Nhs Western Isles
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NHS WESTERN ISLES AGENDA FOR CHANGE
JOB DESCRIPTION
JOB IDENTIFICATION Job Title: Highly Specialist Speech and Language Therapist (Adults with Communication/ Swallowing/Voice Disorders) Department: Speech and Language Therapy Accountable to: Speech and Language Therapy Professional Manager Base: Western Isles Hospital Job Holder Ref: 725
ROLE OF THE DEPARTMENT To provide a comprehensive Speech and Language Therapy service to the population of the Western Isles.
JOB PURPOSE To offer a comprehensive speech and language therapy service to the adult population living in Lewis and Harris.
To lead, develop, co-ordinate and provide a Highly Specialist Speech and Language Therapy service to adults with communication, ENT, voice and/or swallow disorders.
To work collaboratively with other Specialist SLTs to support the service to adult clients with communication, voice and/or swallowing disorders.
To undertake research and co-ordinate clinical audit/clinical effectiveness activities within the specified clinical area.
To provide second opinions, specialist advice/teaching to other SLTs and other professionals regarding the specialist clinical area.
To develop and provide training programmes to meet the needs of SLTs, SLT assistants, other professionals, parents, carers and volunteers.
To utilise strategies to support and provide SLT input for those who use Gaelic as their preferred language.
To supervise work of other SLTs, assistants, volunteers and students working with the postholder.
ORGANISATIONAL CHART Please see attached.
MAIN DUTIES / RESPONSIBILITIES
Clinical
To develop and coordinate the SLT service to a caseload of adults with acquired communication, ENT, voice and/or swallow disorders.
To plan, organise and provide independently, highly specialist SLT intervention to a caseload of this
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 1 client group, and to evaluate outcomes.
To work collaboratively with other SLTs within and outwith the NHS Western Isles Speech and Language Therapy Department.
To work collaboratively with local and mainland consultants, to ensure a high quality, coordinated and effective service for clients.
To write reports reflecting in-depth knowledge of the identified specialist client group.
To provide second opinion highly specialist assessments for other SLTs within the Western Isles.
To provide highly specialist clinical advice regarding this client group throughout the Western Isles, to generalist therapists and to the SLT Manager.
To provide clinical programmes and clinical management strategies to SLT assistant, nursing and care staff, etc.
To provide highly specialist clinical advice to staff from Health, Social Work, other voluntary agencies, carers and families.
To reflect on auditory, visual and kinaesthetic aspects of client’s communication and to identify appropriate strategies to facilitate and enhance communicative effectiveness.
To use highly specialist knowledge to inform sound clinical judgements/decision making for case management.
To make a differential SLT diagnosis on the basis of evidence from assessment.
To develop clear care plans based on best practice, involving clients/carers in planning and prioritisation where possible, and negotiating with clients and others round individual case management.
To demonstrate the ability to reflect on practice with peers and manager and identify own strengths and development needs.
To liaise, work closely with and advise staff from Health (GPs, Occupational Therapists, Consultants, etc.), Social Work (social workers, care workers, etc.), and voluntary organisations, etc., in order to ensure a high quality of multidisciplinary care.
To regularly liaise and work closely with staff from mainland hospitals as required.
To have contact with support organisations relevant to the caseload in order to gain up to date, relevant information, e.g., MND Association.
To disseminate information from relevant specialist groups, e.g., laryngectomy support groups, Special Interest Group in Voice, etc., to other SLTs and manager and to clients, carers and other professionals.
To raise awareness and understanding in the public and other professions of the services available for people with communication and/or swallowing impairment from the Western Isles SLT Department.
To participate in clinical support sessions with other SLTs working within the specified clinical area.
Professional
To act as lead professional in the specified clinical area, advising the manager on policy and planning.
To have responsibility for providing and evaluating the service delivery to the specified client group.
To initiate, develop and participate in health promotion issues relevant to the specified client group.
To maintain continuing professional and personal development.
To identify personal/professional development, evidenced by Personal Development Plan developed within an appraisal framework, including objectives relating to clinical specialist area.
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 2 To attend relevant training and development in order to maintain and develop skills and knowledge in the specified clinical area.
To attend specialist short courses and advanced training in specialist clinical area.
To attend meetings and special interest groups relevant to clinical specialist area.
To have a detailed knowledge of relevant procedures in relation to the legal framework, e.g., Adults with Incapacity Act, etc.
To apply the principles of clinical governance to professional practice.
To maintain up to date HCPC (Healthcare Professions Council) registration and RCSLT (Royal College of Speech and Language Therapy) registration.
To demonstrate knowledge of and adhere to RCSLT Professional and Clinical and National and Local Clinical Guidelines.
To develop and deliver specialist training (formal and informal) to others, in clinical specialist area.
To keep up to date with new techniques and developments for the promotion and maintenance of good practice in the clinical specialist area.
To provide advice to non-specialists and other specialists/professionals within the clinical specialist area.
Education and Research
To provide clinical placements for SLT students within the Department.
To provide observational opportunities for students from other professions and work experience students.
To identify training needs, and to develop and provide specialist training as appropriate, for SLTs and SLT assistants.
To provide mentoring for newly qualified members of staff.
To develop and provide formal and informal specialist training courses as and where appropriate for staff within Social Work, Health, and voluntary organisations.
To identify training needs and provide training as and where appropriate for carers.
To provide lectures for the University of Stirling nursing students and Lews Castle College students.
To ensure formal and informal training is targeted to the needs of the participants.
To reflect on and evaluate training provided.
To provide supervision to volunteers.
To supervise the work of student SLTs on placement in the Department.
To lead in the development of health related services to the specified client group within the framework of national and local strategies.
To ensure the effective planning and management of multidisciplinary care across the department, through close liaison with other agencies.
To advise the SLT manager of departmental training and equipment needs for the specified clinical area.
To participate in the development and implementation of quality standards, outcome measurement and clinical effectiveness.
To initiate and develop innovations within the service relating to specialist area.
To initiate, develop, and undertake research, clinical governance/audit projects within the specified
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 3 specialist area, collecting and providing research data as required, e.g., ongoing project involving continuous gathering of statistics relating to outcomes for all client groups with the expected result of improving clinical effectiveness locally and informing the evidence base nationally.
To demonstrate a high level of clinical effectiveness by use of evidence based practice and outcome measures.
Organisational
To manage and prioritise own caseload/workload independently.
To monitor assessment and therapy equipment in own service area and request new equipment as required.
To be responsible for the security, care and maintenance of equipment ensuring standards of infection control and safety are maintained, including equipment on loan to clients.
To maintain up to date and accurate case notes in line with RCSLT professional standards and local policies.
To share information with others, observing data protection guidelines.
To gather and update activity and statistical data accurately and regularly, ensuring the provision of this information promptly as required by local policy.
To plan and implement training programmes to others.
Communication
To employ excellent communication skills, for example explaining and clarifying on an ongoing basis, highly complex condition/diagnosis-related information to clients/carers with significant barriers to communication, often in a highly emotive environment.
To contribute to clinical teams both multi- and uni-disciplinary by discussing own and others’ input regarding clients’ needs, ensuring a well coordinated care plan.
To lead in the development of detailed case plans for individual clients, using tact, negotiation and empathy, to ensure effective collaboration, between the family and other professionals, and between professionals.
To communicate complex condition-related information from SLT and multidisciplinary assessment, to clients, carers, families and members of the multidisciplinary team/other professionals.
To work closely with clients, carers and families, agreeing decision making relevant to the patient/client management.
To demonstrate empathy with clients, carers and families and colleagues ensuring that effective communication is achieved, particularly where barriers to understanding exist.
To recognise potential breakdown of communication/relationships and conflict when it occurs and seek support to resolve it where necessary.
To demonstrate skills in motivating clients and/or carers to engage in the therapeutic process.
To demonstrate established negotiation skills in the management of conflict across a range of situations.
To deal with initial complaints sensitively, avoiding escalation where possible.
To form productive relationships with others who may be under stress and/or have challenging communication difficulties.
To employ excellent presentation skills to meet the needs of a broad range of audiences, including other professionals.
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 4 Managerial and Freedom to Act
To manage a highly complex, specialist caseload independently.
To adapt practice to meet individual client circumstances.
To monitor and evaluate own highly specialist area of service delivery and that of others, providing intervention within the specified clinical area.
To have autonomous responsibility for all professional actions and recognise own professional boundaries through interpretation of clinical/professional policies.
To work within defined departmental and national protocols/policies and professional code of conduct.
To work independently accessing appraisal within an Individual Performance Review (IPR) at predetermined intervals.
To take a lead on the development of objectives or projects relating to the specified clinical area and to support peers in its implementation.
To assume delegated tasks as requested by line manager, including leading working groups, policy development groups, etc., within area of clinical specialism.
To use specialist knowledge to inform service/policy developments as appropriate.
To interpret and implement national and local policy, relevant to specialist area.
SUPPORTING EVIDENCE
Physical Demands of the Job
To demonstrate highly specialist physical skills in carrying out invasive procedures, e.g., changing tracheo-esophageal valves used in surgical voice restoration for clients who have had the larynx removed.
To provide specialist clinical and technical skills for interpretive assessment techniques and interventions, e.g., videofluoroscopy.
To demonstrate highly developed auditory, perceptual and manual skills in the assessment, diagnosis and treatment of clients.
To demonstrate skills in handling clients with physical disabilities.
To demonstrate physical and technical skills required for AAC (alternative and augmentative communication) strategies, e.g., programming and operating communication aids.
To demonstrate physical skills needed for phonetic transcription necessary for specialist assessment of speech.
To demonstrate physical skills in operating a computer, e.g., for word processing, inputting statistics, and using programmes with clients.
To drive to and from patients’ homes, community locations (clinics, nursing homes, etc.) as required.
To have due regard for own personal safety and that of clients/carers; particularly to have regard for moving and handling regulations, and to ensure safe positioning of self and others.
Mental Effort
To maintain intense concentration in all aspects of client management throughout the working day. In particular, (a) to monitor the client’s response during invasive procedures such as valve replacement and take action in the event of an adverse reaction, (b) to continually be aware of very small changes in the client’s vocal characteristics to guide both assessment and therapeutic intervention for voice disorders, (c)
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 5 to continually assess the level of risk to the client while carrying out swallowing assessments, and (d) to monitor auditory, visual and kinaesthetic aspects of client’s communication, adapting and facilitating according to perceived client’s needs, including cultural and linguistic differences.
To maintain intense concentration on all aspects of carer interaction with client, in particular to monitor auditory, visual and kinaesthetic aspects of interaction, encouraging adaptive strategies to maximise effective communication.
To be adaptable to the demands of the environment including unpredictable work patterns, deadlines and frequent interruptions.
Emotional Effort
To manage exposure to highly distressing situations, e.g., clients/carers coming to terms with a recent diagnosis.
To employ counselling skills with clients/carers with highly complex needs.
To maintain sensitivity at all times to the emotional needs of clients/carers, in particular when imparting potentially distressing information regarding the nature or prognosis of the client’s difficulties and the implications of this, e.g., informing client with absent swallow reflex that they will require non- oral feeding.
Working Conditions
To work within infection control and health and safety guidelines in order to manage highly unpleasant conditions related to client contact, e.g., direct contact with saliva, blood, vomit, infectious conditions, HAIs (healthcare acquired infections) one to two times a day.
To employ appropriate strategies to manage aggressive behaviour within the workplace (once a month), e.g., clients/carers in a distressed or an aggressive state, etc.
To drive for long periods on hazardous and single track roads (approx 3 times a month).
To travel by various modes of transport to locations throughout the Western Isles in inclement weather (less than three times a month).
To stay overnight away from home as required during travel to the mainland (about 3 times a year).
STANDARD ELEMENTS
Confidentiality
Comply with all approved NHSWI Policies and Procedures. Comply with NHSWI Communication Strategy and Media Strategy. This involves taking the necessary precautions when transmitting information only disclosing it to those who have the right and need to know it.
All personal health information is held under strict legal and ethical obligations of confidentiality.
NHS Staff must follow guidance (NHS Code of Practice on Protecting Patient Confidentiality) before disclosing any patient information. All staff must respect confidentiality of all matters that they may learn relating to their employment, other members of staff, patients and their families
Health and Safety: Assist in maintaining own and others’ health, safety and security.
This involves:
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 6 a) Complying with Board health and safety policies, procedures and participating in mandatory training b) Maintaining a safe working environment and reporting any issues of concern as appropriate
NHS Western Isles attaches the greatest importance to the health and safety of its employees. It is the Board policy to do all that is reasonable to prevent personal injury and hazard to health by protecting staff and others including the public from foreseeable hazards compatible with the provision of proper services to patients. The Board expects its entire staff to take reasonable care of their own health and safety and that of others who may be affected by their acts or omissions at work. More detailed information is given in departmental safety policies where appropriate.
Ensure own actions support equality, diversity and rights.
This involves:
a) Acting in ways consistent with the Board’s policies and procedures b) Treating those you come into contact with equitably and with respect c) Recognising the need for aids or adaptations
JOB DESCRIPTION AGREEMENT
I, …………………………………………………………….., confirm that the job description and person specification attached have been discussed with me and are an accurate and up-to-date account of the duties and responsibilities and skills/qualifications required to undertake the post.
Job Holder’s Signature: Date:
Head of Department Signature: Date:
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 7 ATTACHMENT
ORGANISATIONAL CHART Speech and Language Therapy Department February 2014
Speech and Language Therapy Manager/Professional Lead
Personal Assistant to SLT Manager [0.7 w.t.e.]
Adult Team Admin Support Paediatric Team Uist/Barra Team
1 x w.t.e. SLT 0.5 x w.t.e. Support 1 x w.t.e. SLT 1 x w.t.e. SLT [Highly Specialist Worker [Advanced Specialist [Highly Specialist Adults with [general admin Autism/ASN] Paediatrics/Adults] Communication/ support for whole Swallowing/Voice of Lewis based 1 x w.t.e. SLT 0.5 x w.t.e. Disorders] team] [Highly Specialist SLT Assistant This post Learning Difficulties/ ASN/Autism] 0.2 x w.t.e. SLT [Highly Specialist 0.8 x w.t.e. SLT Adults/Stroke] [Highly Specialist Paediatrics] 1 x w.t.e. SLT Assistant 2 x w.t.e SLT [Adults] [Developing - Highly Specialist Paediatrics]
1 x w.t.e. SLT Assistant [Paeds]
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 8 NHS WESTERN ISLES AGENDA FOR CHANGE
PERSON SPECIFICATION
Job Title: Highly Specialist Speech and Language Therapist (Adults with Communication, Swallowing, Voice Disorders) Grading: Band 7 Accountable to: Speech and Language Therapy Manager Base/Location: Western Isles Hospital Job Holder Ref: WI 1074
ESSENTIAL REQUIREMENTS DESIRABLE Qualifications/ Degree in Speech and Language Pathology/Therapy Membership Training Registered member of RCSLT of relevant Registered member of HCPC – License to Practice national Special Post graduate Dysphagia qualification and/or experience Interest Groups Completion of specialist post graduate courses relating to adults with ENT/Voice disorders Post graduate training in diagnostic procedures for dysphagia, e.g., videofluoroscopy Extensive study in the clinical specialist area, including working with other highly skilled specialists, e.g., in centres of excellence Knowledge In depth knowledge of issues relating to adults/ acquired Well And Skills disorders, particularly regarding policies and practice relating to developed (Specialist) adults with significant communication impairment, e.g., Adults computer skills to With Incapacity Act produce therapy Skills in implementing and integrating specialist SLT services resources, into multi-disciplinary/agency careplans including the use Highly developed skills in writing SMART targets for of specialist individual careplans, and SLT aims. software Understanding of the roles of other professionals relevant to programmes, e.g., the client group and how they complement each other. Boardmaker Understanding and experience of effective multidisciplinary working. Knowledge of Skills and experience in providing supervision to less and ability to experienced staff. employ, Skills and experience in providing advice and second opinion alternative and assessments. augmentative Experience of identifying training needs, and developing and systems of implementing training for a variety of professional and non- communication professional audiences. including hi-tech Skills in writing reports, research proposals, research results, communication service development proposals, etc., relevant to clinical specialist aids, e.g., touch area. talker, techspeak Knowledge Excellent analytical and reflection skills And Skills Excellent organisational and prioritisation skills (General) Excellent presentation skills (written and verbal) Excellent interpersonal skills including observation, listening and empathy Well developed negotiation skills Well developed concentration skills Excellent auditory discrimination skills and ability to
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 9 ESSENTIAL REQUIREMENTS DESIRABLE transcribe speech phonetically Well-established knowledge of a broad range of assessment tools relevant to client group In depth knowledge of national policies and procedures relevant to the client group In depth knowledge of a range of appropriate therapeutic interventions relevant to the client group, and an ability to compare and contrast relative benefits In depth knowledge of the principles of clinical governance/audit Knowledge of standards of record keeping Experience Relevant post graduate experience with clients with a variety Experience of communication disorders with clients who Experience of working with clients with dysphagia have ENT Experience with clients who have voice disorders conditions Experience of working in multidisciplinary settings and including cancer contributing to multidisciplinary assessment. of head and neck. Disposition/ Enthusiastic Personality Adaptable and flexible Friendly, approachable manner Sensitivity and empathy Confidence and assertiveness Good listening skills Co-operative, team player Ability to engage with a variety of professionals, clients, carers with differing experiences and philosophies Interests Broad general interests Shows a general interest in issues relating to services to clients with acquired communication and/or swallowing disorders Special Excellent communication skills Aptitudes Strong organisational skills Is able to be independent and flexible Is able to show initiative. Is able to deal with conflict effectively General Able to function in a variety of settings with a variety of people Able to motivate others Keen to further own knowledge and personal development Sensitive to cultural issues. Able to adopt a highly professional manner. Car driver
Job Description for Highly Specialist SLT (Adults with Communication/Swallowing/Voice Disorders), Ref: WI 1074 Page 10