Band 8a Clinical Endoscopist

Job summary

We are seeking an enthusiastic and dynamic Clinical Endoscopist to join our brand new Transnasal Endoscopy Service at Finchley Memorial Hospital NHS Community Diagnostic Centre. The service is open 7 days a week and working hours are between 8am-8pm.

This is a unique and exciting opportunity to join an NHS service that is focussed on delivering the best healthcare services to the local population. Our ambition at the CDC is to transform the way we traditionally deliver healthcare and explore new and innovative delivery models that reflects the needs of both our staff and our patients.

Main duties of the job

To assist Lead nurse endoscopist to develop clinical endoscopy service across the Trust. To carry out diagnostic upper GI/Transnasal endoscopy service providing advanced assessment and diagnosis for patients referred. To manage patients appropriately through the diagnostic pathway using pre assessment, outpatient and telephone clinics and MDT review. To take responsibility for own evidence-based practice. To develop and work inside clear advance practice policies and evidence-based guidelines to support the service. To develop all staff within the multidisciplinary team, providing support, advice, formal and informal education on endoscopy management. To work independently and autonomously within the endoscopy department. To support the endoscopy leadership team in ensuring world class standards within the endoscopy units across the Trust and to gain and maintain JAG accreditation. To work alongside the endoscopy leadership team in the implementation Trans nasal UGI endoscopy at Finchley memorial hospital CDC

About us

Finchley Memorial Community Diagnostic Centre (CDC), occasional requirement to attend other Royal Free London sites.

Finchley Memorial CDC works in close collaboration with its sister site Wood Green CDC, hosted by Whittington Health NHS Trust. As the service develops there is a potential requirement for staff working at either site to cross cover. The post holder will be expected to be onsite 5 days per week.

Job description

Job responsibilities

Leadership

1. Provide a visible presence within the clinical areas and be responsible for leading the delivery of high-quality care.

2. Ensure that the needs of patients are placed at the centre of care delivery, thus achieving trust and national standards for clinical quality, safety and patient experience.

3. Provide professional, clinical and managerial leadership to nursing and associated staff, and ensure the provision of a high quality, responsive nursing service.

4. Be accountable for all aspects of quality management related to the nursing and clinical area.

5. Lead the implementation of improvements in nursing practices within own areas of responsibility in line with local and national agenda and patient feedback

6. To have a thorough understanding of safeguarding procedures and knowledgeable with respect to safeguarding triggers and risks.

Clinical Practice

1. To undertake upper GI endoscopic procedures (including gastroscopy/Transnasal) with informed consent and due regard to patient safety and safe use of equipment.

2. To establish and maintain effective personal relationships with patients and relatives and ensure that the individuals physical, psychological, and spiritual needs are identified.

3. Ensure patient needs are met by working collaboratively with other professionals and agencies, especially in relation to ongoing care needs and discharge arrangements, liaising with a wide remit of agencies/multidisciplinary teams, hospital based and community, and has a wide knowledge of all the services offered, , has the authority to admit and discharge patients and refer to other health care providers as appropriate.

4. Performs a comprehensive problem focused health history, physical examination, analyses and interprets history, presenting symptoms, physical findings, and diagnostic information to develop differential diagnosis within specialist area.

5. Ensure patients are investigated appropriately, interpretation of results and communication of results to patient, carer, and GP/referrer. Deciding a management plan resulting in appropriate follow-up and discharge.

6. Use clinical judgement to identify, request and organise further investigations Blood tests- biochemical/ haematology/microbiology, radiology - CT scan/colon, Barium Enema/meal/ follow through, ultrasound scan etc. to aid diagnosis, receive results and interprets the findings and communicate to GPs, medical consultants, patients and carers.

7. Possess and demonstrate extensive, complex clinical skills and be able to deliver specialised nursing care, , Physical examination, cannulation, drug administration, venepuncture.

Non-Medical Prescribing

8. As a registered Nurse Prescriber or Independent Prescriber, the practitioner will undertake prescribing duties within their identified and agreed scope of prescribing practice. They will:

Clinically manage patients in a designated clinic / clinical area

Monitor the patients, order tests, and monitor blood results and respond by modifying treatment or liaising with designated medical staff if medical review is required.

Make clear, contemporaneous records in the patients case notes and communicate with the patients GP as necessary.

Provide written information to patients, on procedures that may be needed, their condition and the therapeutic options and involve the patient in therapeutic decisions.

Provide other information or education for the patient as required or on request.

9. As a Non-Medical Independent Nurse Prescriber utilise highly developed specialist knowledge and skills, administer and be accountable for the giving sedation, muscle relaxants, recognising any adverse reactions and administrating the appropriate anti-dote, for endoscopic procedures under the Patient Group Directions as per local policy Directives and independently prescribe other medicines to patients undergoing endoscopic UGI endoscopy as per protocol.

10. Use highly developed specialist knowledge to take Informed Consent from the patient by informing the patient and explaining the reason for the procedure, benefits, risks, complications and effects of the intended diagnostic endoscopic procedure and alternative treatments.

11. Recognise and respond appropriately to urgent and emergency situations, complete and possess Advanced Life Support skills to initiate first line treatment in emergency situations , Cardiac/Respiratory arrest.

12. Deal with highly complex clinical situations , recognising and instigating treatment in patients experiencing an adverse events or reaction from the nurse led endoscopic procedure. , perforation, bleeding, respiratory/cardiac arrest due to adverse reaction to sedative.

13. Frequently and directly involved in the giving of bad news to patients and/or relatives, , informing patients of a cancer or life altering disease , Upper GI cancer, Barrett's Oesophagus/ Coeliac disease. Provide support to anxious and /or bereaved relatives, demonstrating empathy and sensitivity in a professional manner.

14. Accountable for identifying the patient's health education needs and collaboratively implementing programmes of health promotion according to the diagnosis.

15. Actively monitor to ensure safe prescribing and administration of drugs in accordance with current NMC guidelines and Trust Policies.

16. Discuss the future management plan with the patient and their carer if appropriate and liaise with the referring medical practitioner.

17. Communicate and liaise with primary care colleagues regarding patient care, management, and monitoring. Be responsible for documentation of care and treatment and subsequent letter/report to GP.

18. Highly provide specialist advice and support to colleagues regarding endoscopic procedures across primary and secondary care.

19. Work autonomously to carry out complex/specialist care , symptom management, medications management for patients with complex needs.

20. Competence in the use of all medical devices and specialist equipment relevant to the role, , endoscope.

21. Backfill in the absences of the consultant endoscopists, as appropriate.

22. Request and organise further investigations , Blood tests- biochemical/ haematology/microbiology, radiology - CT scan/colon, Barium Enema/meal/ follow through, ultrasound scan etc. to aid diagnosis, receive results and interprets the findings and communicate to GPs, medical consultants, patients and carers.

23. Participate in Specialist Nurse, Multidisciplinary Team, Endoscopy User Group & other meetings relevant to upholding good clinical, professional, and nursing practice in the multi-disciplinary team.

Professional Development and Education

24. Complete and maintain the required specialist training and related advanced clinical, technical, and interpersonal skills and competence required as an autonomous practitioner.

25. Look to develop, with the endoscopy Training Lead, delivery and provision of education and training for medical staff linked to Endoscopy and Endoscopy nursing staff in complex conditions/treatments.

26. Act as a communication channel to all different staff groups, patients and relatives, as well as staff in other disciplines and agencies.

27. Provide professional guidance and advice whilst monitoring and maintaining professional standards.

28. Comply with NMC Professional Registration, practice in line with current NMC Code and keep up to date with advanced nursing practices.

29. Act as a role model for expert clinical nursing practice, demonstrating high professional standards and patient centred care provision.

30. Teach and evaluate Nursing and Medical staff to perform diagnostic and therapeutic Endoscopy.

31. Use presentation skills to present complex and highly developed specialist information to large multi-agency groups both internally and outside the Trust, , presenting audit results, service developments, teaching and education and representing the Trust to promote and share best practice.

Accountable for identifying the patient's health education needs and collaboratively implementing programmes of health promotion according to the diagnosis.

32. Responsible for the supervision of Medical and Nursing staff whilst delivering specific training within the department.

33. Plan and develop training programmes and deliver the expert practice component of the role for students of endoscopic procedures , training of medical Trainees and Nurse Endoscopist in endoscopic procedures. Also responsible for teaching and assessing practical and theoretical skills to nursing staff , use of equipment for endoscopic procedures.

34. Plan, schedule, facilitate and deliver study days/events for regional endoscopy training courses.

35. To identify poor practice and take steps to rectify the situation. Provide advice on the training needs analysis which reflects the future needs of the service in collaboration with the Head of Nursing.

36. To co-ordinate and monitor both Trainee and Trainer feedback to ensure continuous development of the Endoscopy training within the department.

37. To support the Endoscopy/CDC department manager with the on-going development of the Nursing Competency based Training programme.

38. To liaise with the Head of Nursing, and General Manager and external providers to ensure appropriate educational opportunities for personal, professional, and service development.

39. To take an active role in teaching informally and formally, to play an active role in health education and educating patients about their lifestyles.

Person Specification

Education & Professional Qualifications

Essential

Registered Nurse Basic skills Upper GI qualification (JAG accredited) Advanced knowledge of GI tract anatomy and physiology.

Experience

Essential

3 years post registration experience within a relevant area Experience of service development Experience of research and audit

Skills & Aptitudes

Essential

Knowledge of gastro-intestinal disease processes Understands physiological systems, disease processes and risks of associated medical technologies Able to work autonomously Able to organise and prioritise workload

Desirable

Competent in financial management

Personal Qualities & Attributes

Essential

Approach to work that promotes and demonstrates high work standards and ethics. Excellent communication, negotiation, influencing and diplomatic skills both orally and in writing

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