Senior Specialist Paediatric Dietitian - Home Enteral Nutrition

This job is brought to you by Jobs/Redefined, the UK's leading over-50s age inclusive jobs board.

Lewisham and Greenwich NHS Trust, (LGT), is a community-focused provider of local and acute care, delivering high-quality services to over one million people living across the London boroughs of Lewisham, Greenwich, and Bexley. We provide whole-life care and are here to support our communities to live healthier lives as well as taking care of them when they need us the most.

Employing almost 7,500 colleagues, affectionately known as Team LGT, we provide services at Queen Elizabeth Hospital in Woolwich, University Hospital Lewisham, and at over a dozen community settings in Lewisham. We also provide some services at Queen Mary's Hospital in Sidcup.

We have recently launched our new vision and values to mark the LGT10 - the tenth anniversary of our Trust forming in 2013. Our trust vision is to be exceptional. In the quality of our patient care; our support for colleagues; and in the difference we make through our partnerships and in our communities.

To achieve this we value Respect, Compassion, and Inclusion; Being accountable over staying comfortable; Listening over always knowing best; and Succeeding together over achieving alone. You can read more about our visions and values here

Our hospitals and community sites provide a wide range of inpatient and outpatient services, as well as emergency and planned care. The Trust is rated as "good" or "outstanding" in over three-quarters of the services inspected by the Care Quality Commission.

Every year our work includes performing 10,000 procedures in our theatres; bringing seven and a half thousand new lives into the world; carrying out 570,000 visits to patients in their homes or communities and providing emergency care for more than 300,000 patients arriving in our busy Urgent and Emergency Departments.

LGT is a centre for the education and training of medical students enrolled with King's College London's GKT School of Medical Education. We are a training centre for nurses, midwives and allied health professionals. We are pioneering new roles that will support the changing needs of our patients and are one of the largest employers of physician associates in the country.

We are committed to working with our partners to deliver the best outcomes for our local communities. This means playing an active role in the South East London Integrated Care System (ICS), and in formal partnerships including the South East London Acute Provider Collaborative, provider partnerships with our local mental health trusts and borough-based boards of the ICS in Bexley, Greenwich and Lewisham.

Job overview

An exciting opportunity has arisen for an enthusiastic and motivated Dietitian to join our friendly and innovative paediatric team.

This community role with our paediatric Home Enteral Nutrition Team will be ideal for a Dietitian with experience in paediatrics and/or nutritional support, who wants to develop clinical skills working with babies, children and young people living in the community with a feeding tube.

You will work closely with the multidisciplinary team including Dietitians, Speech and Language Therapists, Specialist Nurses and Community Paediatricians. Children are seen in a range of settings, such as children's centres, nurseries, schools or the child's home. Some work can also be caried out remotely through video and telephone clinics.

You will have excellent communication and organisational skills to manage a diverse caseload of children as well as effective team working skills.

You will be actively encouraged and supported in your personal development. There will be opportunities to be involved in service development, research and audit, and training Health Care Professionals, including student Dietitians.

Post is based in the Community at Waldron Health Centre, New Cross, and Kaleidoscope Children's Centre in Catford.

Main duties of the job
• Specialist Dietitian in the provision and the service development of the paediatric dietetic service provided by the HEN team across Lewisham, Lambeth and Southwark.
• To autonomously assess and treat a specialist dietetic caseload of children receiving HEN, liaising with their families, carers, acute and community staff. This could be in the patient's own home, clinics, nursery or school
• To provide specialist paediatric dietetic advice and training to patients, carers and all other health professionals
• To write, update, disseminate and implement policies and procedures related to Paediatric Home Enteral Feeding. These policies would impact all Health Care Professionals involved in Home Enteral Nutrition
• To regularly undertake research and audit in specialist area

Working for our organisation

Our people are our greatest asset. When we feel supported and happy at work, this positivity reaches those very people we are here for, the patients. Engaged employees perform at their best and our Equality, Diversity & Inclusion (EDI) initiatives contribute to cultivate a culture of engagement. We have four staff networks, a corporate EDI Team and a suite of programmes and events which aim to insert the 5 aspirations:

1. Improving representation at senior levels of staff with disabilities, from black, Asian, and ethnic minorities background, identify as LGBTQ+ and women, through improved recruitment and leadership development
2. Widening access (anchor institution) and employability
3. Improving the experience of staff with disability
4. Improving the EDI literacy and confidence of trust staff through training and development
5. Making equalities mainstream

Detailed job description and main responsibilities

Job Summary:

1. Specialist Dietitian in the provision and the service development of the paediatric dietetic service provided by the HEN team across Lewisham, Lambeth and Southwark.
2. To autonomously assess and treat a specialist dietetic caseload of children receiving HEN, liaising with their families, carers, acute and community staff. This could be in the patient's own home, clinics, nursery or school
3. To provide specialist paediatric dietetic advice and training to patients, carers and all other health professionals
4. To write, update, disseminate and implement policies and procedures related to Paediatric Home Enteral Feeding. These policies would impact all Health Care Professionals involved in Home Enteral Nutrition
5. To regularly undertake research and audit in specialist area

Key Result Areas & Performance:

Clinical Duties and Responsibilities

Communication and Relationship Skills

• To provide expert, specialist, evidence based, dietetic advice and care to paediatric patients and their carers regarding home enteral nutrition. Communicating highly complex and sensitive information on nutrition using negotiation, counselling and behavioural change skills.

• To work autonomously when assessing patients, making clinical decisions, selecting treatments and evaluating outcomes of dietetic interventions.
• To collaborate with team members to ensure the patient receives care and advice on all aspects of tube feeding at home. This will require particularly close liaison with the Children's Community Nursing Team and Speech and Language therapists.

• To develop and maintain close communications with all health care professionals (Consultants, GPs, Acute Dietitians, Children's Community Nurses, SALTs, School Teachers, School Nurses, Social workers, Portage workers), private sector companies and other agencies as necessary in order to provide co-ordinated patient centred care.

• To arrange visits/clinics for patients and their families at the various children's centres, schools and nurseries. Attend, where appropriate, local hospital or community meetings and clinics with other members of the MDT.

• To work with families who may have learning disabilities, mental health problems and challenging behaviours
• To work with patients who have language barriers to effective communication. This may often require the use of interpreting services via the telephone or with a relevant interpreter at the patient's place of care.
• To empathise, communicate and reassure families who may be dealing with unpleasant circumstances/diagnosis relating to their child. This may include relaying additional unwelcome information relating to the long term nutritional requirements of a child.
• To use motivational and negotiating skills to facilitate acceptance and ongoing compliance with nutritional treatment plans.

• To act as a keyworker to certain families. Besides acting as an emotional support for the family the Dietitian will be responsible as the organisational link between all health professionals involved in the acute and community settings ensuring consistency of services.
• To be involved with children and their carers placed on the child protection register. The dietitian will be responsible for receiving highly confidential, complex and sensitive information and will act within Lewisham and Greenwich and Guy's and St Thomas' Paediatric Community Services child protection policies.
• To document all activities concerning patient care in the paediatric dietetic patient record notes including all confidential correspondence with health care professionals and enteral feeding delivery company in accordance with trust policies.

• To be responsible for ordering and changing regimes for all enteral feeds and tube feeding ancillaries.

• To produce timely and informative reports for Consultants, Paediatrician, GPs and other health professional relevant to a specific family.

• To negotiate with carers, clients and other members of the multi-disciplinary team around individual case management and to provide support to other team members and health care professionals in the specialist area of home enteral tube feeding.

Analytical and Judgement skills

• To make all clinical decisions and judgments autonomously guided by broad professional and organisational policies.
• To implement specialist clinical dietetic assessment, treatment and management of patients referred to the HEN team. This will include the advising, ordering and prescribing of specialist products listed as ACBS (Advisory Committee on Borderline Substances).

• To analyse dietary intake and calculate nutritional requirements using clinical judgement and experience as well as computer software as required when completing a treatment plan for a specific patient.
• To be trained to trainer level in the use of anthropometrics equipment for the assessment of nutritional status such as skin fold callipers, portable and hoist scales, enteral feeding pumps and equipment.
• To take anthropometric measurements and interpret as part of nutrition assessment of patients ongoing monitoring

Planning and Organisational Skills

• To manage and act as an independent holder of the paediatric caseload ensuring high quality dietetic care is delivered. Carrying out systematic review of patients at appropriate intervals according to prioritising criteria and clinical judgement.
• To liaise with health care professionals regarding hospital discharges or new referrals and offer joint visits as required enabling them to formulate care plans in relation to enteral feeding which are based on specialist assessment and recommendations.

• To ensure that the enteral feed and equipment delivery company have accurate information on each patients enteral feeding requirements and that all regimen changes are communicated with adequate notice.

• To provide cover for the other dietitians within the HEN team during periods of staff absence.

• To devise and implement specialist evidence/research based guidelines and protocols that can be used Trust(s) wide for the dietetic care management in relation to paediatric enteral nutrition.

• To demonstrate highly skilled clinical expertise within own team and LSL Primary Care Networks and act as a resource in the specialism of paediatric enteral nutrition, advising colleagues on the management within the specialist area.

Managerial and Administrative Responsibilities

• To be solely responsible for prioritising and managing own caseload and to oversee the organisation and development of the caseload across the service, identifying shortfalls and issues to be addressed.
• To supervise dietitians and dietetic assistants who would assist in the care and administration of Paediatric HEN patients.

• To provide support and training to the HEN team administration staff.
• To be involved in the development of, write and update, disseminate and implement policies and procedures related to all aspects regarding Paediatric Home Enteral Feeding across Lewisham, Southwark and Lambeth. This will be used as a point of reference for all organisations, i.e. Special Needs schools, Children's Community Nurses, Special needs nurses, and Speech and Language Therapists

• To be aware of trust policies and procedure and participate in their creation and development. The dietitian will be responsible for working under these broad guidelines and when the need arises is able to discuss problems as part of a peer review.

• To assist in the co-ordination of HEN team service objectives and projects contributing to the team service plan.

• To ensure all equipment defects, accidents, complaints and clinical incidents are reported to the team leader and necessary action is taken by those concerned.

Person specification

Qualifications & Training

Essential criteria

• 4 year degree in dietetics or equivalent
• Current State Registration
• Advanced BDA course in paediatrics (or equivalent)
• Specialist paediatric training/experience working to or at masters level
• Registration with Health Professional Council
• British Dietetic Association member or equivalent professional insurance
• Evidence of ongoing Professional development

Desirable criteria

• Advanced British Dietetic Association Course in Nutritional Support
• Nutritional Support Training
• Interest in Research

Experience

Essential criteria

• Significant experience of paediatric dietetics
• Experience of working as part of a multi-disciplinary team
• Evidence of training student dietitians
• Able to decide priorities for own work area, balancing patient-related and managerial role
• Experience of working in a multi-ethnic and cultural setting
• Experience of working in complex safeguarding situations

Desirable criteria

• Working in the community setting
• Previous experience of conducting audits and or research

Knowledge & Skills

Essential criteria

• Understand and abide by standards of professional practice, including confidentiality
• Able to demonstrate awareness of current NHS changes and professional issues
• To have an understanding of the roles and responsibilities of the other disciplines within the MDT team
• Computer Literacy, able to use Word, Excel
• Accurate anthropometrics measurement skills

Desirable criteria

• Full driving licence

We reserve the right to close the post before the stated closing date, please apply early. We do not contact applicants with the outcome of the shortlisting. If you have been shortlisted, you will receive an invite to an assessment day or interview.

As a local employer and anchor institution we work closely with our community to recruit locally and we welcome applications from the widest variety of people to ensure our workforce are reflective of the local communities which we serve. We encourage all suitable candidates to apply including if you are Black, Asian or other ethnic minorities, live with a disability (visible or not) or are LGBT+. We have a number of active staff networks including Disability, LGBT+, Multicultural Inclusion and Women's staff networks to bring staff together and celebrate diversity across our whole workforce.

Please note, not all roles will meet the criteria for a skilled worker visa.

Employer certification / accreditation badges

Applicant requirements

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.

Documents to download

• Job Description & Person Spec (PDF, 516.4KB)
• Working at LGT (PDF, 4.2MB)