Diabetic Retinal Screener, Band 4

at  Gloucestershire Hospitals NHS Foundation Trust

KNOWLEDGE, SKILLS & EXPERIENCE REQUIRED - Some knowledge of ophthalmic imaging or Diabetic Eye Screening will be desired. Successful applicants will be expected to work towards the diploma in Diabetic Eye Screening and must complete the qualification within 2 years of start date as well as meeting specific milestones to completing the qualification during this time. - Must have current full UK driving license and be able to drive the department vehicles. - Must have two A levels or equivalent qualification, one of which should be in a relevant subject, such as but not limited to, Biology, Science or Photography.

• Basic knowledge of all aspects of diabetic retinopathy disease, sufficient to enable post holder to indicate images that are disease positive. - Good all round knowledge of diabetes and associated risk factors. - Ability to communicate effectively within a multidisciplinary team both Trust-wide and nationally and with diabetic patients in a calm, sensitive, reassuring and persuasive way. - Enhanced levels of dexterity and accuracy pertaining to clinical skills including the use of diagnostic equipment i.e.

fundus cameras and direct ophthalmoscopes in the direct examination of patients eyes. - Ability to work using own initiative, efficiently and professionally in county-wide General Practice Surgeries. - Enhanced IT skills including experience of windows based software, capture and grading software for diagnostic purposes and Microsoft word. - An up to date knowledge and understanding of key professional developments and recommended good practice - Demonstrate understanding of research based practice, and participate as required in audit.

• Ability to respond flexibly, resourcefully and using department policies issues occur, e.g. when equipment fails in outreach clinics whilst maintaining a calm environment for patients present. KEY RESULT AREAS - Proven competence to work without direct supervision and effectively without access to supervision, in General Practice surgeries, requiring the ability to plan travel time appropriately and to plan and organise own clinic time, screening a minimum number of patients per day under current workflows. To maintain a good throughput of patients in the event that workflow practices change.

Capacity to work accurately whilst maintaining intense periods of concentration and competing claims on time. To be accountable and make clinical decisions involving patients within local guidelines, without direct supervision from medical staff. - Post holder will receive on the job training for all aspects of the role by a qualified screener grader and will be supervised in clinics for the first four months. After this period the post holder will be subject to competency and quality assurance checks by senior team members.

• Proven competence in digital retinal photography. Retinal photographs should be of sufficient quality to meet the National Quality Assurance Standard. - Post holder will be required to work up to two Saturdays per month instead of a normal working day and up to two late clinics per week. - Competence to be able to distinguish a disease positive image from a disease negative image and undertake monthly Test and Training Image Sets.
• To remain calm and focused during screening clinics in particular during adverse conditions such as IT failure. - To communicate effectively with health professionals and frequently with patients, sometimes in distressing and sensitive circumstances, using empathy and reassurance in the management of information regarding diabetes management, diabetic retinopathy, diabetic eye disease and loss of sight. - To safely administer mydriatic eye drops within the Procedure for the Ordering, Prescribing and Administration of Medication Guideline and following department Patient Specific Protocols. - Proven competence to deliver effective one-to-one patient education, using their retinal images as a teaching tool, in a motivating and persuasive manner so as to encourage effective diabetes management and reduction in the risks of diabetic eye damage whilst encouraging annual screening attendance.
• Competence of accurate image and data handling, including image capture and retrieval. - Carry out proficiently and safely the frequent movement of a digital fundus camera (87kgs) and equipment between county-wide surgeries, being aware of and acting in accordance with Trust manual handling protocols. - Adhere to all Trust policies and procedures and maintain accurate patient records. - Proactively seek and maintain up to date information and training to ensure that professional skills are sustained to a high standard.

COMMUNICATION & WORKING RELATIONSHIPS - To develop and maintain communication and commitment with all members of the immediate team and other eye screening programmes in the UK. - Multidisciplinary team within the Trust. - Ophthalmologists and members of the diabetes team - Patients. - General Practitioners, Practice Nurses, Practice Managers and other surgery staff.

• National Screening Committee for Diabetic Retinopathy - Trust IT department - Outside agencies for IT, camera and software support. MOST CHALLENGING PART OF THE ROLE Ability to work without direct supervision in General Practice, often under pressure, on rare occasions with no guidance from peers, senior team members or the departmental managers, whilst maintaining a high standard of patient care, safety, education and time management. Responsibility for handling patient images and data and prioritising time to ensure timely transfer of data to ensure the service meets national standards. To remain focused and resourceful in adverse working conditions so that technical problems can be analyzed and solved.

Post holder will be required to work up to two Saturdays per month instead of a normal working day and up to two late clinics per week. PHYSICAL EFFORT AND WORKING CONDITIONS -Will be required to work within recognised Manual Handling guidelines. - Will be required to manoeuvre equipment up to 86kg, using specially designed trolleys, often in confined spaces and in and out of vans to deliver to county-wide practices. Will be required to carry a laptop and case (approx 5-7kg) on a daily basis to the screening clinic, and handle and move a large volume of paperwork, in a suitcase with wheels, when setting up and finishing a screening clinic.

• Will be required to conduct screening clinics in a darkened room, using a VDU and specialist equipment, often in confined spaces. Image grading is also conducted in a darkened room using a VDU. - Ability to work where there is a requirement to concentrate for prolonged periods. - Will be required to follow Policies and Procedures pertaining to infection control and COSHH regulations.
• Will be expected to work some Saturdays in lieu of a weekday. Notice will be given but may be required to provide sickness cover at short notice.

fundus cameras and direct ophthalmoscopes in the direct examination of patients eyes. - Ability to work using own initiative, efficiently and professionally in county-wide General Practice Surgeries. - Enhanced IT skills including experience of windows based software, capture and grading software for diagnostic purposes and Microsoft word. - An up to date knowledge and understanding of key professional developments and recommended good practice - Demonstrate understanding of research based practice, and participate as required in audit.

• Ability to respond flexibly, resourcefully and using department policies issues occur, e.g. when equipment fails in outreach clinics whilst maintaining a calm environment for patients present. KEY RESULT AREAS - Proven competence to work without direct supervision and effectively without access to supervision, in General Practice surgeries, requiring the ability to plan travel time appropriately and to plan and organise own clinic time, screening a minimum number of patients per day under current workflows. To maintain a good throughput of patients in the event that workflow practices change

Capacity to work accurately whilst maintaining intense periods of concentration and competing claims on time. To be accountable and make clinical decisions involving patients within local guidelines, without direct supervision from medical staff. - Post holder will receive on the job training for all aspects of the role by a qualified screener grader and will be supervised in clinics for the first four months. After this period the post holder will be subject to competency and quality assurance checks by senior team members.

• Proven competence in digital retinal photography. Retinal photographs should be of sufficient quality to meet the National Quality Assurance Standard. - Post holder will be required to work up to two Saturdays per month instead of a normal working day and up to two late clinics per week. - Competence to be able to distinguish a disease positive image from a disease negative image and undertake monthly Test and Training Image Sets.
• To remain calm and focused during screening clinics in particular during adverse conditions such as IT failure. - To communicate effectively with health professionals and frequently with patients, sometimes in distressing and sensitive circumstances, using empathy and reassurance in the management of information regarding diabetes management, diabetic retinopathy, diabetic eye disease and loss of sight. - To safely administer mydriatic eye drops within the Procedure for the Ordering, Prescribing and Administration of Medication Guideline and following department Patient Specific Protocols. - Proven competence to deliver effective one-to-one patient education, using their retinal images as a teaching tool, in a motivating and persuasive manner so as to encourage effective diabetes management and reduction in the risks of diabetic eye damage whilst encouraging annual screening attendance.
• Competence of accurate image and data handling, including image capture and retrieval. - Carry out proficiently and safely the frequent movement of a digital fundus camera (87kgs) and equipment between county-wide surgeries, being aware of and acting in accordance with Trust manual handling protocols. - Adhere to all Trust policies and procedures and maintain accurate patient records. - Proactively seek and maintain up to date information and training to ensure that professional skills are sustained to a high standard