CNS - Upper Gastrointestinal Rapid Diagnostic Service

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This post will be based at East Lancashire Hospitals Trust with the main purpose of supporting the Rapid Diagnostic Service pathway's. This includes non-site specific, HPB, Gynaecology and Prostate. The RDS will support the Faster Diagnostic Standard (FDS) whilst complementing work to improve screening programmes where appropriate.

The RDS Clinical Nurse Specialist (CNS) will assess and rapidly triage patients referred into the  UGI RDS 2 week rule pathway, plan and implement care across a variety of settings, providing highly specialist advice; maintaining accurate associated records.

The CNS will ensure cancer patients are directed onto the most appropriate diagnostic and treatment  pathway of care.  An essential aspect of the RDC CNS role is to lead on appropriate and timely onward referral to the right non-cancer specialist service for further support, investigation, treatment and/or care.

The aim of each specialist pathway is to reach a definitive diagnosis as quickly as possible, providing clinically relevant diagnostic tests as quickly as possible, targeting and reducing any health inequalities that may currently exist. 

MAIN DUTIES & RESPONSIBABILITIES

To receive referrals from GP’s, Choose & Book, Emergency Department, medical and surgical  wards/departments directly into the service  

To participate in the decision making process with the clinical lead for RDS and MDT to ensure appropriateness of the referral

To clinically assess and triage the patient ensuring they are comprehensively assessed within the set guidelines and protocols

To determine the most appropriate list of diagnostic investigations that should be offered, drawing on additional MDT members as needed

To book appropriate investigations for the patient and to ensure these are completed within the set guidelines times whilst also considering the sequence of each investigation

To ensure that the consultation environment is conducive to a professional and specialist patient assessment, positively reflecting the reputation of the service and affords the patient maximum privacy and dignity

Delegate and refer to other practitioners when this will improve health outcomes or when risks and needs are beyond own competence and scope of practice  making every contact count

Monitor and review the effectiveness of interventions with the patient and colleagues and modify this to meet changing needs and established goals of care

Promote peoples’ equity, diversity and rights, through ensuring that own and others’ practice is in the best interests of patients

 To review the patient results and complete referrals as required to appropriate services

To ensure the patient is informed of the outcome of their tests within the set guidelines times via telephone or clinic consultation

To ensure the GP is informed of the outcome of the patient consultation and future plan, or inform GP if unable to accept referral to RDS 

To liaise directly with the MDT regarding any actual/potential significant clinical risk issues.

To participate in variance tracking and analysis with MDT, presenting results at appropriate forums, and using the results to lead appropriate clinical practice changes

To initiate referral/s to other relevant members of the MDT at any stage in accordance with service policy/guidelines/protocols.

To maintain a patient-centred approach when planning care, involving patients, carers and members of the MDT in care decisions

Ensure quality is central to clinical practice by delivering evidenced based individualised care, through holistic needs assessment, planning and evaluation of care promoting personalised at all times

Support patients in the delivery of care and meeting their health and wellbeing needs by providing expert advice and information, promoting their wishes and beliefs and addressing their concerns

To lead on the formulation and update the RDS policies in line with latest research for best practice

To ensure a smooth transition from the outpatient and inpatient settings through robust effective planning and collaboration, co-ordinating continuing care and evaluating effectiveness

To lead on the development and monitoring of referral  pathways, protocols, policies and guidelines with particular relevance to the RDS

To promote a patient-focused, multidisciplinary approach to care in collaboration with carers, health care professionals and other agencies

Employ effective decision making skills to address complex issues and use effective change management skills to implement these

Use effective prioritisation, problem solving and delegation skills to manage time effectively

COMMUNICATION

To provide and receive complex and sensitive information to patients and carers regarding diagnostic results and treatment pathways

To work in partnership with all members of the MDT to achieve a seamless pathway of care for the patient through presentation of highly complex information

To ensure that communication with the MDT, other departments both internal and external to ELHT is optimized

Develop and maintain others’ awareness of role, the organisation and local networks and maintain mechanisms for contact and referral

Maintain appropriate channels and styles of communication to meet the needs of patients, relatives and carers, managers, peers and other professions / agencies.

Identify, develop and sustain mechanisms to support patient involvement and feedback.

Provide expert advice and support to colleagues internally and externally 

Ensure that appropriate information is disseminated within the organisation and within external agencies and forums

 TRAINING AND DEVELOPMENT

Identify objectives for own professional development which reflect local and national service needs

Establish networks with other specialists at a local, national and international level, to exchange and enhance knowledge and expertise.

Act as a specialist resource to others in developing and improving knowledge and skills in clinical practice, through acting as an assessor, teacher and facilitator

To lead on clinical audits in RDS; sharing action plans and learning form specialist audit results

Maintain a peer network of support, information and learning with other nurse specialists within the organisation

Contribute to the development of practice knowledge within the speciality through internal and external presentation and publication.

Promote a learning environment through identifying opportunities and seeking resources required for own and others learning

Provide specialist input to post-registration courses and professional development programmes.

Reflect on own practice through clinical supervision / mentorship and to act as a clinical supervisor / mentor to others

Maintain own and others’ awareness of relevant research evidence related to the speciality and work with others in applying this to practice.

Identify areas of potential research relating to the speciality and to participate in relevant research activities

Take part in reflection and appropriate learning from practice, in order to maintain and develop competence and performance

To provide specialist advice, support and education to patients and their carers from diagnosis through treatment and follow up care to enable patients to determine their own future needs

ORGANISATIONAL RESPONSIBILITIES

To ensure that relevant robust data is collected which can be used to evaluate and improve care and service delivery

Review and evaluate services collaboratively with own and other professions and users, identifying areas for service development and acting on this accordingly, making best use of resources, improve practice and health outcomes in line with local and national best practice.

Evaluate clinical effectiveness, identifying poor quality and a plan for quality improvement which embraces the audit cycle

To use outcome data to review and refine the RDS

To lead on the identification of service risk/s and act in accordance with the relevant policies and procedures

To ensure completion of clinical incident reporting where an adverse incident is identified which has caused harm or has the potential to cause harm to a patient, staff member or any individual

Participate in developing a shared vision of the service and work with the multi-disciplinary team, organisation and external agencies to achieve this

Negotiate and agree with individuals, groups and other practitioners’ outcomes, roles and responsibilities, and action to be taken to develop resources, services and facilities

Ensure adequate arrangements are in place to cover absence

Lead on the development and implementation of national policy and practice initiatives and to implement these at a local level

Develop evidence based standards, policies and guidelines at a local, network and national level to improve the practice of own and other professions