Highly Specialist Dietitian for Cystic Fibrosis

To be responsible for leading the specialist dietetic aspects of the Blackpool Adult Cystic Fibrosis Service using a high level of knowledge, skills and experience as an independent practitioner.

To deliver a high quality, evidence-based Nutrition and Dietetic service to a specialised area. To act autonomously in the management of a cystic fibrosis adult caseload with varying degrees of nutritional complexity.

To contribute to the main Nutrition and Dietetic service within Blackpool Teaching Hospitals NHS Foundation Trust in terms of offering in reaching mentorship and continuous professional development opportunities to the acute and community dietetic team.

To act as an expert nutritional resource within the defined specialist area, Cystic Fibrosis, and to educate and train dietetic students and other health professionals within the Trust.

To contribute to the Trusts clinical governance programme by taking a lead within the specialist area for audit, development and implementation of evidence-based guidelines/protocols/policies and continuing professional development.

1) Post holder will work independently (work will be self- directed and autonomous) to manage and provide the cystic fibrosis dietetic service. You will be expected to seek peer support and clinical supervision via the specialist cystic fibrosis dietetic networks.

2) To provide highly specialist dietetic advice to patients and/or carers with Cystic Fibrosis, whilst taking into account ethical, social, emotional, psychological and cultural needs. To be able to use this complex and sensitive information in formulating individual dietetic advice. Communicating this information effectively to the MDT and patients/carers alike.

3) To provide nutritional and dietetic counselling to educate a diverse patient population. To understand the complex dietary changes which are needed and to employ advanced motivational and behavioural change skills to overcome barriers to change particularly where there is non-compliance.

4) To utilise and develop communication tools and teaching skills in order to educate patients who may have barriers to understanding e.g. disabilities, non-English speaking, poor literacy.

5) To organise and deliver training sessions for groups of patients with specialist dietary needs in person and via virtual forums such as Attend Anywhere or Microsoft Teams.

6) To receive and communicate highly complex and sensitive information, which may include unwelcome or difficult information; for example, long-term adherence to complex and multiple dietary interventions or initiation of invasive nutritional support e.g., tube feeding. To present this in an understandable form to patients and their carers to facilitate compliance with treatment leading to improvements in clinical condition.

7) To make dietary recommendations after calculation of nutritional requirements based on interpretation of biochemistry, anthropometrics, anatomy and physiology, clinical condition/prognosis and other physical parameters.

8) To provide appropriate treatment, monitoring and review of patients dietary needs, involving other agencies when indicated.

9) To be the nutritional lead within Blackpool Adult Cystic Fibrosis Service area for multidisciplinary team meetings and case conferences. To communicate expert nutritional assessment and advice regarding individual patient care to the team.

10) As the nutritional lead for the speciality to advise the medical team on any medications which may affect nutritional therapies e.g. laxatives, anti-emetics.

11) To advise on appropriate use of nutritional products. The Dietitian will specify product type, quantity and regime to meet individual patient needs.

12) To support patients diagnosed with CF related diabetes to adapt their nutritional intake with the aim of stabilising their blood glucose and or support with advice which will optimise diabetes medication which may include teaching on carbohydrate counting.

13) To be competent with the use of enteral feeding equipment used within the Trust and community setting by attending annual training sessions.

14) To advise the multi-disciplinary team and the patient on most appropriate routes of feeding, product type, rate and volume to meet patients individual nutritional requirements.

15) To be responsible for organising the discharge of patients on alternative feeding. This includes prescription of feeds, liaising with community nursing, other hospital trusts, medical and dietetic teams and the companies providing the feed in the community.

16) To work in a frequently stressful environment with patients who may be critically ill, chronically ill, terminally ill or undergoing long periods of rehabilitation. To support them and their carers, both nutritionally and emotionally during the course of their disease.

17) To advise the catering department on the provision of nutritionally adequate menus within budgetary constraints. To be responsible for the adaptation of standard menus to suit therapeutic diets.

18) To be accountable for the appropriate supply of nutritional products to ward areas in accordance with the pharmacy department and trust policy.

Working relationships

1. Provides specialist Nutrition and Dietetic input to a multi-disciplinary team including medical, nursing, AHPs, catering and ward staff.

2. Provides specialist advice to patients, carers, community services e.g. GPs, community organisations, doctors, nurses and other allied health professionals, voluntary organisations and companies that provide nutritional products.

Professional

1) To participate fully in the appraisal system in line with Trust policy. Develop an individual Personal Development Plan (PDP) in line with the Health Professional

Council requirements for registration.

2) To ensure own practice is up to date and evidence based, and able to demonstrate an awareness of current relevant research through teaching, attending courses/study days and peer review.

3) To promote safe caseload/workload management, using appropriate assessment, organisational, time management and reporting skills.

4) To be responsible for the clinical supervision and training of junior staff, facilitating their professional development and postgraduate learning. To be involved in and evaluate the junior staffs rotational programme.

5) To facilitate/support the induction of new staff within the team.

6) To identify the need for educational resources for patients treated within the speciality. To lead and develop non-biased evidence based written materials and teaching resources as required for a diverse client group. Undertake regular review of these resources.

7) To identify nutritional training needs of other health care staff within the area of clinical speciality. To develop, plan and deliver training in relevant aspects of nutrition and dietetics. To evaluate and monitor this training in order to promote understanding of nutrition in relation to patient care and improvement in quality of care.

BACFS is the first new adult service in the UK for over 40 years, it was formed in 2016. We provide a locally accessible and highly specialised service improving life expectancy and quality of life for adults with Cystic Fibrosis (CF) in Blackpool and surrounding areas. The service is based at Blackpool Victoria Hospital. We are one of the first Cystic Fibrosis Services to offer a digital CF service in the form of virtual clinics, home monitoring, communication for our patients via Attend Anywhere, email and text.

BACFS is a close-knit, highly supportive and encouraging team. The multidisciplinary team (MDT) is made up of 3 Nurses, a Dietitian, a Physiotherapist, a Clinical Psychologist, an Associate Psychological Practitioner, a Social Worker, and 3 x Medics with admin and and service manager support. Work-life balance is greatly endorsed within our team with the opportunity for flexible working.

As this is an innovative service, there are always new areas to develop for someone who is dynamic, works off their own initiate and is confident in working alongside the CF MDT and other specialist services within the hospital and community.

This post is an opportunity to transfer previous experience and skills to the ever-changing speciality of Cystic Fibrosis regionally and nationally.

Education and Qualifications

Experience and Knowledge

Skills and Ability