Specialist Occupational Therapist

Detailed job description and main responsibilities

Main Duties and Responsibilities

Patient contact:

The post holder will participate in regular supervision from a Paediatric Occupational Therapist of a higher grade but will be expected to work autonomously to:

 Provide specialist, evidence-based assessment, treatment and/or advice to children (aged 0 - school leaving age), referred to the Paediatric Occupational Therapy team in liaison with families and other professionals within a multi-agency framework. Children may present with life limiting, physical, multi-sensory disabilities and present with long term postural, functional and independence needs.

Appropriate involvement in Education Health Care Plans and the Education Tribunal process.

Be responsible for the prioritisation and management of a specialist clinical caseload (children with highly complex needs) using specialist paediatric knowledge and evidence based practice.

Work collaboratively with multi-disciplinary / agency teams to provide a co-ordinated and integrated approach to patient care, e.g. health, social services, education, voluntary sector and families.

To provide spontaneous and planned advice, teaching and instruction to relatives, carers and other professionals in order to promote understanding of the aims of Occupational Therapy and to ensure a consistent approach to the child’s care.

To work with and provide specialist information to members of the multi-disciplinary team regarding the child’s functional ability in order to:-

1. reach a working diagnosis
2. enable subsequent management of any deficit
3. deliver a comprehensive and co-ordinated treatment programme to each child. This is based on their clinical need and may include, where appropriate participation in case conferences, school reviews and discharge planning

Use clinical judgement/reasoning for the assessment and recommendation, of specialist equipment e.g. postural seating and toileting equipment, from budgets such as education. To review and monitor the specialist equipment to ensure it meets the child’s changing needs.  To report any issues affecting health and safety to the provider. This includes the training of children and staff in the safe use of the equipment.

Work with children and families to identify Occupational Therapy child centred SMART goals and to formulate and recommend the best course of intervention. These should address Occupational performance and skill deficits, enabling children to develop/improve in the areas of self-care, access to the National Curriculum, life skills, play and leisure activities.

To monitor, evaluate and modify specialised, individually tailored treatment (evidence based) in order to measure progress using outcome measures to ensure intervention is effective and complimentary to the child’s development, lifestyle and educational programme.

To assess child/carer understanding of treatment plans, gain informed consent and have the capacity to work within a legal framework with children and their families/carers who lack capacity to consent to treatment.

To facilitate a child’s return to school following discharge from Hospitals (local and Regional) following acute admissions and surgery in liaison with relevant services including Hospital staff, Special Needs Community Nurse, Physiotherapist, Education Staff and Speech and Language Therapists.

To contribute to the planned admissions to hospital in collaboration with other members of the multidisciplinary team to ensure the child’s care plan meets their needs and optimises the outcome of their stay.

To follow Trust procedures for incident reporting, and safeguarding  asking for support from appropriate other personnel, in order to report the incident

To provide advanced specialist assessment, treatment, and/or advice to children referred to the Paediatric Occupational Therapy team in liaison with families and other professionals within a multi-agency framework. Children may present with physical, learning, social/emotional and behavioural difficulties e.g. neuromuscular conditions, musculoskeletal conditions, developmental conditions, perceptual difficulties and genetic abnormalities, Muscular Dystrophy, Cerebral Palsy, Developmental Co-ordination Disorder, Attention Deficit Hyperactivity Disorder or Autistic Spectrum Disorder.

To take an active role in and help organise/present as appropriate:

• staff meetings
• peer review
• external courses (where appropriate)

Will be expected to manage and prioritise own workload balancing other clinical, non-clinical and professional demands. Often working under pressure and to tight deadlines. Will use supervision with a more senior Paediatric Occupational Therapy as needed.

To triage referrals as delegated.

Work alone in different environments including patient’s own homes, nurseries, and schools; following CCS Paediatric Occupational Therapy Lone Working Policy.

Refer on to other professionals / agencies as required.

Seek assistance from colleagues where further advice or support is sought with regard to patient care.

Decide on appropriate clinical and non-clinical tasks to be delegated e.g. to assistants, carers, admin staff, school staff.

Professionally and legally be responsible and accountable for all aspects of own work

To demonstrate the ability to critically evaluate and benchmark current clinical practice against national guidelines, standards and Evidence Based Practice and Best Practice.

Interpret conflicting information (within specialist area (and recommend the best course of Occupational Therapy intervention to multi agency staff e.g., health, education and social care.

Project work

 To contribute to/lead on projects as required

To participate in the Paediatric Occupational Therapy teams’ clinical governance arrangements and quality agenda

To adhere to and apply the Professional Standards for Occupational Therapy Practice, Conduct and Ethics (RCOT Version 2/2021).

To participate in the implementation of changes to the service which may have an impact on other services e.g. OT referral criteria, as appropriate.

To have an understanding of national guidelines and legislation relating to health and social care and their impact on local service provision.

Communication

Communicate effectively and appropriately with patients, families, carers, the public and all members of the extended health services, social services and education teams. This involves using a range of verbal, non-verbal, written and presentation skills as required.

Use appropriate communication skills to overcome language and cultural diversity issues/barriers to effective communication which will regularly be evident, including: English as a second language, cognitive impairment, expressive and receptive communication difficulties, embarrassment, anxiety, pain, fear and visual/hearing impairment. To implement strategies to overcome these barriers.

Communicate condition related information to patients / relatives which can be of a highly sensitive or complex nature e.g., prognosis and rehabilitation prospects in chronic or life limiting conditions.

Use verbal and non-verbal skills to communicate effectively with children, young people and their families daily including those with highly complex needs, cognitive impairment, challenging behaviour or terminal illness etc. to gain consent, co-operation and to maximise potential.

Empathise with and support patients and their families in difficult or distressing circumstances, e.g. difficult diagnoses, bereavement and deteriorating conditions.

Represent and promote the Paediatric Occupational Therapy Service.

Participate in working with various stakeholders the co-production, and service redesign teams to coordinate, develop, audit and review aspects of the service.

To contribute a written report to the Educational Health and Care Plan for all children on caseload requiring one.

To provide any additional written advice required for the Education Tribunal process.

To be able to answer questions within an Education Tribunal, to provide clarification and enable further discussion regarding Occupational Therapy recommendations as required.

Important Relationships:

Countywide Paediatric Occupational Therapy Team

Children and their families/carers

Parent Carer Forums

Co-production Team

Multi-agency teams

Education staff within special and mainstream school and pre-school settings

Social Services staff

Wheelchair Services

Acute hospital

Voluntary organisations

Specialized Units/Hospitals e.g. Tadworth

Great Ormond Street Hospital for Sick Children

Augmentative Communication Services

Royal National Orthopaedic Hospital

Second Skin

(NB) This is an illustration of the important relationships and is not an exhaustive list

 To maintain up-to-date and accurate, comprehensive case notes (including treatment records) in line with professional standards, local trust policies and medico-legal criteria including what equipment has been issued.

To provide written and verbal reports on all children on caseload, at appropriate intervals, including following assessment and at end of intervention.

People Management

Maintaining own professional development and requirement to take part in appraisal

To participate in supervision to enable reflection on practice and subsequent enhancement of professional skills.

To be responsible for individual supervision and education of junior Occupational Therapy staff, support staff and student Occupational Therapists.