-ordinated patient centred care.

• To arrange visits/clinics for patients and their families at the various children’s centres, schools and nurseries. Attend, where appropriate, local hospital or community meetings and clinics with other members of the MDT.

• To work with families who may have learning disabilities, mental health problems and challenging behaviours
  
  
• To work with patients who have language barriers to effective communication. This may often require the use of interpreting services via the telephone or with a relevant interpreter at the patient’s place of care.
  
  
• To empathise, communicate and reassure families who may be dealing with unpleasant circumstances/diagnosis relating to their child. This may include relaying additional unwelcome information relating to the long term nutritional requirements of a child.
  
  
• To use motivational and negotiating skills to facilitate acceptance and ongoing compliance with nutritional treatment plans.

• To act as a keyworker to certain families. Besides acting as an emotional support for the family the Dietitian will be responsible as the organisational link between all health professionals involved in the acute and community settings ensuring consistency of services.
  
  
• To be involved with children and their carers placed on the child protection register. The dietitian will be responsible for receiving highly confidential, complex and sensitive information and will act within Lewisham and Greenwich and Guy’s and St Thomas’ Paediatric Community Services child protection policies.
  
  
• To document all activities concerning patient care in the paediatric dietetic patient record notes including all confidential correspondence with health care professionals and enteral feeding delivery company in accordance with trust policies.

• To be responsible for ordering and changing regimes for all enteral feeds and tube feeding ancillaries.

• To produce timely and informative reports for Consultants, Paediatrician, GPs and other health professional relevant to a specific family.

• To negotiate with carers, clients and other members of the multi-disciplinary team around individual case management and to provide support to other team members and health care professionals in the specialist area of home enteral tube feeding.

Analytical and Judgement skills

• To make all clinical decisions and judgments autonomously guided by broad professional and organisational policies.
  
  
• To implement specialist clinical dietetic assessment, treatment and management of patients referred to the HEN team. This will include the advising, ordering and prescribing of specialist products listed as ACBS (Advisory Committee on Borderline Substances).

• To analyse dietary intake and calculate nutritional requirements using clinical judgement and experience as well as computer software as required when completing a treatment plan for a specific patient.

• To be trained to trainer level in the use of anthropometrics equipment for the assessment of nutritional status such as skin fold callipers, portable and hoist scales, enteral feeding pumps and equipment.
  
  
• To take anthropometric measurements and interpret as part of nutrition assessment of patients ongoing monitoring.

Planning and Organisational Skills

• To manage and act as an independent holder of the paediatric caseload ensuring high quality dietetic care is delivered. Carrying out systematic review of patients at appropriate intervals according to prioritising criteria and clinical judgement.
  
  
• To liaise with health care professionals regarding hospital discharges or new referrals and offer joint visits as required enabling them to formulate care plans in relation to enteral feeding which are based on specialist assessment and recommendations.

• To ensure that the enteral feed and equipment delivery company have accurate information on each patients enteral feeding requirements and that all regimen changes are communicated with adequate notice.

• To provide cover for the other dietitians within the HEN team during periods of staff absence.

• To devise and implement specialist evidence/research based guidelines and protocols that can be used Trust(s) wide for the dietetic care management in relation to paediatric enteral nutrition.

• To demonstrate highly skilled clinical expertise within own team and LSL Primary Care Networks and act as a resource in the specialism of paediatric enteral nutrition, advising colleagues on the management within the specialist area.

Managerial and Administrative Responsibilities 

• To be solely responsible for prioritising and managing own caseload and to oversee the organisation and development of the caseload across the service, identifying shortfalls and issues to be addressed.
  
  
• To supervise dietitians and dietetic assistants who would assist in the care and administration of Paediatric HEN patients.

• To provide support and training to the HEN team administration staff.
  
  
• To be involved in the development of, write and update, disseminate and implement policies and procedures related to all aspects regarding Paediatric Home Enteral Feeding across Lewisham, Southwark and Lambeth. This will be used as a point of reference for all organisations, i.e. Special Needs schools, Children’s Community Nurses, Special needs nurses, and Speech and Language Therapists

• To be aware of trust policies and procedure and participate in their creation and development. The dietitian will be responsible for working under these broad guidelines and when the need arises is able to discuss problems as part of a peer review.

• To assist in the co-ordination of HEN team service objectives and projects contributing to the team service plan.

• To ensure all equipment defects, accidents, complaints and clinical incidents are reported to the team leader and necessary action is taken by those concerned.