1. JOB IDENTIFICATION 2. JOB PURPOSE JOB DESCRIPTION. Job Title: Macmillan Nurse Endoscopist/Upper GI Cancer Nurse Specialist

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1 JOB DESCRIPTION 1. JOB IDENTIFICATION Job Title: Macmillan Nurse Endoscopist/Upper GI Cancer Nurse Specialist Department (s): Cancer and Endoscopy Job Holder Reference: NM2023 No of Job Holders: 1 2. JOB PURPOSE To lead and develop Upper GI cancer services in the context of multidisciplinary working across professional boundaries and health and social care settings by providing an expert nurse led service offering advice, support and holistic care from investigation, diagnosis, treatment and ongoing management through to palliative care and bereavement as appropriate. To become an integral part of the endoscopy team applying specialist knowledge and expert clinical skills to provide patient centred nurse led endoscopy services, performing flexible sigmoidoscopy, gastroscopy and colonoscopy. Demonstrate ability to practice autonomously and provide leadership and educational development within the speciality, establishing close links with the multidisciplinary team to provide continuity of care. To advise on and participate in Upper GI Cancer Service development within NHS Borders and the South East Cancer Area Network (SCAN)

2 3. ORGANISATIONAL POSITION General Manager Planned Care and Commissioning Associate Director of Nursing Service Manager Planned care and Commissioning Macmillan Nurse Consultant Cancer Endoscopy and GI Service Team Macmillan Nurse Endoscopist/Upper GI Cancer Nurse Specialist (This Post) Macmillan Centre Specialist Cancer Service Team 4. SCOPE AND RANGE This post is a dual role delivering clinical nurse specialist support to patients with upper GI cancers as well as delivery of non medical endoscopist investigative lists for inpatients, daycases and outpatients. The post holder will require to work flexibility to meet the needs of patients with cancer and provide investigative lists as demand requires. The post holder provides expert non medical endoscopist / expert nurse input to the strategic planning for Endoscopy Services and upper GI cancer services within NHS Borders. The post holder must collaborate with the multidisciplinary medical, surgical, oncology, palliative and primary care teams as well as support services to ensure the provision of a quality, best value service for all service users providing a high quality, safe and supportive environment for patients undergoing investigation, treatment and on-going care. The post holder participates in regional provision of services as a member of the Managed Clinical Network for South East of Scotland Network for Cancer (SCAN) SCAN Upper GI group. The post holder acts as a specialist resource across NHS Borders delivering expert advice to all disciplines, as well as patients and carers, which is evidence and research based. OUR VALUES IN ACTION Care and Compassion Quality and Teamwork Dignity and Respect Openness, honesty and responsibility

3 5. MAIN DUTIES/RESPONSIBILITIES Clinical Provide an expert non-medical endoscopist service for patients and maintain clinical expertise by carrying a clinical caseload and co-ordinating investigation, treatment and ongoing care for this patients group. To have regular contact with patients and their relatives, who will frequently be highly distressed and anxious, using advanced communication skills and empathy to sensitively communicate: 1. Distressing news at diagnosis or recurrence of conditions 2. Complex information about diagnosis and treatment plans 3. Outcomes of treatment, results of investigations Independently perform advanced clinical skills in assessment, diagnosis and treatment working collaboratively and co-operatively within the clinical team to assess complex individual patient needs, initiating investigations, determining a differential diagnosis and initiating appropriate holistic, evidence based treatment and care within agreed local, regional and national guidelines and protocols. Initiate and develop Specialist Nurse services, e.g nurse-led clinics, to enhance the delivery of patient care. Provide expert information, advice and support to inpatients and outpatients for patients with upper GI cancer, explaining complex pathways and treatment options enabling them to fully understand their diagnosis and treatment choices thus assisting them to participate in decisions relating to their care management. Following appropriate academic study, practical training and assessment of competency, undertake diagnostic gastroscopy, flexible sigmoidoscopy and colonoscopy according to NHS Borders protocols and established National Training Guidelines (British Society of Gastroenterology). Become accredited to undertake procedures as part of the bowel screening service. Provide cross cover for other endoscopists in the organisation. Provide evidence-based clinical expertise, advice and guidance in Upper GI cancer and upper and lower endoscopy developing policies, procedures and clinical guidelines for implementation within and across clinical teams. Promote the individual needs of the patient, acknowledging their personal preferences, rights and choices according to their plan of care by promoting anti-discriminatory practice, privacy, dignity, and respect for personal values and identity. Ensure the delivery of holistic and seamless care through promoting multi-disciplinary working by actively participating in weekly multi-disciplinary meetings and closely liaising with primary, secondary and tertiary care. Independently accept and make appropriate referrals from/to other professional colleagues. Lead the development of programmes of care, which facilitate self-management and independence, and provide continuing professional support on an individual basis after diagnosis and completion of treatment.

4 Management Use expert knowledge and experience to contribute and participate in the development of upper GI cancer and endoscopy services regionally and locally. In collaboration with others take a lead role in developing/implementing evidence based practice within the clinical environment with a multi-professional focus having the ability to facilitate, initiate, manage and evaluate change in practice across acute, primary and tertiary care settings to improve quality of care. Lead in the development and implementation of multi disciplinary policies and protocols to promote service quality, effectiveness and patient safety within the service locally and regionally. Enter data, obtain and collate information from computer systems using agreed software packages in conjunction with other members of the team. Provide and participate in clinical peer supervision. Participate in recruitment and induction of staff as required. Work collaboratively with the wider team to ensure resources (financial and human) are managed and utilised effectively. Establish strong links with and report annually to Macmillan Cancer Support. Leadership Maintain own clinical and professional development through reflection, continued education, staff appraisal and personal development plan. Ensure clinical practice is developed in line with regional and national strategy by attending and participating in relevant regional and national groups. By virtue of being a senior nurse work collaboratively with the nursing and midwifery directorate to provide leadership and promote nursing and organisational strategy across the organisation. Demonstrate leadership within the wider multi disciplinary team across health and social care settings whilst providing expert knowledge and skill in clinical practice. Contribute to the change process to meet future needs of the service, keeping up to date with local and national agenda s. Seek, provide, and evaluate information to solve problems and support decision-making on the effective and efficient use of physical and financial resources. Identify problems with resources within clinical teams, including offering suggestions and solutions. Carry out additional requirements of the job role as required. Ensure compliance with organisational policies, procedures and guidelines for self and others, by taking action/alerting senior management team if practice appears to contravene policy. Education Liaise with clinical staff and education organisations to ensure appropriate educational opportunities exist for NHS borders employees.

5 Organise, prepare and deliver formal and informal multidisciplinary educational programmes relevant to the post. Participate in regional and national education and conferences as part of the multi disciplinary team. Provide mentorship and clinical leadership to all disciplines as necessary in relation to endoscopy practice and upper GI cancer services. Research and Development Initiate and lead research projects and clinical audits relevant to patient and service needs developing, producing and disseminating evidence based clinical guidelines locally and regionally. Audit and monitor self and service quality to ensure resource effectiveness and impact of specialist nursing input. Evaluate the impact of changes on standards of patient care through auditing and benchmarking. Assist with the collection of endoscopic data as agreed with the organisation and consultant colleagues. To lead and promote findings of research and evidence practice which in turn reflects and influences practice. Adhere at all times to NHS Borders Policies. 6. SYSTEMS AND EQUIPMENT Use specialised clinical equipment safely including sigmoidoscopies, colonoscopes, biopsy forceps, snares, grasping forceps, endoscopic injection needles,video processor etc Use specialist electronic information equipment Maintain accurate health records either paper or computer based The post holder must be computer literate Moving and handling equipment Intravenous infusion devices Resuscitation equipment Endoscopy washer disinfector Care and storage of all scopes and associated equipment Oxygen and suction equipment

6 7. DECISIONS AND JUDGEMENTS Work/goals will be largely self generated and self directed arising from local operational plans and the post holder will be required to work without direct supervision. The post holder after interpretation of clinical history and results will be required to autonomously make clinical and managerial decisions and formulate an appropriate treatment plan for patients recognising when advice from the wider team is necessary. To work unsupervised and manage own time and caseload effectively. Recognise own ability and limitations and identify these to line manager. 8. COMMUNICATIONS AND RELATIONSHIPS Engage frequently in highly complex and distressing conversations and dialogue with patients and carers utilising advanced communication skills and empathy to convey information relating to diagnosis, changes in condition and treatment. Prepare, write and deliver reports and presentations within NHS Borders as well as regionally and nationally as required. Network with Primary, Secondary and Tertiary services and specialist professional groups regionally and nationally. Network with Macmillan Cancer Support. Actively listen and seek patients and public opinions on all aspects of care. Promote collaborative relationships with patients, public and all staff across professional and organisational boundaries. Communication verbally and in writing with NHS Staff and departments locally and regionally and with other agencies and organisations as appropriate. Motivation and negotiation with junior, peer and senior staff groups across all disciplines and multiple organisational settings to facilitate change and service development. Ability to deliver informal and formal multi disciplinary teaching programmes. Report complaints, clinical, non-clinical incidents and completed risk assessments verbally or in writing. 9. PHYSICAL DEMANDS OF THE JOB The post holder will be continually mobile for the majority of the shift. Be able to respond speedily and accurately to emergency or unplanned situations. Assist with moving and transport of patients ensuring moving and handling guidelines are adhered to. Potential control and management of physically aggressive patients.

7 Require excellent dexterity, accuracy and highly developed physical skills to enable the manipulation of fine tools including sigmoidoscopes, colonoscopes, endoscopes, biopsy forceps, snares and insertion of intravenous cannulae. Ability to meet the needs physically and mentally of an unpredictable workload which includes the ability to stand for long periods, concentration on patient assessment and procedures. 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB The high level of autonomy and clinical decision making required on a daily basis. Managing expectations of the wider clinical team and management of a new role. Emotional demands of frequently imparting and discussing complex diagnostic and treatment information to patients and relatives. Prioritising and meeting competing demands from patients, relatives, members of the health professional groups, and management with the ability to work flexibly in a rapidly changing environment. Achieving a balance between the operational and developmental aspects of the role while providing the opportunity for training and development of other health professionals involved in the delivery of endoscopy services across NHS Borders. The ability to work in frequently highly unpleasant conditions including exposure to body fluids, faeces and hazardous chemicals/cleaning solutions.

8 PERSON SPECIFICATION For the post of Macmillan Nurse Endoscopist/Upper GI Cancer Nurse Specialist Below are the essential knowledge, training (including qualifications) and experience required to do this job. ESSENTIAL 1. Registered Health Care Professional. 2. Completion of non-medical endoscopy course including skills in flexible sigmoidoscopy, gastroscopy and colonoscopy. 3. Educated to masters level or equivalent level of experience. 4. Relevant post registration experience. 5. Experience of working within the speciality. 6. Evidence of continuing professional development relevant to the post and willingness to study towards advanced practitioner status (masters level) 7. Excellent clinical decision making and problem solving skills and the ability and confidence to work autonomously with minimal supervision. 8. The ability to communicate complex information sensitively and empathise with patients and relatives. 9. Excellent communication, leadership, and organisational skills and the ability to work independently as well as part of a team. 10. The post holder must be innovative and have the necessary interpersonal skills to motivate others and manage change. DESIRABLE 1. Experience of audit/research 2. Experience of teaching 3. Experience of change management

9 TERMS AND CONDITIONS Grade and salary: Hours of work: Annual leave: Band 7: 32,013-42,205 per annum pro rata 37.5 hours per week, Permanent 27 Days per annum (pro rata) Details of other types of leave entitlement (such as sick leave) are set out in the Agenda for Change handbook. Public Holidays: Superannuation: 8 days per annum (pro rata) on dates designated by NHS Borders The post-holder is entitled to join the NHS superannuation pension scheme. If Unsuccessful: If you have NOT heard from us within 4 WEEKS of the closing date, then we regret that your application has not been successful on this occasion. However, we appreciate your interest in working with NHS Borders and your time and effort in completing the application form. We would welcome your application for future posts. Equal Opportunities: In NHS Borders, we believe that all staff should be treated equally in employment. We will not discriminate against any member of staff, or job applicant, on grounds of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion and belief, sex and sexual orientation. Trade Union membership. Disclosure checks: We carry out criminal record checks on new staff who fall within certain staff groups within NHS Borders, through Disclosure Scotland. We send out Disclosure Forms to all shortlisted candidates for these staff groups, and ask for these to be completed and returned at interview. If a successfulat-interview candidate forgets to bring their completed form to interview, then they will be required to return the form (and proofs of identity) within 7 days, otherwise the provisional job offer will be withdrawn. Unsuccessful candidates forms will be shredded. The Rehabilitation of Offenders Act does not apply to this post. Tobacco policy: We have a Tobacco policy in place. When selecting staff, we do not discriminate against applicants who smoke, but staff must observe our policy on smoking. Hepatitis B: We offer Hepatitis B immunisation through our Occupational Health Service (OHS). If you think you may be at risk of contracting Hepatitis B through your job, you should ask for this immunisation at OHS. If your work involves exposure-prone procedures, you must keep to the document Protecting Health Care Workers and Patients from Hepatitis B, and the NHSiS Management Executive Directive on this issue. You must be immune to Hepatitis B, and if you cannot prove that you are immune, OHS will investigate to find out whether you are Hepatitis B positive or not.

10 Health and Safety at Work: You must look after the health and safety of yourself and anyone else who may be affected by what you do at work. You must also co-operate with us to make sure that we keep to legal and organisational safety regulations. You can get more information from the NHS Borders Health & Safety Adviser. The closing date for completed application forms is: 5pm on Thursday 28 September 2017