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Swydd ddisgrifiad a phrif gyfrifoldebau manwl

• Make professionally autonomous decisions in relation to individuals infected with viral hepatitis.

• Screens patients for disease risk factors and signs of illness.

• See patients with undifferentiated and undiagnosed problems and make a clinical assessment of their health needs.

• Order the necessary investigations, make differential diagnosis, provide highly specialised clinical advice and provide treatment and care to those infected with viral hepatitis. This involves dealing with sensitive information and breaking bad news which may be met with a range of emotions including hostility and extreme distress.

• When treatment is clinically indicated assess patient’s suitability for treatment. Prescribe the most appropriate type of medication for a given patient and their condition. Monitor for side-effect of treatment and intervene as appropriate i.e. additional prescribing onward referral etc.

• Ongoing responsibility for repeat prescribing.

• Carry continuing responsibility for a cohort of individuals infected with viral hepatitis including the clinical assessment, planning, implementation and evaluation of programmes of specialised care and provide highly specialised clinical advice to this patient group. This will include monitoring adherence to medication and developing strategies to maximize adherence. For patients with hepatitis B or C manage the total care of patients receiving treatment for their hepatitis B or C disease. This includes educating patients about treatments, discussing potential side effects, training patients to administer their treatment.

• See patients on treatment for hepatitis C, at weekly to four weekly intervals (dependant on clinical need) to obtain blood samples, reviewing the results and adjusting the dose of medication according to the blood results. In patients with hepatitis C make decisions to stop treatment earlier than anticipated in patients who are not responding to treatment – this will involve breaking bad news of treatment failure as, if treatment fails, currently, there are no other treatments available   Repeat prescribing. Arranging to see patients for post-treatment monitoring. Establishing the outcome of treatment and giving the result to the patient – this may involve breaking bad news of treatment failure, if treatment fails, currently there are no other treatments available.

• See patient on treatment for hepatitis B as clinically indicated but once established on treatment at least once every three months to six months as indicated by clinical need. Monitor for side-effects, complications of ongoing infection, treatment efficacy and drug resistance.

• Refer patients on to other healthcare professionals including consultants in psychiatry, dieticians, and psychologists.

• Discuss differential diagnoses with patients including breaking bad news i.e. the diagnosis of liver tumours and or cirrhosis.

• Provide ongoing highly specialised clinical advice, monitoring and support to those patients who fail treatment with onward referral as necessary.

• Provide a consultancy function to other professionals within the healthcare setting, and external agencies concerned with social issues including highly specialist clinical advice on all matters relating to viral hepatitis. Accessible via face to face consultations and the telephone.

• Venepuncture, often with individuals who have poor venous access and who are infected with viral hepatitis. This may involve deciding to use butterflies and or needles and syringes in order to obtain the sample.

• Provide ongoing highly specialised clinical advice and support to individuals infected or affected by viral hepatitis. These individuals will include GPs and other healthcare workers, members of the public, the occupational health department and statutory and non-statutory services. Provide highly specialised clinical advice (including issues relating to hepatitis B post exposure prophylaxis) and support to staff occupationally exposed to blood and body fluids which may be infected with blood

• Provide highly specialised clinical advice on matters relating to viral hepatitis to other healthcare professionals i.e. GPs, hospital consultants, occupational health, midwives and nursing staff.

• Setting of county-wide standards of care with responsibility for monitoring and ensuring maintenance of set standards.

• Work with the communicable disease consultant to develop services and strategies to prevent the spread of viral hepatitis in Gloucestershire.

• Promote and maintain good working relationships with the county-wide statutory and non-statutory sector i.e. staff within the healthcare Trusts, General Practitioners, Turning Point and Gloucestershire Independence Trust.

• Responsibility for developing clinical policies related to viral hepatitis across the healthcare Trusts.

• Plan specialist service provision for viral hepatitis in Gloucestershire and propose policy or service changes – dependant on new evidence and research.

• Develop protocols relating to viral hepatitis for use in both the statutory and non-statutory sector (including health and social care)

• Provide highly specialised advice at Trust level and above, in relation to the developing face of the service.

• Provide highly specialised clinical advice to the healthcare Trusts in relation to patient notification exercises. Set up and manage the resulting telephone help lines.  Oversee the testing of notified patients and give positive results.

• Provide highly specialized training on viral hepatitis to other healthcare professional including nurses and doctors.

• Maintain up to date knowledge of developments and treatments through dedicated activities such as accessing recognised professional internet sites, attendance and involvement in professional groups at a local, regional and national level e.g. professional group liaison, and the south west hepatology group.

• Data entry using the hepatitis C database.

• Record interventions accurately in patient records (both written and electronic).

• Support, supervise, educate and assess students on placement with the service.

• Ongoing involvement in South West Region hepatitis C study. Lead clinical nursing audit in viral hepatitis. Participate in local and national research and audits as required as part of the job.

• Line management and support to new/junior staff on team

• Education to team

• Expert advice to out-patients

• Appropriate referrals

• You will be required to demonstrate compliance with the terms of all safeguarding policies and processes relevant to the safeguarding of adults and children in the care of GHNHSFT and to undergo regular mandatory training concerned with safeguarding matters.

• Post holder will carry a mobile phone and is therefore likely to experience frequent interruptions

• Work pattern will be unpredictable

• Responsibility for ordering stock, drugs and vaccinations.

• Monitor the viral hepatitis budget