Specialist Surveillance Practitioner

The Specialist Surveillance Practitioner is senior clinical role within the programme and is a fundamental role as part of our screening surveillance pathway. The Surveillance Practitioner will undertake the capture and grading assessment of Optical Coherence Tomography (OCT) scans, independently carry out assessment using a slit lamp bio-microscope, as well as the grading of digital retinal images at ROG grading level. The post holder will support the SLB & OCT capture and grading training for the wider team, as well as ensuring the highest standards of clinical governance via audit and quality assurance activities.

The role will work predominantly within a named locality team, however the role will require regular travel across all 4 of our locality teams. The successful applicant will be an enthusiastic professional who is comfortable working independently and as part of a team and able to deliver the highest standards of patient care.

The post holder will be required to deliver training, including the development and review of training material. This role would suit an expert screener/grader with experience of grading fundus images at ROG level and previous experience of grading OCT scans. Independently, managing surveillance clinics and ideally, someone with experience of delivering training to others.

Main duties of the job

• Acting as a clinical point of call for OCT surveillance queries
• Capturing and grading OCT scans in line with SELDESP grading protocols
• Grading retinal fundus images at senior grading level (ROG & Arbitration)
• Delivering both 1-1 and group OCT capture and Grading training & feedback for the wider team
• Reviewing and developing OCT training materials
• Ensuring quality assurance for the OCT pathway via audits
• Assisting in the review and development of the OCT pathway including development on policies, protocols, guidance and resources

About us

The South East London Diabetic Eye Screening Programme is part of Guys & St Thomas' NHS Foundation Trust.

The South East London Diabetic Eye Screening Programme is one of the largest eye screening programmes in the country, offering screening to over 100,000 patients registered with 240 GP practices throughout South East London. The multi-disciplinary screening team includes nurses, optometrists and screener/graders qualified with the diploma in health screening. The clinical workforce is organised into 4 locality teams based around the hospital ophthalmology services into which each team refers. Each locality team has close links with the lead ophthalmologist and diabetes clinicians within the acute services.

Job description

Job responsibilities

Job Summary

This role will be predominantly engaged within the programme surveillance clinics undertaking the capture and primary interpretation of Optical Coherence Tomography (OCT) scans, but will also need to provide screening and grading within the routine photographic screening clinics as required.

Key Relationships

The post holder will have regular contact with:

• Members of the screening team
  • Multi-disciplinary members of the diabetes departments at the acute hospital sites within the 6 boroughs of London covered by the programme.
• Members of the programme administration team
• Surveillance Manager
• Screening Team Leader
• Programme Manager
• Clinical Lead, and Lead Ophthalmologists

Duties and Responsibilities

Clinical Duties and Responsibilities

• Work autonomously, managing own caseload in community and hospital clinics
• work constructively with colleagues to ensure clinics operate smoothly
• instil mydriatic eye drops into the patients eyes, in line with appropriate protocols, recording this information on the IT system
• capture digital retinal photographs in line with national standards and local protocols
• capture and assess OCT scans for patients with maculopathy and ensure appropriate onward management in line with local protocols
• Independently carry out retinal reviews using a slit lamp biomicroscope and making appropriate onwards management decisions
• grade retinal images to referral outcome level, making an assessment of the level of disease in line with local grading protocol and deciding onward management in line with local protocol
• Independently carry out the assessment of the retina using a slit lamp biomicroscope and make clinical decisions for the most appropriate onwards management of the patient.
• refer any issues preventing patients being screened on that day to the administration team so that they can rearrange appointments and record this in the patient notes
• plan own clinical case load and that of others deal with any telephone and drop in enquires, providing information to patients and colleagues that is commensurate with training and referring any clinical queries to the team leader or clinical lead
• undertake regular audit and quality assurance of surveillance clinics, reporting outcomes to the programme leadership
• participate in research activities
• adjust the camera settings appropriately, and troubleshoot any camera/hardware issues that arise before reporting any problems up the line
• to be confident with the use of the IT system, finding patients, adding new patients, updating patients and archiving patients in line with screening and administration policies.

Communication Duties and Responsibilities

• Act professionally and courteously at all times to patients and colleagues
• communicate complex information regarding screening to patients and professional colleagues where tact may be required or where there may be barriers to communication such as disabilities
• explain to patients how their images will be assessed following their attendance and when they should expect to receive their results
• to deal with any complaints or issues they arise and attempt to resolve, but to know when to report them up to line to the team leader or deputy programme manager as appropriate.
• Act as a patient experience champion for the service. Develop and implement improvement projects, based on patient feedback.

Education

• Develop and maintain specialist knowledge of screening and surveillance procedures through continual professional development
• Train, supervise and sign off local screener/ graders on the OCT capture and grading plans. demonstrate commitment to the development of others
• provide ongoing clinical supervision for junior colleagues on screening plan teaching sessions and deliver training
• Provide 1-1 and group feedback on OCT grading performance and signpost any OCT performance concerns to the nominated Team Leader & Grading Lead.
• Provide SLB feedback to the wider team
• support trainee screener/graders to achieve the Diploma in Health Screening (NVQ level 3).
• Continue to assist in the review and development of the OCT pathway, including regular reviews of resources and training templates.

Person Specification

Qualifications/Education

Essential

• Good standard of general education, 5 GCSES A-C or equivalent
• Education to graduate level or equivalent experience in a health related field
• City and Guilds NVQ Level 3 Diploma in Diabetic Retinopathy Screening

Desirable

• An OCT interpretation qualification or equivalent

Experience

Essential

• Experience providing training and/or clinical supervision for junior staff
• Experience of capturing OCT scans
• Ability to independently grade OCT scans
• Experience of participating in external quality assurance

Desirable

• Experience of working in an ophthalmology clinical setting
• Experience of grading diabetic retinopathy via slit lamp bio-microscopy
• Experience of undertaking audit and research
• Experience of developing local policy and procedures
• Experience of grading at Arbitration and Referral Outcome Level
• Experience of working autonomously to manage busy retinal screening clinics

Skills

Essential

• Excellent computer literacy
• Ability to prioritise multiple competing tasks
• Good customer service and communication skills
• Presentation skills
• High level of accuracy when grading diabetic retinopathy from digital retinal images
• Ability to recognise common non-diabetes related eye conditions and refer appropriately
• Excellent understanding of national diabetic eye screening referral pathways
• Excellent understanding of internal quality assurance within a retinal screening programme
• Displays the Trust values and behaviours
• Manual dexterity to operate a retinal screening camera / slit lamp / OCT
• Ability to assist patients from wheelchairs to the examination chair

Employer details

Employer name

Guy's and St Thomas' NHS Foundation Trust

Address

South East London Diabetic Eye Screening Programme, Guys & St Thomas NHS Foundation Trust

3rd Floor, Conybeare House

London

SE1 9RT

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