Highly Specialist Head & Neck/Cancer Dietitian

Communication and working relationships To work as the lead dietetic member of the Cancer H&N team To communicate and establish working relationships with: o H&N, Oncology & Haematology consultants, CNS teams, AHP's, ward managers and matrons and the wider teams o Allied health professionals o Cancer MDT, rehabilitation teams, ward medical and nursing teams o Nutrition team and nutrition nurse specialists o Home Enteral Feeding (HEF) Dietitians and HEF Team o Catering department o Local dietetic team, including acute teams of dietitians, community dietitians, diabetes dietitians, Primary Care Network (PCN) dietitians o Students dietetic and other professions o Other health and social care professionals Planning and organisation To manage own clinical caseload as an autonomous practitioner within the H&N service To manage own time, prioritise clinical referrals and manage the demands received from different parts of the service Actively evaluate the dietetic H&N service, identifying any areas for development, together with support from senior members of Cancer H&N team.

To deliver dietetic care to a caseload of complex adult patients in collaboration with the CNS and the H&N MDT and other MDTs as required To provide a source of expert knowledge and advice on nutrition to the H&N and cancer services. Responsibility for patients and client care To lead provision of evidence-based, individualised, disease specific and often complex dietary/nutritional treatment plans for H&N, Cancer patients with, appropriate review and evaluation of these plans To be responsible for reviewing, monitoring and making appropriate clinical changes to each patients dietetic care plan based on medical, emotional, ethical and social developments in addition to multidisciplinary decisions on the patients care To use behaviour change and advanced communication techniques to support and aid compliance with recommended dietary/nutritional treatment plans To explain treatment plans (verbal and or written) in an easily understandable way to patients, carers and relatives and other relevant individuals, to enable patients to make informed choices about their own health To provide resources such as patient information leaflets, recipes and menu plans and to signpost them to other resources where appropriate (e.g. NHS patient webinars, relevant charities and support groups).

To provide dietetic care, both practical and empathetic, for people requiring long-term nutrition support or long-term dietary changes (including those who may be in the end stages of their life) with gastroenterology diagnoses To be pro-active in initiating appropriate dietetic treatment and/or referral, and to signpost to other appropriate services To advise on commencing enteral nutrition (either orally or by way of a variety of tube feeding routes dependent on gut anatomy and function) and transitioning between routes To request, review and interpret blood biochemistry results to monitor the safety and efficacy of nutritional support, and make clinical changes where necessary To understand and be fully aware of the range of oral nutrition support products, enteral tube feeds and associated equipment To be responsible for recommending nutritional supplements To recommend nutritional supplements for prescription (e.g. from GP, or hospital doctors where appropriate) To ensure safe and timely discharge of tube fed patients from hospital to home, with the support of the nutrition team, ward staff and home enteral feeding team including monitoring of high-risk patients (e.g. those being fed post-pylorically or with complex gastrointestinal needs) on home enteral feeding in the community To advise off script enteral tube feeds for home use To maintain accurate and timely documentation of patient interactions and clinical care provided in line with record keeping standards Policy and service responsibility To lead the development of policies, resources and guidelines relevant to this role, with the support from gastroenterology To contribute to the wider service development of the dietetic service To follow Trust policies and procedures To undertake clinical practice in line with local policy and guidelines, such as refeeding, enteral feeding and nutrition screening To relate clinical practice to broader clinical guidelines, including NICE To promote the role and value of the Dietitian in all aspects of nutritional care Responsibility for finance, equipment and other resources To promote the clinical and cost-effective use of oral nutritional supplements, for example, when inpatients are discharged from hospital into the community Responsibility for supervision, leadership and management To provide nutrition expertise within the Cancer teams Information technology and administrative duties To use Trust IT systems To accurately record own Dietetic activity using computerised statistics and to collate this data for service evaluation and development purposes To use Attend Anywhere or equivalent for patient assessments, when clinically appropriate To prepare own presentations, reports, and documents Maintain clinical records including Dietetic records and GP letters and in line with professional and department standards.

Use electronic patient records where available To work within the requirements of Data protection legislation and access to health records To communicate via email, social media and other internal IT systems Responsibility for research and development To be responsible for own and gastroenterology dietetic services continued professional development and be proactive within annual Achievement Reviews and monthly 121s To maintain and improve professional knowledge through CPD (continued professional development), for example, journal review, shadowing, attendance at courses/conferences/webinars as agreed with the Team and the wider dietetic department To liaise with other specialist dietitians To work within the HCPC (Health and Care Professions Council) Standards of Conduct, Performance and Ethics and the BDA (British Dietetic Association) Code of Professional Conduct To proactively identify and lead project work to develop the service to provide high quality nutritional care to patients