Adult Home Enteral Feed (HEFT) Lead Dietitian, Band 7

at  Gloucestershire Hospitals NHS Foundation Trust

Do you want to be part of an award-winning, innovative, friendly team?
Gloucestershire Hospitals NHS foundation Trust Home Enteral Feeding Team (HEFT) has several exciting opportunities to join their well-established, experienced team following a successful bid for further expansion.
We are looking for a Dietitian with expertise in enteral feeding to join our dynamic team.
lead and provide line management to a team of specialist dietitians and a dedicated Dietetic Assistance Practitioner for the team
work alongside other team leads to help in the day-to-day management of the team and service
have the opportunity to extend your scope of practice with practical tube competencies
utilise well developed communication skills to liaise with members of diverse MDTs
have the opportunity to undertake research and further post-graduate study at Master level.
The post holder will work within the Home Enteral Feed Team (HEFT) to manage and clinically lead a team of specialist HEF Dietitians and Dietetic Support workers within the Adult HEF specialism of the HEFT service.
The post holder will be accountable for the oversight and delivery of a specialist adult HEF nutrition and dietetic service for the community of Gloucestershire within a variety of settings. The role will involve domiciliary visits to provide on-going dietetic care to those who are enterally fed in the county. The role also provides specialist Dietetic advice to patients within a third level disability college.
This post will be responsible for ensuring a high level of dietetic care, evidence-based practice and efficient and effective service delivery. The post holder be required to report regularly on service delivery and outcomes within their specialism and will lead on service development projects and research within the Adult HEF Dietetic team
Gloucestershire Hospitals is one of the largest hospital trusts in England serving a diverse population of almost 620,000 people. We provide acute hospital services from two large district general hospitals, Cheltenham General Hospital and Gloucestershire Royal Hospital. Maternity Services are also provided at Stroud Maternity Hospital.
Our people are at the heart of what we do. Our workforce is almost 8,000 strong and our caring and dedicated staff are recognised as providing good and outstanding patient-centred care across a range of clinical areas. We also have exceptional teams of professional services staff underpinning our vision every step of the way.
We are committed to diversity, inclusion and equality of opportunity for everyone, valuing and celebrating differences and encouraging a workplace and culture where all can thrive. We endeavour to ensure each and every person working in our organisation feel respected and valued. Respecting and valuing differences will help to ensure that our policies and services reflect the needs and experiences of the people and community we serve.

In return, we offer the opportunity to work at a trust that is on a truly exciting Journey to Outstanding and to make a real difference to the lives of our patients, their families and the wider community. We are also committed to training and developing you to be the best you can be and offer you a rewarding career, whatever your role.

• Be the clinical lead for the HEFT’s Adult service providing line management to band 5 and 6 registered clinicians within this team
• Oversee the clinical case load assigned to members of the HEF Adult service, to ensure safe caseload balance and to manage patient complexity allocation within the team
• To develop the adult HEF service in areas where it is felt increased clinical input is needed
• To include development of staff within the team, facilitating and supporting learning opportunities
• To support the Band 6 Specialist Adult Dietitian with line management of the Dietetic Support Worker within that specialism
• To lead on induction and training of the HEF Adult specialism’s staff against local and national frameworks, with support from the Deputy HEF Service leads
• To work collaboratively with all other Team Leads within HEFT, but especially the Specialist Neurology and HEFT Team Lead Dietitian, to deliver agreed strategies and clinical workload.
• Keep up-to-date and lead on any changes to local and national frameworks relevant to HEF
• To support training programmes within the HEFT, covering Dietetic students, junior and specialist staff within the team with support from the Deputy HEF Service leads and senior leadership team
• Be a key resource for the creation and management of documentation for enteral nutrition support. This will include competency development for the staff within the specialism, internal policy, patient and carer literature development and external publication
• Contribute to and support the clinical governance agenda within the HEFT and the wider Nutrition and Dietetic department for audit and research as part of the multi-disciplinary team (MDT) within the trust
• To adopt and adapt new ways of working to improve outcomes
• To continually reflect on own practice, improve quality of care through continual innovation and participation in wide ranging peer review
• Work countywide
• To be an authorised signatory for HEFT staff timesheets, participate in staff recruitment, inductions and undertake appraisals

Clinical

• To use highly specialist knowledge and clinical expertise to assess, agree, implement and monitor a nutrition and dietetic care plan based on a range of treatment options for adult HEF patients who have complex medical, nutritional and psychological needs. This would include patients that require a domiciliary assessment, handover of patients who are acutely unwell and need admitting to the acute ward, domiciliary ventilated patients, patients that require long-term rehabilitation and patients requiring palliation.
• To manage a specialist caseload of adult HEF patients, which will include complex patients, alongside overseeing all clinical work delegated, including to members of the Dietetic Assistant Team (DAT) within the specialism
• To provide specialist training to all member of the specialism and wider service when required
• To prescribe the appropriate feed for the patient, utilising clinical expertise within the field of adult HEF dietetics
• To use advanced communication/behaviour change skills and motivational techniques to negotiate with the patient the necessary lifelong changes to both their diet and care of enteral feeding tubes and stoma sites
• To overcome resistance to dietary change by motivating and delivering to patient/carers, the appropriate information and skills needed to meet their nutritional requirements, empowering the patient and carers to control nutritional wellbeing. This includes patients with multifaceted dietary needs of differing age groups with a wide range of medical conditions
• To overcome complex barriers to communication due to social and emotional issues as well as cognitive or physical impairment e.g., dysphasia, deafness, blindness and depression
• To have knowledge and understanding of working with communication devices
• To keep abreast of new and emerging clinical practices and be instrumental in supporting the senior service leads to embed these locally, mitigate risk, gather evidence and ensure budgeting is covered
• To undertake an extended role, providing care/repair of gastrostomy tubes and care of stoma sites for patients in their own homes, escalating complex enteral tube and stoma site issues to the ENNS Team within the HEFT, helping to avoid the patient returning to hospital
• To support and advise other health professionals as part of an MDT; communicating the dietetic treatment of patients to nursing, medical staff, and other health professions by providing appropriate verbal and written instructions to ensure they understand and can support the patient’s treatment plan
• To update the MDT on patient progress and changes to the treatment plan, including changes to swallow, prescribed feeds or physical condition
• To recognise other medical and social problems that the patient may have, identify the appropriate professional and refer the patient appropriately
• To ensure patient information is accurately completed for departmental and nationwide reports, in a timely manner
• To ensure all information regarding prescribed feeds is recorded accurately and updated whenever changes occur
• To provide up to date feeding regimens to all relevant agencies and care settings

Evidence Based Practice

• Continually maintain clinical knowledge of most up to date evidence in adult HEF Dietetics and lead on the implementation of these
• To lead on the development of clinical guidelines, policies and written information for nutrition and dietetic HEF services
• To work with other members of the Dietetic department and MDT on audit projects within adult HEF and enteral feeding clinical areas and be the key expert on nutrition support for adult HEF patients
• Lead and participate in research within the Adult HEF cohort of patients

Leadership Responsibilities

• To lead on adult HEF nutritional support training for the department. To provide clinical updates for multidisciplinary staff working with adult HEF patients across the county (for example at specialist interest group meetings and at the residential centres).
• Play a leading role in networking and planning of service improvements
• To provide expert clinical support to junior dietitians and support staff in delivering nutritional care to adult patients within the HEFT and acute settings. To be an expert resource to them.
• To lead in the development of members of the staff within the specialism through undertaking tutorials, clinical supervision and contributing to development reviews
• To plan the programme, supervise and assess the dietetic students within adult HEF areas
• To lead with the recruitment and selection of staff within the specialism through assisting in the development of job descriptions and taking part in the interview and induction process

Professional and Managerial

• Be the professional lead for the Adult HEF specialism, delivering and progressing the staff training programme enabling the staff to undertake their key roles and develop
• Be the line manager for the Adult HEF specialism in the HEFT, appraising the staff annually and setting agreed personal and service objectives
• Responsible for ensuring all care is given in accordance with agreed protocols and to agreed service levels
• Provide support and guidance to colleagues so that they are able to deliver a client focused service
• To support senior service leads and at times lead in cross-department process improvement and planning
• To support the development of strategies designed to promote and improve enteral nutritional health in individuals and groups by identifying and selecting from a range of health and social agencies to improve nutritional enteral care
• To support senior service leads in clinical risk management activities within the clinical setting and lead on active risk management within their specialism with particular reference to the un-registered workforce
• Ensure the formal reporting and recording of adverse incidents in line with Trust Policy via the Datix system
• Utilise and maintain information systems to aid our Clinical Information Lead and audit to provide regular active analysis reports
• To support and advocate the best use of available resources within agreed budget to provide a cost-effective service
• To support the senior service leads in monitoring monthly spending to ensure it remains within budget
• Recognise ethical and legal issues which have implications for dietetic practice and take appropriate action
• Identify gaps in service provision and escalate these in a timely manner to senior service leads to enable changes required to improve the service
• To create additional, effective links within primary, secondary and tertiary care to ensure effective communication
• Recognise and act as an advocate for patients, carers, HEF service and our trust
• To observe and maintain strict confidentiality of personal information relating to patients and staff
• To observe the rules, policies, procedures and standards of our trust, together with all relevant statutory and professional obligations, ensuring all staff within their specialism abide to these also.
• Maintain a professional portfolio to demonstrate competency in line with trust competency framework and HCPC guidelines

In return, we offer the opportunity to work at a trust that is on a truly exciting Journey to Outstanding and to make a real difference to the lives of our patients, their families and the wider community. We are also committed to training and developing you to be the best you can be and offer you a rewarding career, whatever your role.

• Be the clinical lead for the HEFT’s Adult service providing line management to band 5 and 6 registered clinicians within this team
• Oversee the clinical case load assigned to members of the HEF Adult service, to ensure safe caseload balance and to manage patient complexity allocation within the team
• To develop the adult HEF service in areas where it is felt increased clinical input is needed
• To include development of staff within the team, facilitating and supporting learning opportunities
• To support the Band 6 Specialist Adult Dietitian with line management of the Dietetic Support Worker within that specialism
• To lead on induction and training of the HEF Adult specialism’s staff against local and national frameworks, with support from the Deputy HEF Service leads
• To work collaboratively with all other Team Leads within HEFT, but especially the Specialist Neurology and HEFT Team Lead Dietitian, to deliver agreed strategies and clinical workload.
• Keep up-to-date and lead on any changes to local and national frameworks relevant to HEF
• To support training programmes within the HEFT, covering Dietetic students, junior and specialist staff within the team with support from the Deputy HEF Service leads and senior leadership team
• Be a key resource for the creation and management of documentation for enteral nutrition support. This will include competency development for the staff within the specialism, internal policy, patient and carer literature development and external publication
• Contribute to and support the clinical governance agenda within the HEFT and the wider Nutrition and Dietetic department for audit and research as part of the multi-disciplinary team (MDT) within the trust
• To adopt and adapt new ways of working to improve outcomes
• To continually reflect on own practice, improve quality of care through continual innovation and participation in wide ranging peer review
• Work countywide
• To be an authorised signatory for HEFT staff timesheets, participate in staff recruitment, inductions and undertake appraisal

Leadership Responsibilities

• To lead on adult HEF nutritional support training for the department. To provide clinical updates for multidisciplinary staff working with adult HEF patients across the county (for example at specialist interest group meetings and at the residential centres).
• Play a leading role in networking and planning of service improvements
• To provide expert clinical support to junior dietitians and support staff in delivering nutritional care to adult patients within the HEFT and acute settings. To be an expert resource to them.
• To lead in the development of members of the staff within the specialism through undertaking tutorials, clinical supervision and contributing to development reviews
• To plan the programme, supervise and assess the dietetic students within adult HEF areas
• To lead with the recruitment and selection of staff within the specialism through assisting in the development of job descriptions and taking part in the interview and induction proces