Senior Liver Specialist Nurse - Band 7

at  Gloucestershire Hospitals NHS Foundation Trust

The incidence of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) has increased over the past few decades.
The purpose of this position is to develop and lead a one stop Hepatology clinic based at the Community Diagnostic Clinic (CDC) Quays Gloucester. This will enable rapid access to the right services and early diagnosis for those patients identified with NASH/NAFLD. This is a new service that will require leadership and independent decision making from the post holder and no Consultant Hepatologist presence on site. The post holder will help to promote and coordinate a seamless pathway of care for patients with liver disease, from diagnosis through to treatment and outpatient management.
The post holder will develop and lead a one stop Hepatology clinic based at the Community Diagnostic Clinic (CDC) Quays Gloucester. This will enable rapid access to the right services and early diagnosis for those patients identified with NASH/NAFLD. This is a new service that will require leadership and independent decision making from the post holder and no Consultant Hepatologist presence on site. The post holder will help to promote and coordinate a seamless pathway of care for patients with liver disease, from diagnosis through to treatment and outpatient management.
The post holder will be required to work with the Liver Specialist Nurses to provide high quality specialist clinical care within nurse-led clinics and within all wards in both Cheltenham and Gloucester Royal hospitals. The CDC Liver service will provide twice weekly clinics initially, with potential to increase as the service develops. The post holder will be an experienced practitioner and would have the opportunity to line manage and work with the liver specialist nurses, encompassing nurse led clinics such as Rapid access clinic, surveillance clinic, decompensating patient clinics, post discharge/hot seat clinic and nurse led paracentesis.
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 recruiting the best people to work with us to achieve our vision of providing Best Care for Everyone and our success depends on the commitment and dedication of our staff.
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.
Deliver specialist nursing care to a defined caseload of patients and take responsibility for patients with NAFLD/NASH in CDC.
Undertake assessment of individuals using a range of different assessment methods, which may include physical examination, ordering and interpreting diagnostic tests or advanced health needs assessment.
Provide the highest standard of holistic care for patients through the utilisation of enhanced clinical skills and advice in the assessment and management of patients in collaboration with the multi-disciplinary team to improve and maintain the quality and safety of patient care.
Deliver education, support, audit and research as needed and provide clinical support for junior members of team.
Support patients, carers and staff during difficult situations arising in the clinical area, e.g. breaking bad news or following an unexpected event.
Responsible for identifying and assessing complex clinical and non-clinical issues, implementing resolutions and monitoring /auditing outcomes.
Run nurse-led clinics in CGH to ensure optimum patient management including; complex patient monitoring, equipment management and defined expanded clinical roles e.g. non-medical prescribing and performing Paracentesis within nurse-led clinic and wards in CGH/GRH.
Attend relevant medical ward rounds to provide specialist nursing advice
To be accountable for the planning and delivery of all aspects of patient care in relation to the specialist area of practice and as set out in the NMC Code.
Working across the boundaries of hospital and community care.
Liaise effectively with primary care colleagues to explore opportunities to improve and develop services and establish links with community teams/agencies in order to address shared challenges.
Raise awareness and promote understanding of NAFLD/NASH
Lead in the delivery and development of the specialist nurse-led service through the use of effective evidence-based practice in line with agreed national standards for clinical practice.
Knowledge, Skills & Experience Required
NMC registration
Previous experience of multidisciplinary working
Advanced knowledge of liver disease
Ability to perform Fibroscan, interpret results and formulate a suitable treatment plan based on results once appropriately trained
Ability to perform Critical Flicker test, interpret results and formulate a suitable treatment plan based on results once appropriately trained
Leadership and management
To provide guidance and direction to enhance a smooth work flow
Practice autonomously and be self-directed
Allocate resources effectively
Co –ordinate diagnostic Hub and delegate responsibilities to ensure efficient delivery of patient care
Promote a positive work environment
Promote team work
Develop ongoing treatment plans
Encompass at all times evidence-based practice and decision making to optimize patient outcomes
Identify areas for improvement
Analyse clinical outcomes
Develop and implement protocols
To work at all times in accordance within the NMC code of professional practice.
To lead in maintaining effective working relationships with Consultants, GPs, their practice staff and all other care professional within clinical areas in CGH/GRH.
Education and training
Evidence of continued professional development
Ability to perform Fibroscan (desirable) or willingness to undertake training
Ability to perform critical flicker test or willingness to undertake training
Holds non-medical prescribing qualification
Be confident in networking with other Diagnostic Hubs throughout the county to expand and maximise knowledge
Improving quality and developing practice
Participate as required in audit
To provide specialist knowledge and support to patients with a positive diagnosis of liver disease
To be confident in discussing healthy lifestyle changes
Communicate effectively with patients where understanding may be limited or patient ability to communicate effectively is compromised.
To lead and deliver safe care using resources and equipment safely.
Contribute to policy and service development as required
Work closely with other specialist providers including GPs, dietetics, consultants, community services, providing a seamless service for those patients newly diagnosed with NAFLD/NASH and chronic liver disease.
To act as a role model and specialist resource to all staff disseminating clinical skills, knowledge and best practice.
To adhere to all Trust policies and procedures and professional code of conduct
In accordance with the Data Protection act, ensuring own staff’s ability to input and retrieve patient and staff information from computer-based system and maintain accurate records
To actively support and assist line managers with public patient involvement
Physical, Mental & Emotional Effort & Working Conditions
Will be required to work within recognised manual handling guidelines
Will be required at times to deal with difficult situations and discussing diagnostic outcomes
Will be required to follow policies and procedures
Accommodate and provide a flexible service for patient group
Be confident in autonomous working
Professional values
Honest and trustworthy
Compassionate
Person centred
Work within a professional ethical and legal framework
Communication and interpersonal skills
Excellent written and verbal communication
An ability to deal with challenging individuals with tact and diplomacy
High levels of sensitivity/empathy when dealing with patients
Ability to deal with diverse situations in a sensitive manner
Maintain confidentiality of patients’ and carers’ information when communicating with wider multi-disciplinary team in accordance with Trust and national guidelines.
Apply counselling and advanced communication skills to consultations with patients.

Please refer the Job description for details