Dietician Band 5 - Salary Range 21,388-27,901 per annum Full Time 37.5 hours per week Relocation assistance up to 8000 available

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Dietician Band 5 - Salary Range 21,388-27,901 per annum Full Time 37.5 hours per week Relocation assistance up to 8000 available This new role provides a superb opportunity for a qualified dietitian to contribute to the delivery of a remote and rural dietetic service. Working closely with the Senior Dietitian, the post holder will manage a varied workload including hospital-based inpatient and outpatient services as well as working within the community as part of a multi-disciplinary team. Responsibilities include outpatient clinics, nutritional assessment, advising on alternative feeding methods, dietary supplements and reviewing care plans. The successful candidate will hold an honours degree or equivalent in Nutrition and Dietetics approved by the BDA/HPC and be a Health Professional Council registered Dietitian. Minimum work experience should include clinical placements, and knowledge will include appropriate dietetic treatment of patients with medical & surgical conditions and the needs of the elderly as well as basic knowledge of the field of obesity and diabetes prevention and treatment and weight management and diabetes for adults. Shetland is a great place to live and work. With a wide variety of wildlife, outdoor activities and cultural events, there is plenty to see and do! Shetland offers low pollution, low crime, excellent schools, great leisure facilities, unique wildlife and amazing scenery, whilst still only a short flight away from the UK mainland. To find out more about living and working in Shetland go to www.shetland.org For an informal discussion, please contact (up to 20 th September) Laura Hayden, Senior Dietician, on 01595 743000, extension 3394 or (after 20 th September), Clare Burke, Head of Speech & Language Therapy on 01595 744242. Please quote reference number D78/SHOW Closing date: 9.00am on Friday 4 th October 2013 Interview date: Friday 1 st November 2013 In addition to salary, all posts qualify for a Distant Islands Allowance of 1,671 per annum (pro rata for part-time and fixed term positions). For more information and an application form, please visit our website www.shb.scot.nhs.uk. Alternatively, contact the Human Resources Department, Brevik House, South Road, Lerwick, Shetland or telephone: (01595) 743067 (24 hour answerphone), quoting the appropriate reference number. All applications must be on our standard application form CVs will not be accepted. In promoting equal opportunities, we welcome applications from all sections of the community.

JOB DESCRIPTION 1. JOB IDENTIFICATION Job Title: Dietitian Responsible to: Senior Dietitian Department: Nutrition and Dietetics Directorate: Clinical Services Last Update: 10 th September 2013 2. JOB PURPOSE To work alongside the Senior Dietitian to provide a dietetic service to both inpatients and outpatients at the Gilbert Bain Hospital. To work alongside the Senior Dietitian to provide community dietetic service to patients within Shetland including home visits and telephone reviews. The post holder will be required to function as an active member of multidisciplinary teams in the delivery of the service. The post holder will also contribute to the Nutrition and Dietetic service as a whole through participation in service provision, development and small projects. 3. DIMENSIONS No line management or budgetary responsibilities. Provide general dietetic service to inpatients and outpatients based at Gilbert Bain Hospital which is a General Hospital situated in Lerwick. Total Population of Shetland c. 22,000 10 GP Practices 1 Community Health and Care Partnership One Local Authority Thirty Five Schools Over 500 Community and Voluntary Groups 40% of men and 30% of women in Scotland are overweight 24% of men and 27% of women in Scotland are obese (Scottish Health Survey 2003)

4. ORGANISATIONAL POSITION AHP Lead/Service Manager Other Community AHP Services Head of Speech & Language Therapy Senior Dietitian Health Improvement Department & Support from NHS Grampian Dietitian (This Post) Dietetic Assistant 5. ROLE OF DEPARTMENT The Nutrition and Dietetic Department will consist of two dietitians responsible for the organisation and delivery of the NHS Shetland Dietetics Service in acute and community settings. This involves providing a dietetic service to the following areas: Inpatients at Gilbert Bain Hospital Outpatients as two weekly general clinics (adults and paediatrics) and one Diabetes MDT clinic. Renal and maternity units when requested Weekly attendance at ward MDTs and possible attendance at ward rounds. Regular review of home enteral nutrition patients and other domiciliary visits. The dietitian is also nutrition lead for practice change for example implementation of the Food, Fluid and Nutrition Care Standards and nutritional screening using MUST; ongoing development of home enteral nutrition service; development of weight management programme and diabetes programmes.

6. KEY RESULT AREAS CLINICAL Delivery of the dietetic service to inpatients on medical, surgical and rehab wards at Gilbert Bain Hospital. Support Senior dietitian in delivery of dietetic service to community patients e.g. home visits and in care homes. Undertake a weekly general outpatient clinic at the Gilbert Bain Hospital. Carry out detailed nutritional assessments and anthropometry and provide evidence -based nutritional and dietetic advice which is suitable for the patient s medical, social and cultural circumstances. Assess, identify and recommend appropriate alternate feeding methods e.g. nasogastric/gastrostomy tube using tact and empathy to support clients through the decision making process. Accurately calculate nutritional requirements for, and have knowledge of, enteral feeds, equipment and dietary supplements to advise prescribing agents appropriately. Negotiate change (which may include giving unwelcome or difficult to accept information) with patients and help them overcome any barriers to change in order to achieve dietary targets set. Monitor and review nutritional care plans against outcome measures and adjust care plans to facilitate achievement of goals. Maintain accurate dietetic records and prioritise and manage own caseload. Ensure safe and timely discharge of patients on home enteral feeding liaising with appropriate internal and external agencies. Attend weekly MDT meetings and ward rounds where required. Develop and deliver cardiac rehabilitation, diabetes and nutrition based talks to patient and other presentations to patients and colleagues as the need arises. Assess clients needs on an individual and group basis, then plan, manage, deliver and evaluates appropriate weight management programmes. SERVICE DEVELOPMENT Work with the Senior Dietitian to develop organisational policies and procedures e.g. referral criteria.

To assist the Head of Service in the planning, monitoring and development of the service To be aware of the Health and Safety aspects of dietetics, including prompt recording and reporting of any incidents / near misses / accidents to the appropriate staff. EDUCATION AND TRAINING To contribute to the training and clinical supervision of pre-registration dietetic students. To contribute to and take the lead at defined patient group sessions which will facilitate lifestyle change such as cardiac rehabilitation and diabetes. This includes planning the session, providing clear, consistent and evidence-based advice and evaluating the session. Attend and contribute to the Remote and Rural Dietetic Network. Attend and contribute to: Nutrition Steering group; Nutrition Link Nurse meetings and the AHP meetings in the Principle Dietitians' absence. COMPETENCE TO PRACTICE Meet requirements of the Health Professions Council and maintaining professional registration. Work within the Health Professions Council, British Dietetic Association and local codes of conduct. Organise and carry out work effectively and manage any risks to quality e.g. change in workload. Regularly audit own practice, evaluate own work and in particular the impact of Counterweight on services, patients and the public. Comply with local policies, procedures and statutory regulations and attend mandatory training. Build on knowledge with the aim of providing specialist weight management advice to patients and clients. Take the opportunity to develop other specialist skills by shadowing the Principle Dietitian in areas such as: Home Enteral Feeding; Type one Diabetes; renal. Together with the Principle Dietitian develop own personal developmental plan to meet identified needs. Generate and use appropriate learning opportunities and apply own learning to the future development of own dietetic practice.

7a. EQUIPMENT AND MACHINERY 7. EQUIPMENT AND SYSTEMS Desk top or lap top computer daily up to 2 hours per day Photocopier twice a week for short periods The following equipment can be used several times daily for short periods of time: Weighing scales Height Stadiometer Calculator Knee height callipers Tape measure Skin fold callipers Electronic food weighing scales Food models Pedometers 7b. SYSTEMS Responsibility for keeping up-to-date confidential dietetic records and clinic reports. Keeping up to date statistics of patient contact. 8. ASSIGNMENT AND REVIEW OF WORK To agree with the Senior Dietitian the annual work programme and specific objectives to be achieved within the year. To attend monthly supervision session with the Senior Dietitian to reflect on clinical work. To manage own caseload and work autonomously whilst being aware of own limitations and receiving regular support and feedback from the Senior Dietitian. 9. DECISIONS AND JUDGEMENTS To assess patients, plan dietetic intervention and decide on appropriate monitoring To be responsible for managing a varied workload of both hospital and community, allowing appropriate time for each. Ability to prioritise as unplanned urgent work arises. Due to annual leave etc., there will be periods of time when the postholder will be the only dietitian available within in Shetland, therefore it is important to be aware of own limitations and the routes for seeking guidance when required.

10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB Effectively managing a varied caseload. Helping patients to overcome barriers to change. Coping with limited supervision during periods of absence of line manager. 11. COMMUNICATIONS AND RELATIONSHIPS Provide motivation, empathy and reassurance to patients to help them achieve their dietary goals. Communicate effectively to other health care professionals and agencies with regard assessment, treatment and outcomes. Communicate with individuals and groups whilst delivering the Counterweight programme. Communicate effectively with patients, families and carers and groups to convey comprehensive details of care/treatment in a manner appropriate to the individual. Use of behaviour modification techniques to motivate and empower practitioners, patients and carers. Maintain confidence at all times in line with data protection procedures. The Postholder will be expected to communicate with: Patients, families and carers Patient support groups Primary care and ward staff Medical staff Nutrition Champion Sodexho catering staff Health Improvement Department Principle Dietitian Grampian Nutrition and Dietetics Department. Pharmacist. Care Centre managers, kitchen staff and carers Community Carers Ward sisters, staff nurses, auxiliary nurses Remote and rural network staff Specialist nurses, e.g. cardiac, MS, Diabetes and stroke AHPs and Social workers.

12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB Physical Regularly carry out anthropometric measurements in accordance with manual handling procedures. Transport appropriate equipment, e.g. weighing scales to different venues. Stand or sit for long periods e.g. while delivering training or recording data. Mental Concentrate for long periods when delivering training/presentations to groups (up to half a day at a time). Ability to concentrate on the ward where there may be numerous distractions. Take responsibility for collecting and collating data for the Counterweight programme on behalf of Dietetics and reporting to Health Improvement Team. Emotional Regularly work with patients who have depression, chronic conditions, loss of independence, bereavement or behavioural problems. Work with more complex weight management patients who require input from a dietitian rather than primary care staff. Requirement to work alone during absence of Senior Dietitian. Environmental May need to travel throughout Shetland and will therefore need to travel by car and ferry. Lone working in patients' houses may be required. May experience exposure to cigarette smoke and odours on a weekly basis.

13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB CRITERIA ESSENTIAL DESIRABLE Experience Undertaken clinical placements Post-registration experience in acute and community settings. Qualifications Knowledge and skills Health Professional Council registered Dietitian Honours degree or equivalent in Nutrition and Dietetics approved by the BDA/HPC Knowledge of appropriate dietetic treatment of patients with medical & surgical conditions and the needs of the elderly Basic knowledge of the field of obesity and diabetes prevention and treatment and weight management and diabetes for adults. Use of anthropometric equipment e.g. scales, height, etc. Ability to organise and manage own caseload with supervision as required. Ability to work as a team member and independently as required. Excellent written and verbal communication skills, and presentation skills. Excellent presentation skills and some experience of group presentation from clinical placements. Excellent time management skills. Word processing and data input skills. Appreciation of CPD Delivering group interventions. Member of the BDA. Groupwork/training skills qualification European Computer Driving Licence (ECDL) or equivalent. Skills in motivational interviewing Knowledge of current NHS Scotland guidelines. Awareness of research methods and audit skills to inform and evaluate practice.

Other Able to demonstrate an interest in group work and develop new skills in this area. Enthusiastic, inspirational and selfmotivated Ability to work well under pressure Full driving licence and ability to travel within Shetland for work purposes 14. JOB DESCRIPTION AGREEMENT A separate job description will need to be signed off by each jobholder to whom the job description applies. Job Holder s Signature: Head of Department Signature: Date: Date: