o   To be professionally responsible and accountable for the management of own clinical caseload and to organise this effectively with regards to clinical priority and effective use of time in a variety of settings.

o   To work autonomously to provide highly complex advice to paediatric patients with highly complex medical and surgical conditions that are reliant on artificial nutrition support in the community.  This will involve nutritional assessment (based on interpretation of biochemistry, anthropometry, clinical condition and dietary history) and development of nutritional care plans which are both realistic, practical and evidence based (based on assessment of medical, social, economic, cultural and psychological factors).

o   To manage and be responsible for an individual caseload of paediatric patients with a wide range of medical, neurological, physical, social and emotional needs, including life limiting and degenerative conditions in an outpatient setting.

o   To assess and interpret the medical diagnoses and changes in medical conditions and treatment plans of individual patients requiring artificial nutrition support and understand how it affects nutritional management.

o   To formulate feeding regimens based on medical condition, fluid management, biochemical and anthropometric monitoring.

o   To have an awareness of tube site complications and to alert appropriate health care professionals to these complications if detected.

o   To respond to urgent complex problems with enteral feeding tubes e.g accidental removal or blockages.  Where possible to arrange emergency replacement of balloon retained gastrostomy devices or emergency assistance to clear blocked enteral feeding tubes in order to prevent hospital admissions.

o   To provide training to patients and carers alongside nutrition nurses on the correct procedures of care for their enteral feeding tube.

o   To maintain knowledge and awareness of guidelines for correct administration of medicines via enteral feeding tubes and where appropriate to liaise with the medicines management pharmacist for patient medication review.

o   To attend relevant multidisciplinary meetings in order to provide expert advice to clinicians regarding provision of appropriate nutrition support interventions based on clinical evidence.

o   To communicate effectively with patients and carers to maximise condition management, recovery potential, further disease prevention and during terminal care.

o   To liaise with the acute nutrition support team to ensure the safe and timely discharge of patients on artificial nutrition support.

o   To work with acute nutrition support team in the development of trust wide nutrition support guidelines with particular relevance to home enteral nutritional support.

o   To liaise and work collaboratively with Home Enteral Nutrition dietitians across the peninsula and nationally.

o   To advise on appropriate use of prescribable nutritional products to healthcare professionals and General Practitioners. 

o   To maintain accurate and timely dietetic patient records in line with national and local record keeping standards.

o   To co-ordinate the production and review resources to ensure that they are evidence based, up to date and in line with trust policies on document control.

o   To act as a specialist expert resource on artificial enteral nutrition in primary care for other dietitians and health care professionals 

o   To facilitate implementation of Trust wide nutritional policies and guidelines for artificial nutrition support using appropriate strategies to identify and meet training needs.

o   To be involved in the pro-active monitoring, review and development the Dietetic Service, identifying priorities and assist in the long term planning of the service.

o   To participate where deemed appropriate by the service manager, in the recruitment, appointment and induction of junior members of staff.

o   To organise and chair meetings as required.

o   To demonstrate a sound understanding of Clinical Governance and Risk Management and apply to work situation.

o   To work with the HEF team members to ensure that service delivery is evidence-based and in line with national standards. 

o   To participate in regular audit against local HETF standards and as part of the peninsula HEFT group and present findings at relevant meetings.

o   To keep workload statistics as required by the Nutrition and Dietetics services manager.

o   To liaise with HEF Dietitians in the Southwest Region on the care and management of patients working towards standards of best practice.

o   To contribute to the National Virtual HETF forum.

o   To undertake any other duties requested by the Nutrition and Dietetic Services Manager commensurate with the post.

o   As part of the Home Enteral Feeding Team, to develop, deliver and evaluate HETF teaching programmes for primary and secondary care to include district nurses, staff nurses, agency staff, pharmacists, GPs and learning disabilities services.

o   To be involved in the clinical training programme for student dietitians.

o   To initiate, plan, implement and evaluate multi-professional group teaching sessions in primary and secondary care settings

o   To plan and deliver training on artificial enteral nutrition and related topics in primary care to less experienced senior and junior dietitians within the dietetic department

For further details please see the attached JD & PS.