Job summary
This is a fantastic opportunity for anyone with an interest in oesophagogastric (OG) surgery and wishes to work as part of a tumour-site specific multi-disciplinary team who values and respects the role of the Dietitian.

This post will support and work alongside the OG dietetic team to provide a comprehensive dietetic service to pre- and post-operative OG patients treated at the Churchill Hospital, part of the Oxford University Hospitals NHS Foundation Trust (OUHFT), Oxford.

The OUH is a regional centre for OG cancer management covering the Thames Valley and one of a few UK centres providing the surgical management of trachea-oesophageal fistula (TOF), end stage achalasia and other complex benign diseases of the oesophagus and stomach.

We encourage every Band 6 to protect 20% of their time within the role to development, both individually and as a service. This can include quality improvement projects, clinical audit and CPD, as well as service development, such as reviewing the way the service is delivered and the patient pathway. This role therefore provides a great opportunity to develop clinical and leadership skills.

Main duties of the job
The primary focus of this post will be to support the OG cancer patients who are treated surgically but also those who have complex benign disease and require pre- and post-operative dietetic support. This will includes:

• Provide screening and assessments of patients at all stages of treatment
• Manage weekly telephone/video clinics +/- face to face clinics
• Liaise with the OG MDT with regards to the nutritional management of patients (e.g. feeding tube insertions, treatment decisions, hospital admissions).
• Provide short and long-term follow-up and management of treatment side effects of surgery and systemic anticancer treatments
• Work alongside the ERAS and Prehab nursing team to run OG specific virtual prehabilitation group sessions
• Run a pre surgery, virtual education group session for patients
• Support patients with home enteral feeding, jejunostomy and gastrostomy care advice and trouble shooting
• Support patients with the monitoring and appropriate supplementation of micronutrient status after OG surgery.
• Work alongside dietetic colleagues to develop departmental guidelines and standards of best practice.
• Work as a member of the dietetic department and contribute to departmental projects
• Advise and teaching both medical and nursing staff on the dietetic management of OG surgical patients and enteral nutritional support
• Provide dietetic cover to other members of the OG dietetic team.

About us
Oxford University Hospitals NHS Foundation Trust is one of the largest NHS teaching trusts in the country. It provides a wide range of general and specialist clinical services and is a base for medical education, training and research. Find out more here www.ouh.nhs.uk

The Trust comprises four hospitals - the John Radcliffe Hospital, Churchill Hospital and Nuffield Orthopaedic Centre in Headington and the Horton General Hospital in Banbury.

Our values, standards and behaviours define the quality of clinical care we offer and the professional relationships we make with our patients, colleagues and the wider community. We call thisDelivering Compassionate Excellenceand its focus is on our values of compassion, respect, learning, delivery, improvement and excellence. These values put patients at the heart of what we do and underpin the quality healthcare we would like for ourselves or a member of our family. Watch how we set out to deliver compassionate excellence via theOUH YouTube channel.

Job responsibilities
CLINICAL
To work as part of a team of Oncology, Haematology and Elective Surgery Specialist Dietitians and Macmillan Dietetic Support Workers, and as an integral member of multiple tumour-site specific multidisciplinary teams to ensure a holistic approach to patient care. This involves attending oncology team meetings, dietetic department meetings and liaising with Oncologists, Specialist Nurses, Radiographers, Allied Health Professionals, Dietetic colleagues, Dietetic Assistants and GPs regarding dietetic and nutritional support for Oncology patients in order to optimise nutritional status during treatment.

Organise own workload, prioritising and balancing patient-related and professional demands and contributing to the effectiveness of the oncology team.

To assess and prioritise referrals made by members of the multidisciplinary team

To review how the dietetic service is provided along the patient pathway, in order to provide an effective use of time and resources.

Obtain and analyse relevant information from different sources including: electronic patient records, the client, staff and/or carers, in order to make a comprehensive assessment of the patients diagnosis, prognosis and treatment plans so that a decision on the most appropriate dietetic treatment to support this can be made in the short and long term.

Interpret and monitor biochemical data generally and specifically in relation to patients receiving cancer treatment.

Assess patients nutritional status by weight history, fluid balance, nutritional intake, stool output, vomiting and physical signs of deficiency.

Estimate nutritional requirements using specific assessment tools and calculations. To remain up to date with the literature and ensure that this is an evidence based process and clinically relevant to oncology patients.

Formulate individualised patient care plans, artificial feeding regimens, taking into consideration factors which may affect requirements or help/hinder provision of nutrition support such as: prescribed drugs, biochemical derangements, fluid balance etc. Within the care plan this could include modified-texture diets, oral nutritional supplements and enteral tube feeds.

Evaluate the effectiveness of nutritional goals and modify these goals and care plans as necessary based on ongoing analysis, assessment of information available and changing patient needs.

Address and monitor their changing nutritional needs over the course of their disease and advise other members of the multidisciplinary team.

Modify dietary advice according to biochemistry, lifestyle, treatment undertaken, drugs and associated medical conditions adding to complexity of dietetic management.

Use communication techniques i.e. behavioural change and motivational interviewing to work with the patient to adapt their diet.

Communicate effectively and sensitively with patients, carers and other health professionals. Skills of persuasion, motivation, explanation and gaining consent may be used in a wide variety of different, sometimes sensitive, situations. It is important to be able to communicate complex information at an appropriate level. Barriers to communication may be evident e.g. loss of sight, loss of hearing, lack of English, both written and spoken, requiring the use of translators.

Deal with patients with chronic conditions and those with poor outcomes/terminal conditions.

To be sensitive to the religious and ethnic needs of patients' dietary requirements.

To be actively involved with the development of evidence based, trust-wide guidelines - to be a resource to other dietitians as a specialist surgical practitioner, writing and compiling diet sheets, protocols and advice.

To provide specialist training and supervision of dietetic colleagues and students using skills of reflective practice.

To cover for other dietitians when sickness or leave necessitates.

Any other duties that may from time to time be allocated by the Team Leader and Acute Dietetic Service Manager

PROFESSIONAL
Be accountable for own actions within the professional, ethical and legal framework for dietetics set out in the Health and Care Profession Councils code of practice for Dietitians and the British Dietetic Associations professional standards for Dietitians.

To take responsibility for own continuing professional development and providing evidence for this by maintaining a CPD portfolio. CPD involves critical evaluation of scientific papers, attending professional development meetings, working as a reflective practitioner and attending relevant internal/external courses.

Participate in annual appraisal, identifying own developmental and training needs and setting personal developmental objectives.

To participate in departmental audits and initiate audit within own work area in order to monitor and evaluate whether local/national/international standards are being met and make recommendations for change. To be involved with the planning of departmental clinical effectiveness and audit strategies.

Actively contribute to the dietetic student training program, facilitating the development of skills and knowledge, being involved in the assessment process and acting as a mentor to students.

To provide specialist advice, teaching and training to dietetic colleagues, students or members of the multidisciplinary team, regarding the nutritional management of patients, particularly with respect to OG surgical procedures.

To have a detailed understanding of different surgical procedures and systemic anticancer treatments and their side effects.

To take the lead on corporate departmental projects.

ORGANISATIONAL
To determine priorities for own work area based on clinical need and balance patient caseload with professional demands.

To collect data as required by the department, trust and outside agencies.

To maintain accurate and up to date documentation of patient interventions on electronic records. To communicate dietetic interventions to appropriate members of the multidisciplinary team by documentation within nursing/medical notes or by means of generating a letter/report.

Person Specification
Qualifications
Essential

• Registration as a Dietitian with HCPC
• BSc (Hons) Nutrition / Dietetics degree or post graduate diploma or equivalent
• Evidence of a range of CPD activities

Desirable

• Completion of relevant post registration clinical courses (e.g. PENG, clinical supervisory skills, behavioural change).
• Member of BDA & relevant BDA Interest Group

Experience
Essential

• Demonstrates knowledge, skills and experience of a wide range of clinical areas
• Range of experience of nutrition support, including managing patients requiring artificial nutritional
• Experience of working as part of a multidisciplinary team.
• Experience of teaching and training.

Desirable

• Experience of Oesophagogastric Surgery
• Experience of service development, research or audit

Behavioural Skills
Essential

• Ability to work autonomously & as part of a team.
• Able to set priorities and manage own time.
• Adaptable and flexible.

Technical Skills
Essential

• IT skills (e.g. experience of working with electronic patient records, Microsoft Teams, Microsoft Office 365, preparation of audit reports and presentations, internet use)

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the UK Visas and Immigration website (Opens in a new tab).

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. Guidance can be found here Criminal records checks for overseas applicants (Opens in a new tab).

Applicants must have current UK professional registration. For further information please see NHS Careers website (opens in a new window).