Job Description

Do you have a passion for gastroenterology? Do you have a drive for service development and quality improvement? This is an excellent opportunity to develop your career and to further develop and strengthen skills in clinical practice, leadership, education and training and research.



The post is based in the acute setting at Torbay Hospital, supported by a friendly and innovative team.



The post holder will work closely with the gastro team (9 Consultants and multiple Specialist Gastroenterology Nurses) to further develop, lead and provide a specialist medical gastroenterology dietetic service for inpatients and outpatients supporting the work of the consultant gastroenterologists.



You will supervise and work closely with a Band 6 gastro dietitian, as well as providing support to Band 5s and a Dietetic Support Worker in the acute based team.



Torbay boasts excellent transport links across the South West. Close to Torquay's stunning seafront, and access to the incredible Dartmoor National Park for outdoor adventures. It's a fantastic place to work, live, and thrive!



To co-ordinate gastroenterology dietetic services (including supervision of gastroenterology dietitians). To work as an autonomous dietetic practitioner, taking the lead in the comprehensive assessment of the route of nutritional support, nutritional requirements, provision of optimal, safe, nutritional therapy and assessment of efficacy of nutritional support, and specific nutrition therapy for complex patients under the care of the medical gastroenterology department for both in- and out-patients. To lead a patient centred out-patient service to all medical gastroenterology patients. To design and implement a completely dietetic led coeliac disease service including direct to dietitian triage from primary care. To include assessing newly diagnosed patients, providing comprehensive patient education and support to patients and their carers or relatives, responsibility for monitoring biochemistry, liaising with the consultant gastroenterologists for specific patients and guiding GPs as needed. To design and implement direct to dietitian IBS service from primary care (including setting up service with clear pathway, evaluation, improvement and education of primary care) with support of consultant gastroenterologists. To provide cohesive dietetic care for gastroenterology patients, providing cover for the surgical gastroenterology and/or Nutrition Support Team Dietitian as required.













Why Work With Us



About your new team and department



This post is based at Torbay Hospital with the Acute team dietitians. The acute dietitians cover speciality areas of nutrition team, medical and surgical gastro, ICU, head & neck cancer, nutrition support across 12 wards at Torbay Hospital and outpatient clinics for these specialties. The Acute team is part of the wider dietetic team including Community, Diabetes, Paediatrics, Weight Management, and Cancer Services. The team has over 40 staff members - dietitians, dietetic support workers and admin support. The team is actively involved with training of student dietitians from the University of Plymouth.



Communication and working relationships



To work as the lead dietetic member of the medical gastroenterology MDT

To communicate and establish working relationships with:

o Gastroenterology consultants, ward managers and matrons



o Allied health professionals



o Gastroenterology MDT, rehabilitation teams, ward medical and nursing teams



o Nutrition team and nutrition nurse specialists



o Home Enteral Feeding (HEF) Dietitians and HEF Team



o Catering department



o Local dietetic team, including acute teams of dietitians, community dietitians, diabetes dietitians, Primary Care Network (PCN) dietitians



o Other medical gastroenterology dietitians, locally and regionally to share best practice



o Students - dietetic and other professions



o Other health and social care professionals



Planning and organisation



To manage own clinical caseload as an autonomous practitioner within the medical gastroenterology service

To manage own time, prioritise clinical referrals and manage the demands received from different parts of the service

To lead on development of new gastroenterology dietetic services, including planning, organisation and implementation.

To collate evidence to evaluate gastroenterology dietetic services, for example, identifying the strengths of service provision, patient activity statistics, health outcomes and patient satisfaction (e.g. Friend and Family Tests)

Actively evaluate the dietetic medical gastroenterology service, identifying any areas for development, together with support from senior members of medical gastroenterology and dietetic teams



To plan, organise, deliver, and evaluate training sessions to a variety of groups including health and social care professionals and patients. Training may be face to face or via virtual platforms.



Responsibility and accountability



To be the nutritional lead for development of dietetic services in the medical gastroenterology team.

To deliver dietetic care to a caseload of complex adult patients in collaboration with the gastroenterology MDT and other MDTs as required

To provide a source of expert knowledge and advice on nutrition to the gastroenterology service and other gastroenterology dietitians.

To carry out other duties as agreed with the Head of Nutrition and Dietetics



Responsibility for patient's and client care



To lead provision of evidence-based, individualised, disease specific and often complex dietary/nutritional treatment plans for medical gastroenterology patients with, appropriate review and evaluation of these plans

To undertake nutritional assessments, which may be either face to face or remotely as clinically indicated

To measure and interpret individual patient's nutritional status based on weight, height, body mass index, nutritional intake, biochemistry, and clinical presentation/condition

To calculate disease specific nutritional requirements for patients, using knowledge and evidence-based practice

To assess the efficacy, safety and appropriateness of nutritional support routes

To be responsible for reviewing, monitoring and making appropriate clinical changes to each patient's dietetic care plan based on medical, emotional, ethical and social developments in addition to multidisciplinary decisions on the patient's care

To use behaviour change and advanced communication techniques to support and aid compliance with recommended dietary/nutritional treatment plans

To explain treatment plans (verbal and or written) in an easily understandable way to patients, carers and relatives and other relevant individuals, to enable patients to make informed choices about their own health

To provide resources such as patient information leaflets, recipes and menu plans and to signpost them to other resources where appropriate (e.g. NHS patient webinars, relevant charities and support groups).

To provide dietetic care, both practical and empathetic, for people requiring long-term nutrition support or long-term dietary changes (including those who may be in the end stages of their life) with gastroenterology diagnoses

To be pro-active in initiating appropriate dietetic treatment and/or referral, and to signpost to other appropriate services

To advise on commencing enteral nutrition (either orally or by way of a variety of tube feeding routes dependent on gut anatomy and function) and transitioning between routes

To request, review and interpret blood biochemistry results to monitor the safety and efficacy of nutritional support, and make clinical changes where necessary

To understand and be fully aware of the range of oral nutrition support products, enteral tube feeds and associated equipment

To be responsible for recommending nutritional supplements

To recommend nutritional supplements for prescription (e.g. from GP, or hospital doctors where appropriate)

To be a key member of relevant MDTs providing a source of expert knowledge and advice on nutrition, being actively involved in MDT discussions (inpatient and outpatient settings) and decisions around nutritional care and feeding for patients, including medically, socially and ethically challenging situations (e.g. decision making around feeding/tube feeding, patients lacking mental capacity or being treated under the Mental Health Act, end of life care, best interest meetings and safeguarding).

To ensure safe and timely discharge of tube fed patients from hospital to home, with the support of the nutrition team, ward staff and home enteral feeding team including monitoring of high-risk patients (e.g. those being fed post-pylorically or with complex gastrointestinal needs) on home enteral feeding in the community

To advise "off script" enteral tube feeds for home use

To maintain accurate and timely documentation of patient interactions and clinical care provided in line with record keeping standards

To be aware of, identify and raise safeguarding issues observed during clinical practice

To provide support where quality or safeguarding issues have been identified



Policy and service responsibility



To lead the development of policies, resources and guidelines relevant to this role, with the support from gastroenterology

To develop resources such as patient information leaflets, recipes and menu plans

To contribute to the wider service development of the dietetic service

To follow Trust policies and procedures

To undertake clinical practice in line with local policy and guidelines, such as refeeding, enteral feeding and nutrition screening

To relate clinical practice to broader clinical guidelines, including NICE

To promote the role and value of the Dietitian in all aspects of nutritional care

To attend other relevant team meetings which may include gastroenterology management meetings and dietetic meetings



Responsibility for finance, equipment and other resources



The post carries no budgetary responsibility

To take anthropometric measurements to assess nutritional status, including the use of weighing scales, calipers, grip strength during patient assessments

To promote the clinical and cost-effective use of oral nutritional supplements, for example, when inpatients are discharged from hospital into the community



Responsibility for supervision, leadership and management



To provide nutrition expertise within the gastroenterology teams

To provide clinical support and supervision to dietitians to include monthly 121s and annual achievement reviews

To participate in the training of dietitians, student dietitians and students of other professions

To provide cover for specialist dietitians (with appropriate training) during periods of leave

To actively support own wellbeing, as well as to support the wellbeing of the other members of the team



Information technology and administrative duties



To use Trust IT systems

To accurately record own Dietetic activity using computerised statistics and to collate this data for service evaluation and development purposes

To use Attend Anywhere or equivalent for patient assessments, when clinically appropriate

To prepare own presentations, reports, and documents

Maintain clinical records including Dietetic records and GP letters and in line with professional and department standards. Use electronic patient records where available

To work within the requirements of Data protection legislation and access to health records

To communicate via email, social media and other internal IT systems

To use Microsoft Teams to attend meetings and deliver training virtually, and virtual patient education groups (e.g. IBS)

Use IT to project manage and collect data for service evaluation



Responsibility for research and development



To be responsible for own and gastroenterology dietetic services continued professional development and be proactive within annual Achievement Reviews and monthly 121s

To maintain and improve professional knowledge through CPD (continued professional development), for example, journal review, shadowing, attendance at courses/conferences/webinars as agreed with the Team and the wider dietetic department

To liaise with other specialist dietitians

To work within the HCPC (Health and Care Professions Council) Standards of Conduct, Performance and Ethics and the BDA (British Dietetic Association) Code of Professional Conduct

To proactively identify and lead project work to develop the service to provide high quality nutritional care to patients

Produce reports/summaries to monitor, evaluate and provide feedback about the service

To identify and lead relevant audit and research projects to evaluate nutritional care