The post is based in the acute setting at Torbay Hospital, supported by a friendly and innovative team.
The post holder will work closely with the gastro team (9 Consultants and multiple Specialist Gastroenterology Nurses) to further develop, lead and provide a specialist medical gastroenterology dietetic service for inpatients and outpatients supporting the work of the consultant gastroenterologists.
You will supervise and work closely with a Band 6 gastro dietitian, as well as providing support to Band 5s and a Dietetic Support Worker in the acute based team.
Torbay boasts excellent transport links across the South West. Close to Torquay’s stunning seafront, and access to the incredible Dartmoor National Park for outdoor adventures. It’s a fantastic place to work, live, and thrive!
- To co-ordinate gastroenterology dietetic services (including supervision of gastroenterology dietitians).
- To work as an autonomous dietetic practitioner, taking the lead in the comprehensive assessment of the route of nutritional support, nutritional requirements, provision of optimal, safe, nutritional therapy and assessment of efficacy of nutritional support, and specific nutrition therapy for complex patients under the care of the medical gastroenterology department for both in- and out-patients.
- To lead a patient centred out-patient service to all medical gastroenterology patients.
- To design and implement a completely dietetic led coeliac disease service including direct to dietitian triage from primary care. To include assessing newly diagnosed patients, providing comprehensive patient education and support to patients and their carers or relatives, responsibility for monitoring biochemistry, liaising with the consultant gastroenterologists for specific patients and guiding GPs as needed.
- To design and implement direct to dietitian IBS service from primary care (including setting up service with clear pathway, evaluation, improvement and education of primary care) with support of consultant gastroenterologists.
- To provide cohesive dietetic care for gastroenterology patients, providing cover for the surgical gastroenterology and/or Nutrition Support Team Dietitian as required.
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Why Work With Us
About your new team and department
This post is based at Torbay Hospital with the Acute team dietitians. The acute dietitians cover speciality areas of nutrition team, medical and surgical gastro, ICU, head & neck cancer, nutrition support across 12 wards at Torbay Hospital and outpatient clinics for these specialties. The Acute team is part of the wider dietetic team including Community, Diabetes, Paediatrics, Weight Management, and Cancer Services. The team has over 40 staff members – dietitians, dietetic support workers and admin support. The team is actively involved with training of student dietitians from the University of Plymouth.
Communication and working relationships
To work as the lead dietetic member of the medical gastroenterology MDT
To communicate and establish working relationships with:
o Gastroenterology consultants, ward managers and matrons
o Allied health professionals
o Gastroenterology MDT, rehabilitation teams, ward medical and nursing teams
o Nutrition team and nutrition nurse specialists
o Home Enteral Feeding (HEF) Dietitians and HEF Team
o Catering department
o Local dietetic team, including acute teams of dietitians, community dietitians, diabetes dietitians, Primary Care Network (PCN) dietitians
o Other medical gastroenterology dietitians, locally and regionally to share best practice
o Students – dietetic and other professions
o Other health and social care professionals
Planning and organisation
To manage own clinical caseload as an autonomous practitioner within the medical gastroenterology service
To manage own time, prioritise clinical referrals and manage the demands received from different parts of the service
To lead on development of new gastroenterology dietetic services, including planning, organisation and implementation.
To collate evidence to evaluate gastroenterology dietetic services, for example, identifying the strengths of service provision, patient activity statistics, health outcomes and patient satisfaction (e.g. Friend and Family Tests)
Actively evaluate the dietetic medical gastroenterology service, identifying any areas for development, together with support from senior members of medical gastroenterology and dietetic teams
To plan, organise, deliver, and evaluate training sessions to a variety of groups including health and social care professionals and patients. Training may be face to face or via virtual platforms.
Responsibility and accountability
To be the nutritional lead for development of dietetic services in the medical gastroenterology team.
To deliver dietetic care to a caseload of complex adult patients in collaboration with the gastroenterology MDT and other MDTs as required
To provide a source of expert knowledge and advice on nutrition to the gastroenterology service and other gastroenterology dietitians.
To carry out other duties as agreed with the Head of Nutrition and Dietetics
Responsibility for patient’s and client care
To lead provision of evidence-based, individualised, disease specific and often complex dietary/nutritional treatment plans for medical gastroenterology patients with, appropriate review and evaluation of these plans
To undertake nutritional assessments, which may be either face to face or remotely as clinically indicated
To measure and interpret individual patient’s nutritional status based on weight, height, body mass index, nutritional intake, biochemistry, and clinical presentation/condition
To calculate disease specific nutritional requirements for patients, using knowledge and evidence-based practice
To assess the efficacy, safety and appropriateness of nutritional support routes
To be responsible for reviewing, monitoring and making appropriate clinical changes to each patient’s dietetic care plan based on medical, emotional, ethical and social developments in addition to multidisciplinary decisions on the patient’s care
To use behaviour change and advanced communication techniques to support and aid compliance with recommended dietary/nutritional treatment plans
To explain treatment plans (verbal and or written) in an easily understandable way to patients, carers and relatives and other relevant individuals, to enable patients to make informed choices about their own health
To provide resources such as patient information leaflets, recipes and menu plans and to signpost them to other resources where appropriate (e.g. NHS patient webinars, relevant charities and support groups).
To provide dietetic care, both practical and empathetic, for people requiring long-term nutrition support or long-term dietary changes (including those who may be in the end stages of their life) with gastroenterology diagnoses
To be pro-active in initiating appropriate dietetic treatment and/or referral, and to signpost to other appropriate services
To advise on commencing enteral nutrition (either orally or by way of a variety of tube feeding routes dependent on gut anatomy and function) and transitioning between routes
To request, review and interpret blood biochemistry results to monitor the safety and efficacy of nutritional support, and make clinical changes where necessary
To understand and be fully aware of the range of oral nutrition support products, enteral tube feeds and associated equipment
To be responsible for recommending nutritional supplements
To recommend nutritional supplements for prescription (e.g. from GP, or hospital doctors where appropriate)
To be a key member of relevant MDTs providing a source of expert knowledge and advice on nutrition, being actively involved in MDT discussions (inpatient and outpatient settings) and decisions around nutritional care and feeding for patients, including medically, socially and ethically challenging situations (e.g. decision making around feeding/tube feeding, patients lacking mental capacity or being treated under the Mental Health Act, end of life care, best interest meetings and safeguarding).
To ensure safe and timely discharge of tube fed patients from hospital to home, with the support of the nutrition team, ward staff and home enteral feeding team including monitoring of high-risk patients (e.g. those being fed post-pylorically or with complex gastrointestinal needs) on home enteral feeding in the community
To advise “off script” enteral tube feeds for home use
To maintain accurate and timely documentation of patient interactions and clinical care provided in line with record keeping standards
To be aware of, identify and raise safeguarding issues observed during clinical practice
To provide support where quality or safeguarding issues have been identified
Policy and service responsibility
To lead the development of policies, resources and guidelines relevant to this role, with the support from gastroenterology
To develop resources such as patient information leaflets, recipes and menu plans
To contribute to the wider service development of the dietetic service
To follow Trust policies and procedures
To undertake clinical practice in line with local policy and guidelines, such as refeeding, enteral feeding and nutrition screening
To relate clinical practice to broader clinical guidelines, including NICE
To promote the role and value of the Dietitian in all aspects of nutritional care
To attend other relevant team meetings which may include gastroenterology management meetings and dietetic meetings
Responsibility for finance, equipment and other resources
The post carries no budgetary responsibility
To take anthropometric measurements to assess nutritional status, including the use of weighing scales, calipers, grip strength during patient assessments
To promote the clinical and cost-effective use of oral nutritional supplements, for example, when inpatients are discharged from hospital into the community
Responsibility for supervision, leadership and management
To provide nutrition expertise within the gastroenterology teams
To provide clinical support and supervision to dietitians to include monthly 121s and annual achievement reviews
To participate in the training of dietitians, student dietitians and students of other professions
To provide cover for specialist dietitians (with appropriate training) during periods of leave
To actively support own wellbeing, as well as to support the wellbeing of the other members of the team
Information technology and administrative duties
To use Trust IT systems
To accurately record own Dietetic activity using computerised statistics and to collate this data for service evaluation and development purposes
To use Attend Anywhere or equivalent for patient assessments, when clinically appropriate
To prepare own presentations, reports, and documents
Maintain clinical records including Dietetic records and GP letters and in line with professional and department standards. Use electronic patient records where available
To work within the requirements of Data protection legislation and access to health records
To communicate via email, social media and other internal IT systems
To use Microsoft Teams to attend meetings and deliver training virtually, and virtual patient education groups (e.g. IBS)
Use IT to project manage and collect data for service evaluation
Responsibility for research and development
To be responsible for own and gastroenterology dietetic services continued professional development and be proactive within annual Achievement Reviews and monthly 121s
To maintain and improve professional knowledge through CPD (continued professional development), for example, journal review, shadowing, attendance at courses/conferences/webinars as agreed with the Team and the wider dietetic department
To liaise with other specialist dietitians
To work within the HCPC (Health and Care Professions Council) Standards of Conduct, Performance and Ethics and the BDA (British Dietetic Association) Code of Professional Conduct
To proactively identify and lead project work to develop the service to provide high quality nutritional care to patients
Produce reports/summaries to monitor, evaluate and provide feedback about the service
To identify and lead relevant audit and research projects to evaluate nutritional care