Management 1. The post holder will plan, coordinate, deliver and evaluate the orthoptic/ophthalmology service for patients throughout Frimley Health Foundation Trust and the community. 2. The post holder will be part of the team responsible for policy implementation and the development of the service and will approve and implement changes where necessary. 3. The post holder will liaise with the Matron regarding the units budget for the specialist area and be responsible for supervising budgetary control involving decisions re equipment purchases etc. 4. The post holder will be assist in the training, mentoring, competency assessment and supervision of Orthoptic assistants, Ophthalmic Nurses and Orthoptists Clinical Leadership 1. The post holder will provide a clinical lead for the department, working closely with the AHP Consultant providing advice or guidance on complex cases as necessary and assisting junior colleagues to make decisions regarding a patients care and treatment where complex and conflicting elements may be present requiring a high level of expertise and experience. 2. The post holder will be involved in devising and implementing clinical procedures and protocols and discharge guidelines. 3. The post holder will monitor the quality of the service and ensure high standards of clinical governance reporting any issues to the Consultant Orthoptists/ Clinical Lead as appropriate. 4. The post holder will facilitate audits of the service and guide and promote research within the department working closely with the AHP Consultant. 5. The post holder will encourage staff to reach and maintain high standards of clinical care and best practice. 6. The post holder will keep abreast of national clinical directives and guidelines. 7. The post holder will comply with the British and Irish Orthoptic Society Competency Standards and Professional Practice Guidelines and the HCPC code of ethics. Teaching / Training 1. The post holder will organise and undertake induction of new staff and supervision and teaching of newly qualified and inexperienced clinical orthoptic staff and the induction and training of departmental Orthoptic Assistants. 2. The post holder will manage with the clinical teaching of different staff groups as required e.g. orthoptic undergraduates, junior medical staff, GPs, optometry students, medical students, nurses and health visitors. 3. The post holder will undertake regular staff appraisals following Trust guidelines and support development of the staff through personal development plans and access to the relevant training. 4. The post holder will ensure staff are aware of the need for Continuing Professional Development Portfolios and will encourage and support them in this. 5. The post holder will organise a regular in service teaching session, which may involve audit, teaching, interesting case presentation or journal club. Clinical extended role To undertake the specialised assessment of new and follow-up patients presenting to a specialist service on behalf of the ophthalmologist. To determine the clinical diagnosis, advise the patient and ensure timely intervention of potentially sight-threatening and life changing problems, working closely with the consultant ophthalmologist. To formulate treatment plans and advise the patient of treatment options and regimes, ensuring appropriate follow-up as determined from the clinical report. This will include deciding on laser, surgery or medical therapy as per PGDs To undertake consent for the above procedures. To be responsible for ensuring all administrative duties associated with these clinics are completed Assessment and diagnosis: Utilise own initiative to interpret and apply national guidelines and competencies and local policies, procedures and protocols to your individual caseload. Using advanced clinical reasoning; provide highly specialised Orthoptic assessment and diagnosis for all patients referred to the department from other specialist clinics, both as in-patients or outpatients, including: - Neurology e.g. space occupying lesions, stroke, idiopathic intracranial hypertension, neurofibromatosis, cerebral palsy, epilepsy - Endocrinology, e.g. thyroid eye disease, myasthenia gravis, diabetes - Maxillo-Facial, e.g. orbital trauma, facial fractures - ENT e.g. sinus problems, space occupying lesions - Paediatrics, e.g visual development problems, functional visual loss - Eye casualty referrals, which may include initial Orthoptic symptoms of any of the above. Paediatric vision disorders: Ocular motility disorders, other ophthalmic conditions and related multi-system disorders. This will require the ability to communicate with and obtain co-operation from children of all ages and abilities, including children with special needs and challenging behaviours, requiring dexterity and speed. This may include the use of sign language such as Makaton. Arranging the translator services as required. To participate in the provision of secondary vision screening referred in by the school nurses. Assessment is achieved by selection of pertinent tests for the patient's age and condition to result in an accurate diagnosis. Adult vision disorders: Ocular motility disorders and other ophthalmic conditions, including both acute and complex conditions. Differential diagnosis may include medical, neurological or psychological origins. This will include patients with significantly medically impaired communication and/or comprehension difficulties such as stroke or neurological disease or learning and physical disabilities. Use advanced clinical reasoning to balance medical evidence and patient circumstances. Treatments may include amblyopia therapy, refractive treatments, orthoptic exercises, prismatic therapy, planning strabismus surgery or tertiary referrals. Instruct the patient/carer on continuous courses of home treatments. Adapt the treatment as necessary for the individual, with consideration of circumstances, abilities and compliance at your discretion and in accordance with protocols, thus maintaining a high standard of clinical care. Develop a relationship of trust using two-way communication with patients and other members of staff in order to enable motivation and ensuring good compliance to treatment. Gain consent for this treatment. Review patients and treatment plans using expert knowledge to achieve the best possible visual acuity, binocular vision and ocular cosmetic position for each patient. Further manage each patient as an autonomous practitioner, determining when and which optometric or ophthalmic assessments are undertaken, or arranging appropriate onward referral. Help patients/carers access further information as required from internal and external sources. Identify the opportune timing of surgery and advise ophthalmic consultants when the treatment plan indicates the need for surgical intervention. Undertake accurate pre-operative measurements and squint assessment for squint correction using specific Orthoptic equipment in order to advise the surgeon and discuss the type and amount of surgery to be performed. These take considerable manual dexterity, speed and hand-eye coordination to ensure accurate results, especially in infants. Assess and advise short and long term post-operative outcomes, Discuss the post-operative risks and benefits with the patient/parent or carer. Undertake post-operative assessments referring back to the ophthalmic surgeon if further management is necessary. Advise ophthalmic consultants about the management and/or onward referral as required, of complex neurological patients suggesting the need for further investigation as appropriate such as MRI scan, blood tests and electro-diagnostics. Professional, Supervisory, Education and Training To be responsible for developing and maintaining own competency to practice through CPD activities and maintain a portfolio which reflects personal development. To participate in the staff appraisal scheme as an appraisee and be responsible for complying with your agreed personal development programme To abide by the CSP Rules of Professional Conduct and Core Standards. To maintain own clinical Continuing Professional Development (CPD) by keeping abreast of any new trends and developments, and incorporate them into practice, recording evidence and reflective practice in your CPD portfolio. To be an active member of specialist respiratory physiotherapy service development and training initiatives by the attendance and presentation at staff meetings, tutorials, training sessions, external courses and reflective practice. Share ideas and good practice across the service, with the objective of continually looking at ways to improve the integrated respiratory service. To participate in collaborative service developmental groups which directly influence changes in Trust and Social Services policies and procedures relevant to CBRT. General To be responsible for a designated area of work, as agreed with the AIR team, and to plan and organise efficiently and effectively with regard to time management, particularly in a Domiciliary/ community setting. To decide priorities for own work area, balancing other patient related and professional demands This job description is not exhaustive and can be altered in consultation with the post holder. The post holder will undertake any other duties which may be requested by the line manager in order to facilitate the smooth running of the integrated respiratory service.