Band 7 Highly Specialist Paediatric Dietitian

Job overview

Main duties of the job

• This post has a high degree of autonomy and is responsible for the highly specialist clinical assessment and ongoing dietetic management of children with a number of different clinical conditions within a community setting.  Conditions include complex permanent disabilities, multiple pathologies, life-limiting conditions and challenging behaviours.
• To provide a high quality evidence based service to children with complex disabilities, life-limiting conditions and challenging behaviours.
• To provide therapeutic dietetic care to clients in a range of venues across the City including clinics, client’s own homes, special schools and respite/short breaks.
• To act as a source of clinical expertise/advice and guidance for client’s families, carers and the multi-disciplinary team.
• To raise nutritional awareness and promote the benefits of Paediatric Dietetic services with respect to children both within and outside of the organisation.

Detailed job description and main responsibilities

• To negotiate and agree dietary or nutritional goals with individual patients and/or their parents and carers, including those with diverse or complex nutritional and physical health needs and end of life issues. The post holder will need to use motivational interviewing, counselling and cognitive behaviour therapy tools as applicable.  This may include identifying individual barriers to change and helping clients and carers to manage them.

• To aim to meet these goals using appropriate nutritional interventions including enteral feeding, oral nutritional supplements or specialised formulae. To reassess nutritional requirements and change clinical interventions as appropriate in line with current evidence based practice.

• To plan and deliver individualised nutritional care plans based on comprehensive highly specialist assessments of needs and knowledge of evidence based practice, modifying the care plans as required.

• Independently manage a caseload that includes children with complex eating and drinking difficulties, dealing with issues of mortality and ethical dilemmas.

• Diagnosing nutritionally related disorders and being alert to symptoms and signs of wider systemic disease.

• Directing referrals for specialist medical opinion where appropriate.

• Being alert to safeguarding concerns and consent issues for children.

• To be responsible for maintaining accurate and comprehensive patient records in line with the HCPC Code of Conduct and Trust Policies.

• To provide dietetic leadership and expert opinion across the Trust in the area of common childhood nutrition disorders.

• Provide support for children, their families and acute hospital Dietetic staff through the process of enteral tube fed placements.

• To have an understanding of alternative communication systems that may be used by service users including sign language, gestures, Makaton and other non-verbal methods that will assist optimising a child’s health.

• To disseminate appropriate evidence/research findings and whenever possible ensure the integration of research/evidence based practice in the Department.

• 1.  To maintain a complex clinical caseload within highly specialist areas of Paediatric Dietetics. This involves liaison with other health professionals, suppliers, patients and carers to facilitate the provision of appropriate, timely and cost effective nutritional treatment for children receiving specialist nutritional products. 2.  To undertake comprehensive highly specialist assessments of patients clinical needs in a holistic manner using specialised clinical knowledge and skills and a broad range of nutritional assessment skills, measurements and techniques. This may include the use of dietary analysis software, anthropometric measurements, often in patients with diverse or complex nutritional and physical health needs. 6.  To respond appropriately to frequent requests for highly specialist Dietetic support which include those for children with complex physical health needs with complex clinical and social situations which require detailed analysis and decision-making. 7.  To regularly communicate highly complex and sensitive information to families, carers and staff regarding diagnosis and prognosis and future expectations, gaining co-operation and trust in the ongoing management of the child. 12. To be prepared to deal sensitively with service users, families and carers living with difficult diagnoses and life limiting conditions. 18. To support Service delivery and offer clinical leadership within the Birmingham Community Nutrition team and Children’s Services to facilitate effective patient care, service development and multidisciplinary working.

Professional

• 19. To adhere to the Standards of Conduct, Performance and Ethics and the Dietitians' Standards of Proficiency of the Health and Care Professions Council. 20. To act in a professional manner promoting the organisation, the role of the Dietitian and the importance of nutritional care, respecting clients’, carers’ and colleagues’ views, promoting a positive working environment. 21. To be responsible for logging, maintaining and demonstrating own competence to practice through participation in appraisals process and continual professional development (CPD), within the framework of the professional portfolio.  This may also include membership of a BDA Specialist Interest Group. 22. To undertake the measurement and evaluation of own work and current practices through the use and application of evidence based practice, outcome measures and participation in audit and research as required. 23. Write reports containing highly complex, confidential and sensitive information, which may be used in a legal context.

Planning & Organisational

• 24. To support the service by leading areas of operational development as appropriate. 25. To work autonomously, prioritising in own work area, balancing all service users related and professional demands. 26. To teach staff from social care and health, education, health, voluntary and other agencies to assist in the delivery and implementation of Dietetic advice as appropriate. 27. To develop the Dietetic Service, implement policy and propose policy changes which impact beyond own area of activity. 28. To develop highly specialist knowledge and expertise for an identified area of service provision, as agreed with the manager and participate in strategic development in this area. 29. To collect and collate statistical activity data as required. 30. To provide cover for colleagues as necessary. 31. To be responsible for referring onto other professions and agencies as necessary. 32. To lead on audit and research within the Paediatric team to initiate and contribute to the development of standards and policies for paediatric dietetics. 33. Lead on the development and collection of clinical outcome data for the paediatric dietetic team to report to commissioners. 34. To develop and maintain links with Children & Families Division staff, attending meetings to ensure that the service works in collaboration with all children’s services and provides an expert nutrition service. 35. To lead on specific service/clinical developments as identified within the children’s service including inter-agency and multidisciplinary projects relating to the service objectives. 36. To provide regular reports to your line manager, advising on service delivery, clinical governance, policy development and audit, including proposing changes and developments. 37. To contribute to the department audit programme.

Management and Leadership Responsibilities

• Working collaboratively with the Paediatric Dietitian Team Leader, ensure staff clinical supervision arrangements are in place.  Ensure all staff in your team have annual practice peer review resulting in specific objectives and effective personal development plans in line with service objectives.

• Develop staff knowledge and skills to promote equality and diversity and address inequalities both in employment and service delivery.  Ensure specific equality objective are included in PDR’s.

• Develop a culture that ensure that the standards of Improving Working Lives and Investors in People are achieved and maintained for all staff and that staff’s perception about their working lives are measured and improvements made.

• Participate in the recruitment and selection of staff.

• To identify and work with the Paediatric Dietitian Team Leader to manage clinical risk, including infection control risk, within the team caseload and support others to do so.

• 38. Develop and empower all members of your team to perform to high standards and innovate, working collaboratively with the Paediatric Dietitian Team Leader.

Training

• Develop and empower all members of your team to perform to high standards and innovate, working collaboratively with the Paediatric Dietitian Team Leader.

• Working collaboratively with the Paediatric Dietitian Team Leader, ensure staff clinical supervision arrangements are in place.  Ensure all staff in your team have annual practice peer review resulting in specific objectives and effective personal development plans in line with service objectives.

To undertake other duties commensurate with this grade of post in agreement with the relevant line manager.