Team Lead Dietitian - (Intestinal Failure & Transplant)

Job overview

This position has arisen to backfill a staff member who has been successful in a predoctoral NIHR award for 12months. If you are a Band 7 dietitian looking to gain more leadership experience, or an experienced Band 6 looking to advance your career, we would love to hear from you.

This post offers great MDT working and the ability to advance knowledge and skills in intestinal failure and transplantation. You will also lead the team of 3 dietitians with support from fellow Team Lead Dietitians and MDT members.

This is an exciting opportunity to join one of the best teaching hospitals in the UK and offers the successful candidates the opportunity to gain valuable training so that they can not only advance their careers but join a team that offers the very best in nutritional care.

We encourage every Band 7 to protect 30% of their time within the role to development, both individually and as a service. This can include quality improvement projects, clinical audit and CPD, as well as service development alongside the MDT.

As a valued member of our team, you will receive:

• Flexible working, including opportunities for home working
• Clinical supervision and support from experienced and specialist dietitians
• Dedicated time for professional and service development
• Regular appraisals and personalised development plan
• Access to a range of CPD opportunities, the Oxford AHPs Research & Innovation Unit, and Bodleian Library collection.

Main duties of the job

Provide a specialist, evidence based dietetic service to patients with intestinal failure (IF) who are referred for intestinal transplant (ITx) including their assessment, acute transplant period and long term follow up.

Provide a specialist dietetic service to patient with IF who may require parenteral or complex nutrition support plans.

Support colleagues to deliver dietetic care to patients at all phases of the intestinal failure patient pathway, within the trust, locally, nationally or internationally.

Lead, supervise and support a team of dietitians in the areas of parenteral nutrition (PN), IF and ITx. To initiate and lead discussion on organisational, professional and clinical issues relevant to the team.

Along with the Service Manager, be responsible for the dietetic service provided to their clinical area and its development. Along with the Nutrition Support Team medical, nursing and pharmacy leads to be responsible for the IF service and its development.

Working as an integral member of the multidisciplinary teams to provide a flexible, prioritised service based on clinical need. To act as a source of expertise for local and national dietetic and MDT colleagues and regarding the nutritional management of these patient groups.

Participate in and initiate audits and research as appropriate for the clinical area, Dietetic and NST services.

Work closely with the other Dietetic Team Leads to support the running and development of the whole Dietetic Department

Detailed job description and main responsibilities

CLINICAL

To be be professionally and legally accountable for all aspects of your own work, including sole responsibility for the dietetic management of patients in your care, working within the professional, ethical and legal framework for dietetics set out in the Health and Care Profession Council’s Dietitians Standards of Conduct Performance and Ethics and the British Dietetic Associations Professional Standards for Dietitians and Code of Professional Conduct.

Work autonomously and have responsibility for delivery a highly skilled dietetic service within the multidisciplinary team as part of the whole care pathway for patients diagnosed with intestinal failure (IF), including intestinal transplant candidates and recipients.

Lead and coordinate dietetic provision to ensure a comprehensive specialised dietetic service is provided to IF and transplant patients. This will include:

• Providing a highly specialised clinical service to IF and transplant inpatients, including those requiring TPN within the OUH
• To support the multidisciplinary nutrition team in facilitating the planning and discharge of PN fed patients, coordinating and arranging appropriate follow-up remotely or at the consultant led multidisciplinary nutrition clinic for HPN and complex enterally fed patients being discharged both locally and out of area.
• Lead and support the dietetic service provided to OUH HPN patient and complex nutrition caseload for outpatients, and support the NST to assess and provide nutritional input, including requesting additional information, investigations, blood tests, vitamins and trace elements, review TPN prescription based on nutrient requirements and biochemistry.
• Providing a highly specialised clinical service to intestinal transplant patients including candidates’ assessment, work up, acute transplant period and long term follow up both locally and out of area, including satellite clinic.

Provision of a dietetic service includes the following aspects:

• To judge and determine appropriateness of referrals made by members of the multidisciplinary team to ensure effective use of time and resources;
• Obtain and analyse relevant information from different sources including: medical notes, nursing notes, the client, ward staff and/or carers, in order to make a comprehensive assessment of the patient’s condition, prognosis and treatment plans so that a decision on the most appropriate dietetic treatment to support this can be made in the short and long term;
• To assess the nutritional status of individual patients based on anthropometric measurements e.g. weight, height, weight history as well as biochemical parameters, diet history and other validated methods of nutritional assessment as appropriate;
• Calculate nutritional requirements based on: 1) anthropometric data 2) current nutritional and hydration status 3) current clinical state 4) established guidelines on requirements based on weight and age 5) previous dietary intake;
• Discussion and negotiation of treatment options to individualise and establish the most appropriate methods of treatment, in an attempt to encourage compliance with and acceptance of the dietetic management plan;
• To formulate individualised patient care plans, artificial feeding regimens, taking into consideration factors which may affect requirements or help/hinder provision of nutrition support such as: prescribed drugs, biochemical derangements etc;
• Evaluate the effectiveness of nutritional goals and modify as necessary based on ongoing analysis and assessment of information available and changing patient needs and medical condition.

To communicate effectively with patients, carers and other health professionals. Skills of negotiation, motivation, explanation and gaining consent are used in a wide variety of sometimes sensitive situations. The ability to communicate complex information at an appropriate level to enable understanding is important. Barriers to communication may be evident e.g. loss of hearing, receptive and expressive problems with the formulation and understanding of language, difficulties with speaking.

Work as an integral member of the multidisciplinary team (MDT) to ensure a holistic approach to patient care.

Attend regular team meetings when patient care is reviewed, liaison meetings with other multi-disciplinary teams where patients joint care is planned and reviewed, case conferences, ward rounds and governance meetings.

Liaise and communicate with healthcare professionals in acute and community settings, ensuring seamless continuation of dietetic treatment.

This involves:

• Detailed handover to dietetic colleagues in local hospitals;
• Key role in the planning, coordinating, training and community follow-up for patients requiring on-going dietetic input both locally and out of area.
• Provide the continued dietetic support via telephone for selected patients

To be actively involved with the development of evidence-based, trust-wide guidelines, for example feeding protocols and other resources such as diet sheets in liaison with dietetic colleagues, senior nurses or clinicians.

Participate in research and audit undertaken by the Nutrition, Transplant and/or Dietetic team. Presentation of audit or research results at national or international conferences to promote practise and share expertise with colleagues.

TEAM LEADER RESPONSIBILITIES

To work as part of the team of team leads to support the smooth running and quality service delivery of the Dietetics department, within OUH Therapies CSU.

To lead on service planning within the identified clinical area.

To ensure that all team members receive clinical supervision in conjunction with clinical specialists.

Monitoring and allocating work load / distribution including overseeing annual and study leave requests and cover in clinical team. Monitoring and managing sickness / absence of team members.

Ensuring that all team members have an annual appraisal

Leading on recruitment to vacant posts in clinical team (in conjunction with the Dietetic Services manager)

Act as an advisor to managers as to likely changes and requirements as a result of developments within clinical area. Lead on the development of new services within clinical area.

To organise and lead the clinical team including:

1) Provision of reports/documentation on clinical service as required in a timely manner.

2) To be responsible for authorising and recording annual leave for the clinical team and agree annual leave as required for other dietetic colleagues

3) Ensure regular clinical team meetings involving CPD and team objectives

4) To be responsible for developing a training program for the Band 5 and/or Band 6 dietitians on rotation in the clinical area

To represent the Dietetic Team at Divisional/Directorate Clinical Governance and business meetings

Along with the Nutrition Support Team medical, nursing and pharmacy leads to be responsible for the intestinal failure service and its development.

PROFESSIONAL

Be accountable for own actions working within the professional, ethical and legal framework for dietetics set out in the Health Profession Councils Dietitians Standards of Conduct Performance and Ethics and the British Dietetic Associations Professional Standards for Dietitians and Code of Professional Conduct.

To take responsibility for own continuing professional development (CPD) and provide evidence for this by maintaining a CPD portfolio. CPD involves critical evaluation of scientific papers, attending professional development meetings, working as a reflective practitioner and attending relevant internal/external courses.

Participate in own annual appraisal, identifying own development and training needs and setting personal development objectives with line manager.

Undertake all relevant statutory and mandatory training, maintaining up to date compliance.

To participate in departmental audits and initiate audit within own work area in order to monitor and evaluate whether local/ national standards are being met and make recommendations for change. To be involved with the planning of departmental clinical effectiveness and audit strategies.

To have responsibility to provide input into own clinical area policies and guidelines.

Be involved with the dietetic student training programme, facilitating the development of skills and knowledge and participate in the assessment process.

To provide specialist advice, teaching and training to all members of the multidisciplinary team regarding the nutritional management of patients in the identified clinical area. This involves regular participation in in-house training courses. Participate in external training /teaching when requested to do so for example teaching undergraduate nursing students at local university.

To demonstrate risk management skills and a sound understanding of clinical governance and apply to the work situation. To be involved in clinical governance, including investigating and shared learning of incidents.

ORGANISATIONAL

To determine priorities for own work based on clinical need and balance patient caseload with professional demands.

To provide cover for other colleague’s patient caseloads, this requires time management and excellent organisational skills.

To be an active member of the bank holiday on-call service

To collect and record activity data daily as required by the department, clinical teams, trust and outside agencies. Collation and sharing of audit data including via in house databases or national data repositories, as appropriate.

To maintain accurate and legible documentation of patient interventions on electronic patient records. To communicate any changes in nutritional care to appropriate members of the multidisciplinary team by documentation within nursing/medical notes or by letter/report/secure email.

Applicant requirements

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.