Overall Job Purpose To be part of a highly motivated team, providing a high standard of clinical care in a highly specialised area. To liaise closely with other team members to ensure cover is provided for annual leave and sickness to provide continuity for the podiatric surgery service. To conduct with or on behalf of the responsible Consultant podiatrist, outpatient clinics and theatre sessions, including post operative wound care and medical clinical clerking. To accept clinical responsibility for a designated caseload of patients, (both those referred for Podiatric Surgery and those in general podiatric care), and to organise this effectively with regard to patient, Service and professional priorities and to manage the clinical risk within that caseload. To diagnose and assess podiatric conditions and pathologies and subsequently design and deliver individualised care programmes for patients with a wide variety of clinical needs including those with chronic disease, neurological, vascular and functional problems and wounds. As part of the Podiatric Surgery Team, the Podiatry Service and Northumbria Healthcare Foundation Trust, contribute to the development of, and adhere to the Podiatry Service and Trusts policies, strategies and objectives. Duties and Responsibilities Clinical duties To be responsible for the provision of clinical care prior and throughout the pathway of foot surgery within a highly specialised multi-disciplinary team. To be responsible for the podiatric assessment, diagnosis, planning, implementation, delivery and evaluation of conservative podiatric interventions, which may include: Initiating biomechanical treatment and provision of orthoses/exercises and refer to highly specialised community podiatrists as appropriate. Administering hydrocortisone injections. Providing footwear advice. To undertake the assessment of patients prior to foot surgery, this may include: Obtaining a full medical and social history with a particular emphasis on risk factors pertaining to foot surgery. Initiating advanced tests such as, blood tests, thrombophylic screening, HBA1C, diagnostic imaging. Undertaking cardio-vascular assessment and lower limb vascular assessment, using Doppler, ABPI and blood pressure analysis. Undertaking neurological assessment. Undertaking urinalysis, radiological evaluation and interpretation of advanced test results. To undertake patient care during surgery, this may include: Administering advanced local anesthetic injections including digital, ankle and popliteal regional blocks including use of nerve stimulators and ultrasound guidance. Issuing analgesic, antibiotic, anxiolytic (sedative) and anti-thrombotic medication. Monitoring the patient, for early signs of medical emergencies and taking appropriate action and resuscitation as necessary. Applying appropriate plaster casts post operatively. Assessing for postoperative discharge. Co-ordinating the discharge process. To undertake post operative patient care, this may include: Assess post-operative progress. Wound management. Cast, suture and per-cutaneous wire removal. Advice regarding physical therapy techniques, scar and swelling management, and, overall rehabilitation. Monitoring for signs of post-operative complications including infection, deep vein thrombosis and complex regional pain syndrome. Initiating onward referral to acute services. Managing the eventual discharge of the patient from the service with appropriate follow on advice and realistic expectations. The application of physical skills, precision hand eye co-ordination, which involves highly skilled local anaesthetic techniques, surgical assistance and suture removal, often for prolonged periods requiring intense concentration. To act as a mentor to the community podiatry team and provide specialist clinical observations and advice. To be responsible for the maintenance of high standards of clinical hygiene, stock and equipment control and for the safe and secure storage of all items, such as medication, within the premises used for work. To identify and trial new equipment and products. To participate in the clinical placement of student podiatrists and other health professionals. To supervise and teach podiatrists participating in the podiatric surgery rotation training scheme, about specific specialised care and the surgery service as a whole. To be actively involved in the provision of foot health education and advice to patient, relatives and carers and to participate in foot health training where appropriate. To follow uni- and multi-professional guidelines on evidence based practice. To be actively involved in the development and implementation of department policies, procedures and patient group directives. To follow departmental and trust policies and procedures and guidelines, but have the discretion to make own clinical diagnosis and decisions within professional guidelines. To be responsible for the assessment and diagnosis of often complex foot and lower limb pathologies and the subsequent planning, delivery and evaluation of Podiatric care to a variety of patients with a wide range of clinical needs including: High Risk Diabetes Wound Management/Tissue Viability Rheumatoid Arthritis Acute soft tissue pathologies Functional and biomechanical pathologies Dermatological conditions and presentations Communication To ensure effective communication with patients, relatives and carers using both verbal and non-verbal communication tools for such tasks as: Obtaining medical history and diagnostic information. Ensuring patient understanding and compliance with treatment programmes. Obtaining patient consent including Delegated Consent. To be aware of patients complex conditions or multiple pathologies and will frequently have emotional, physical and psychological conditions, e.g. deafness, dysphasia which may affect their understanding. To inform and reassure patients of the treatment options available, discuss their individual needs and empathise with their concerns regarding both the presenting problem and the nature of the treatments available. To ensure effective communication of complex and highly sensitive and emotional information to patients, which requires excellent interpersonal, negotiation and counselling skills. This includes information regarding diagnosis, prognosis, treatment options, surgical procedures, risks and potential complications and rehabilitation. To maintain accurate records of all patients consultations and related work carried out at each clinical session, including computerised and paper data collection, and the safe movement of patient treatment records between clinics and hospital sites. To attend and actively contribute to departmental meetings. To ensure that all information relating to clients and staff gained through employment with in the trust is kept confidential. To ensure effective communications with other professional disciplines regarding professional and medical issues. Professional Development To maintain registration with the Health and Care Professions Council. Commitment to Continuing Professional Development and life long learning is essential via recognised conferences and courses and the evidence of any changes in practice must be cascaded through the department. To work within the Health and Care Professions Council code of conduct and Trust policies and procedures. To undertake annual performance and review meetings with the Consultant Podiatric Surgeon and to fulfil Continuing Professional Development and personal development requirements identified through the appraisal process. To undertake additional advanced training and regular updates to improve service delivery at the point of care: including venepuncture, IRMER radiology, pharmacology, advanced anaesthetics and Immediate life support. To participate in the planning and delivery of surgical in-service training. Quality and Clinical Governance To participate in established nationwide and local audit review programs to ensure continued delivery of best practice. To participate in the departments Clinical Governance initiatives and the development and implementation of standards, guidelines, policies, protocols and clinical pathways. Health and Safety To report any accidents, complaints, defects in equipment, near misses and untoward incidents following Trust procedure. To ensure that Health and Safety legislation is complied with at all times including COSHH, work place risk assessment, Infection control, Trust Sharps, decontamination and trust lone worker policy To attend all mandatory training sessions as required by the Trust General This job description provides a guide to the duties and responsibilities of the post and is not an exhaustive list. The post holder any be asked to undertake any other relevant duties appropriate to the post. The job description may be amended over time in consultation with the post holder to meet the needs of the service.