High Risk Foot Team Podiatrist

Detailed job description and main responsibilities

PROFESSIONAL / CLINICAL:

Provide assessment and advanced wound care treatment for patients with active foot ulceration in clinical, ward, outpatient and domiciliary settings, providing management plans and communicating this, with all stakeholders 

Provide advanced arterial assessment to those patients with suspected Peripheral Arterial Disease providing management plans

 Identify those who are urgently at risk of limb loss i.e. critical limb ischaemia and facilitate rapid access for urgent vascular assessment

 Provide assessment and treatment for those referred for nail surgery that have a complex medical history or require specialist nail surgery skills

 Make appropriate onward referrals to Consultant Vascular Surgeon/ Diabetologists as per local and national Guidance and facilitate rapid, direct access to Vascular or Diabetes Consultants and Specialist Nurses for patients with limb threatening infection or wounds. 

 Communicate with other key stakeholders and care teams in relation to the management of patients, referring to other disciplines as necessary

May be required to assess and appropriately prescribe medication and therapy within the boundaries of the service’s non-medical prescribing formulary, as appropriate to the post holder’s level of qualification

 To request X-ray imaging of patients’ foot and ankle where osteomyelitis and Charcot neuroarthropathy are suspected

 To support the High Risk Foot Team in ensuring that an effective and high quality service is delivered to at-risk patients by working within the clinical framework and evaluating service effectiveness  through audit

 Develop training packages for staff groups in relation to patients with high-risk feet / limbs

 To provide clinical experience/supervision for a variety of learners within the community and hospital setting

 To provide group and individual education to patients and their carers

 To provide assessment and up to date specialist treatment to patients with complex foot wounds ensuring safe and effective outcomes in accordance with national and local guidance

 To respond rapidly to requests by staff to assess, review and provide urgent treatment to patients with high-risk foot problems at any location within the Tameside and Glossop area including patient homes, acute setting including wards and outpatient clinics. 

To undertake specialist assessments and interventions on patients with high-risk feet / limbs, including vascular assessment involving ankle / brachial pressure index, sharp debridement of wounds / necrotic lesions on the high-risk foot, larvae therapy, negative pressure therapy and casts

To provide clinical input on the Vascular and Diabetes Foot Clinic working alongside Consultants on a weekly basis.

To formulate and implement detailed, structured and comprehensive treatment plans in accordance with wound or vascular assessment results. To communicate these plans with all involved in the patients care. 

To be involved in the assessment and treatment of complex nail surgery cases within the Trust including patients homes, where it is deemed necessary.

 To work within the framework of organisational policies and guidelines

 To be responsible for leading and developing an area of work within the high risk foot team as directed by the Team Leader/ Management team. Reporting and communicating to the rest of the HRFT at monthly team meetings.

 To be pro-active in and participate in service development. This includes assisting in the development of evidence- based guidelines, standard operating procedures and care pathways.

 ADMINISTRATIVE / MANAGERIAL:

To triage referrals on a daily basis prioritising and planning appointments dependent on urgency. Liaise with referrer if further information is required and refer on appropriately if not suitable.

 To organise and prioritise own daily workload, working flexibly with colleagues as necessary in order to accommodate urgent requests

 To attend meetings as appropriate to the role

Maintain accurate clincial records observing Trust Policies, in writing and in electronic format.

 Maintain accurate and contemporaneous electronic records for all patients with due regard to legal status and Trust standards.

Utilise information technology on a daily basis including, EMIS, e-mail, Internet and intranet and Microsoft 365 applications

 Responsible for maintaining appropriate stock levels in clinical settings and ordering in a timely manner.

 Responsible for the safe use and maintenance of service & trust equipment.

 HUMAN RESOURCES MANAGEMENT:

 May be required to provide day to day supervision of a healthcare assistant in the clinical setting

 May be required to support the service in re directing clinical duties during periods of unexpected absences of clinicians

 Ensure that all Trust policies are adhered to.

 To provide support and advice to other clinicians in the management of at risk/ high-risk patients

 To delegate clinical duties and specific individual patient management plans to other clinical staff

 KNOWLEDGE AND SKILLS

 Assess and continuously review status of foot ulcerations and make clinical decisions to maximise outcomes.

Vascular assessment skills, including use of Doppler, ABPI and TBPI equipment, and wound care/ assessment skills, including sharp debridement and production of off-loading devices 

Perform nail surgery on patients with complex needs administering local anaesthetic in injection form

Undertake patient treatments that may involve working in cramped, restrictive and unsanitary environments where risk assessments may be required

Ability to use computer to access emails, internet, Microsoft office and electronic appointment system

Analysis of results of investigations such as Ankle Brachial Pressure Indices, wound swabs and X-ray reports to make decisions about or direct treatment in order to manage the patient’s care appropriately

To plan own diary events following current timetable and undertake work as directed by Team Leader/ Management Team

To plan visit caseload from referrals triaged by the team, diarising by urgency

To review and prioritise caseload in order to provide a rapid high risk foot assessment service for people with deteriorating foot ulceration or urgent arterial conditions of the lower limb.

To triage daily referrals into the service and prioritise urgency,  within existing team commitments

To work flexibly to provide service cover at short notice for High Risk Foot Team priorities as required or directed by the Management team

To communicate confidently, clearly and effectively with a wide range of staff involved in patient care

To effectively communicate complex and detailed information regarding care to members of the multi-professional team, patients and their carers, in verbal and written formats

To maintain key working relationships with other health care professionals involved in the care of the at risk/ high risk patient.

To communicate effectively with patients to inform about their foot condition, possible outcomes, encourage lifestyle and behavior change to improve healing and mortality outcomes

Work with groups who do not use English as a first language, in order to develop informed access to the High risk foot team

Assist in the development and monitoring of standards to be used for the delivery of patient care, by members of the High Risk Foot Team and Community Podiatry Team and other professionals in community healthcare settings, and private sector residential care settings.

 EFFORT AND ENVIRONMENT

Deals with bodily fluids and Larvae regularly over the course of the working day

This job requires regular movement by car to provide services within venues across Tameside and Glossop. 

Will be expected to transport equipment regularly during patient visits, including wound dressing equipment, Equipment to undertake clinical observations, vascular and casting equipment

Regularly deals with patients who have debilitating wounds and conditions. May occasionally impart unwelcome news to patients regarding outcomes of treatments, eg need for amputation

High degree of mental concentration required during patient assessments and reviews in order to process all detailed information presented