Clinical Endoscopist

Job overview

The post holders will be responsible for the efficient and effective provision of the non-medical endoscopy service in conjunction with other members of the multidisciplinary team. They will work with the MDT and contribute to the development, management and delivery of a high quality general and specialist mixed GI endoscopy service.

• Provide a diagnostic endoscopy and bowel cancer screening service for patients
• Cross Site working (including in new Luton CDC)
• Delivery of 5 Endoscopy sessions per week

The post holder will independently undertake diagnostic and therapeutic upper and lower gastrointestinal endoscopy on sedated and non-sedated patients.

If not already done so, the post would require the holder to attend Train the Trainer course and take an active role in training for future Endoscopists

Main duties of the job

To work autonomously with minimal supervision from Consultant Gastroenterologists to undertake therapeutic interventions in accordance with Departmental policies. To take responsibility for developing and reviewing relevant policies. To be an expert practitioner, providing specialist nursing advice and support in all aspects related to the Non-Medical Endoscopist. Maintain awareness and knowledge of national developments related to Non-Medical Endoscopists. Administer conscious Midazolam sedation and analgesia and be responsible for the development and amendment of departmental policies related to conscious sedation in accordance with British Gastroenterology.

Undertake nurse led Gastroenterology related face to face and non face to face Patient Consultations.

To work in partnership with the multidisciplinary team to ensure that local practice is of the highest standard for current and future patients whilst achieving all national and local targets.  At least 70% of the duty time will be spent in providing direct clinical care and advice for gastro-intestinal patients at the diagnostic stage of their care. This involves the utilisation of highly developed specialist knowledge, critical thinking and expert decision making skills in order to assess, plan, implement and evaluate programmes of care for this cohort of patients.

Detailed job description and main responsibilities

• Take full responsibility for the clinical management of the patient during the procedure including pre procedure assessment/ the procedure and recovery.
• Take informed consent prior to the procedure in accordance with Trust policies, when nurse led consent is not deemed appropriate.
• Using highly specialised knowledge ensure that patients and carers receive appropriate health education pre and post procedure
• Working autonomously without clinical supervision, undertake invasive diagnostic flexible sigmoidoscopy, colonoscopy and Upper GI endoscopy. Standard Endoscopy expectations to include; polypectomy and diathermy, tattooing of mucosa with marking ink, lifting sessile polyps.  There is a possibility to work towards more therapeutic procedures including; EMR etc.
• Administer the following in accordance to local protocols
• Conscious sedation
• Reversal agent
• Local anaesthesia
• Intravenous analgesia
• Entonox
• Upon the location of abnormal pathology, undertake biopsies, photographs and complete pathology requests as required following protocol.
• Take responsibility for interpreting the outcome of investigations undertaken on patients, arranging any further necessary diagnostic procedures or staging investigations.
• Ensure specimens are sent to laboratory in a timely manner within agreed protocols.
• Review histological results, taking responsibility for escalating any significantly abnormal pathology to the referring Clinician.
• Refer to other professionals for more specialist support as appropriate, to ensure continuity and co-ordination of patient care along the patient pathway.
• Where appropriate, interpret and present clinical information to patients and their relatives, demonstrating highest levels of interpersonal and communication skills ensure that patients and their carers have sufficient relevant verbal and written information during the patient’s stay. This may require communication of bad news requiring advanced communication skills.
• To have the knowledge and experience to be able to assess endoscopic referrals for appropriateness, following set protocols
• To participate in the non-endoscopic GI service as service need requires (ie outpatient clinic, ward liaison, Non endoscopic investigations) and within own area of expertise.
• Undertake up to 5 Endoscopy lists a week.

Managerial

• In collaboration with Clinical Director, Clinical lead, Endoscopy clinical operation manager and other Advanced Practitioners , contribute to strategy for the development of Clinical Endoscopists to support the Trust performance in achieving all national and local wait times targets and develop guidelines for investigations, drug interventions and the administration of therapies which may be instigated and initiated by Clinical Endoscopists
• Be responsible for the validation of surveillance endoscopy waiting lists and initiation of bowel preparation in accordance with clinical guidance and GRS standards for clinical quality.
• Maintain accurate and up-to-date confidential and timely patient records ensuring that all patient documentation (both written and electronic) is in line with agreed Trust Standards and NMC guidance.
• Take responsibility for inputting clinical information for individual patient reports following examination to ensure National Endoscopy database is kept up to date.
• Take responsibility for checking own data on the JETs National Endoscopy database to record own clinical outcomes.
• In collaboration with the Endoscopy Team support the preparation of evidence for any external reviews.
• Organise time effectively to ensure effective management of workload, prioritising work as necessary
• In collaboration with the Endoscopy leads support the development of patient information leaflets