Paediatric Diabetes Specialist Dietitian

Detailed job description and main responsibilities

The post holder will work collaboratively within the children’s diabetes multidisciplinary team at East Kent Hospitals providing a specialist paediatric diabetes dietetic service to children, young people (CYP) with diabetes including their families and carers.

The post holder will partake in the on-call out of hours telephone service for CYP and their families ensuring they have access to specialist diabetes advice and support (pro-rata).

The post holder will contribute to the continuing development of the service.

Clinical

·         To be professionally and legally accountable for all aspects of work in compliance with the ethical code of practice set out by the health and Care professions Council (HCPC).

·         To work with dietetic colleagues and multidisciplinary diabetes team to formulate and deliver individual diabetes dietetic and education treatment plans for CYP based on a sound knowledge of evidence-based practice and treatment options using clinical assessment, critical thinking, reasoning skills and knowledge of a wide range of dietetic treatments.

·         To act as a specialist resource involved in the development and provision of evidence based dietetic diabetes nutrition services.

·         To provide high quality specialist clinical advice and educational support to others involved in providing care for people with diabetes in the local community. This will include dietetic advice and support for those requiring insulin pump therapy.

·         To work both as an independent practitioner and within a multidisciplinary team to effectively communicate and demonstrate specialist dietetic skills and knowledge in diabetes care.

·         To be responsible and accountable for managing and prioritising a patient caseload including patients with complex needs in a range of settings, predominantly in an outpatient setting.

·         To be competent in use of information technology, including diabetes management health applications (for example, LibreView, Dexcom Clarity, Medtronic CareLink, Glooko, bolus advisor Apps.)

·         To be competent in the use of nutritional databases for determination of nutritional adequacy.

·         Assess patient understanding of treatment proposals, gain valid informed consent and have the capacity to work within a legal framework with patients who lack capacity to consent to treatment.

·         Evaluate patient progress, reassess and alter treatment regimens as required.

·         To manage clinical risk within own patient caseload.

·         Work within Trust clinical guidelines and to have good working knowledge of national and local standards and monitor quality of practice as appropriate.

·         To be responsible for maintaining accurate and comprehensive patient treatment records in line with British Dietetic Association (BDA) and Health and Care Professions Council (HCPC) standards of practice.

·         To partake pro-rata in the on-call service provided to patients and carers

·         To attend and support specialist consultant led multidisciplinary clinics.

·         To teach patients/families and school staff the principles of home blood/glucose/ketone monitoring as required.

·         To support families with insulin dose adjustment in line with the Children’s Diabetes Team guidance.

·         To participate in structured education delivery for newly diagnosed type 1 and type 2 diabetes

·         Support with clinical assessments as needed – anthropometric measurements, BP, HBA1c, foot assessments, insulin injection site assessments.

·         Teach and support with insulin pump initiation and follow-up sessions

·         Inpatient clinical visits to support ward staff in providing education for newly diagnosed CYP/ those admitted to ward with intercurrent illness.

·         Interpretation of carbohydrate counting food diaries to work out starting carbohydrate counting calculations in line with the Children’s Diabetes Team guidance. 

·         Communicate with children’s safeguarding team as appropriate and attend compulsory supervision sessions.

·         Support families for urgent and non-urgent enquires.

Team working and communication

·         Represent the service and/or individual CYP at multidisciplinary team meetings, to ensure the delivery of a coordinated multidisciplinary service, and integrate dietetic therapy into the treatment programme.  This will include discussion of patient care and patient progress.

·         Use a broad range of counselling techniques including cognitive behavioural therapy and motivational interviewing to support CYP living with diabetes (and their carers) to engage and mange their diabetes on a daily basis.  To listen non-judgementally and empathetically to provide a safe environment to explore current diabetes self-management behaviours and address barriers and facilitators of change.

·         To provide specialist dietary advice to CYP and their families, carers and clinicians regarding provision of nutrition and dietetic support based on clinical evidence.   This requires detailed nutritional and lifestyle assessment; to include the calculation of nutritional requirements based on the interpretation of biochemistry, anthropometrics, clinical condition and other physical parameters.

·         To complement nursing and medical teams with dietary and diabetes medications (including insulin) management decisions by review of self-management behaviours and interpretation of diabetes data (self-reported and via downloaded diabetes technologies: blood glucose meters, sensors and insulin pumps).

·         Liaise with the catering department to promote optimal nutrition for inpatients if/when needed.

·         Demonstrate flexibility in providing cover in times of staff shortage within clinical areas.

·         Undertake any other duties appropriate to grade as requested by the lead dietitian/leadership team.

·         Team work providing paediatric diabetes dietetic cover across all EKHUFT sites. 

Research and Training

·           Undertake the measurement and evaluation of your work and current practices through evidence-based practice projects, audit and outcome measures either individually or with colleagues within dietetics or the multidisciplinary team.

·           To participate as directed the collection of data for use in service audit and research projects.

·           To research, develop, audit and publish evidence based departmental patient information; literature for use within and outside the trust.  Development will include involvement of appropriate patient groups.

Quality

·         Plan and organise own workload alongside colleague dietitians ensuring paediatric diabetes structured education and the requirements of the best practice tariff are delivered to CYP and their families in a timely and effective manner.

·         To contribute to the department strategy and annual objectives ensuring recommendations from national guidance are captured and actioned. 

·         To contribute to the resource governance group to ensure all paediatric diabetes patient information is up to date and evidence based.

·         To contribute to the department’s risk register, CQC action plan, audit plan and clinical governance plan annually.

·         To advise line manager of any perceived needs to improve the Clinical Nutrition and Dietetics service to the children’s diabetes service.

·           To review complex reports (NICE/NSF/White papers) relating to paediatric diabetes and advise line manager on areas which require improvement.

·           To ensure equipment used for patient care is safe and appropriate (e.g. weighing scales).

·           To work closely with the leadership team to ensure children’s diabetes service within East Kent is cost-effective.

Personal and Professional

·         To complete paediatric diabetes dietetic competencies relevant to job banding.

·         Participate in the staff performance review scheme as an appraisee for junior staff and be responsible for complying with your agreed personal development programmes to meet required knowledge and competency goals.

·         Work with the lead dietitian and colleagues to produce a risk management plan and ensure standards are set and reviewed and that the services provided are evaluated.

·         Actively participate in, in-service training, tutorials and individual training sessions, external courses and peer review.

·         Be actively involved in professional clinical groups and other professional activities (e.g. regional network and national groups).

·         Regularly attend and participate in the regional network dietetic meeting and attend monthly team multidisciplinary service development meetings.

·         Assist the lead dietitian in ensuring resources are used to best effect and in appropriate aspects of budget management.

·         The post holder will be expected to support and train new and less experienced staff members and supervise band 5 dietitians.

·         Work closely with paediatric diabetes nurses to develop and implement structured education for young people with Diabetes. 

VALUES AND BEHAVIOURS

The post holder is required to uphold and model the Trust values in everything they do.