CLINICAL & PROFESSIONAL RESPONSIBILITIES To be professionally and legally responsible and accountable for all aspects of the clinical workload. Adhere to all relevant Codes of Practice within the Health & Care Professions Council (HCPC) Professional body & maintain an up-to-date professional registration at all times Abide by relevant Code of Professional Practice at all times. Provide the Orthoptic service autonomously both in the hospitals and at outreach clinics in the community as required Independently select and perform a broad range of comprehensive, qualitative and quantitative, investigative, diagnostic and therapeutic Orthoptic procedures which require high degrees of accuracy, hand eye co-ordination, acute observation and dexterity. Analyse and evaluate the results to aid diagnosis and differential diagnosis. The patient group includes all ages from early infancy to the elderly and comprises all cases of ocular motility defects, congenital and acquired. It also includes patients with significant learning difficulties and complex medical conditions. Referrals are received from a range of specialities e.g. paediatrics, neurology, maxilla facial, stroke rehabilitation and endocrinology. Direct referrals are accepted. Using specialist knowledge formulate individual management and treatment plans using clinical reasoning, a wide range of treatment skills and evidence-based practice Take sole responsibility to formulate, implement, monitor and alter treatment. Instruct and support patients/carers on continuous courses of home therapies. Provide condition-related information and motivate good compliance to treatment. Make autonomous clinical and management decisions, in relation to treatment, care and discharge. Use acquired specialised knowledge and skills to deliver an expert level of care to patients. Work in partnership with consultants, optometrists, doctors and other medical professions including multi-disciplinary teams in order to make diagnoses and treatment / management options. Provide expert clinical knowledge to clinical colleagues, patients and carers. Recognise and act when a critical change in findings indicates need for urgent medical intervention. Undertake joint paediatric clinics working closely with specialist paediatric Ophthalmologist. Undertake pre and post-operative measurement and evaluation of squint providing results and advice to surgeon to enable choice of surgical procedure and analysis of post-op diplopia risk. Discuss risks & benefits of surgery with patient or carer. Identify appropriate timing of surgery. A high level of manual dexterity is required especially with paediatric patients where speed and accuracy are essential. Undertake adult ocular motility clinics including neuro-ophthalmology, thyroid eye disease etc and all cases of diplopia requiring investigation, diagnosis and management. Provide Orthoptic service to the acute referral clinic for in and out patients referred direct from hospital accident & emergency departments, wards and /or general practitioners. Provide specialist advice to the Ophthalmologist and other medical colleagues based on interpretation of Orthoptic findings. Highlight and recommend the need for further medical investigations. Autonomously assess, diagnose and formulate treatment plans for patients of all ages experiencing difficulties with learning, particularly reading. Liaise closely with other members of the multi-disciplinary team to promote an inter-professional approach for the management of SLD Undertake visual field analysis when required on specific patients requested by the medical team e.g. children with NF1 where Orthoptic skills are more appropriate. Use of focimeter and assessment of colour vision as required. Effectively communicate with patients, parents, carers, medical, allied health professionals, nursing, clerical, teaching, social work colleagues and managers in the delivery of the Orthoptic service. Communicate initial potential diagnosis, this may be of a distressing nature. Requirement for highly developed interpersonal and communication skills to persuade, motivate and reassure client group which include young apprehensive children. Adopt strategies using ingenuity to achieve effective communication in difficult circumstances e.g. autistic patients, dysphasic patients, stroke patients and patients with learning difficulties. Employ interpersonal skills to impart sensitive and distressing information with diplomacy including cases of guarded and poor prognosis. Use a range of verbal and nonverbal communication skills to explain outcomes and treatment plans, adapting the delivery according to patient understanding e.g. hearing problems, language difficulties, comprehension difficulties. Work with interpreters as and when required. Collect, interpret and evaluate information and maintain a complete and accurate record of each patient encounter. Maintain effective communication to ensure dissemination of information affecting all aspects of delivery of care. This may be written, verbal or electronic format. Manage own workload and make independent clinical decisions based on current evidence-based practice and analysis of clinical findings. Ensure that patients receive appropriate follow-up services based on clinical need and findings. Escalate any concerns to a senior member of staff as needed. Administer ocular medication under Patient Group Direction protocol. Advise patients regarding drug regimes, interactions and side effects. Suggest treatment modification in consultation with senior Orthoptist &/or medical staff. Continue a highly professional relationship with the multidisciplinary team and medical personnel. Be aware of, and adhere to, risk management standards and assess and manage clinical risk in relation to clinical area. ADMINISTRATIVE RESPONSIBILITIES Prioritise, organise and manage appointments and clinics in both hospitals and at all outreach locations. Regularly liaise with senior Orthoptists, Ophthalmologists, Optometry, nursing, medical staff in other specialities, other health care professionals and clerical staff to maintain a high-quality service. Ensure effective and efficient use of physical resources, making recommendations regarding equipment and supplies. Monitor consumables as required. Ensure accurate and up to date completion of all records and paperwork required for the hospital service and outreach orthoptic clinics. Maintain and utilise department and Trust information systems. Use IT skills for the regular input and extraction of information from the orthoptic databases held on the datamart hospital computer system. Use of the electronic patient record system i.e. evolve. Use of the computerised patient administration system i.e. careflow and medisight TEACHING & TRAINING RESPONSIBILITIES Provide Clinical teaching to undergraduate Orthoptic students as required. The department is a recognised clinical placement centre for the Universities which provide an Orthoptic degree course. Participate in the clinical teaching of junior medical staff, nurses, pre-registration optometrists, health visitors, medical students and other health professionals as required. Take responsibility for own continued professional development and maintain own portfolio in accordance with registration requirements. Identify own development needs. Maintain knowledge of current clinical practices and where possible attend appropriate training events relevant to lead role thereby continuing professional development. To participate and, in turn, facilitate clinical journal club within the orthoptic department Comply with Trust and Departmental policies and procedures. To ensure compliance to all Trust Risk Management, research Governance, Information Governance and Infection Control policies and procedures and abide by the Standards for better health. Undertake appropriate mandatory training in infection control and comply with all Trust infection control policies relevant to the post. FINANCIAL RESPONSIBILITIES Ensure effective and efficient use of physical resources, making recommendations regarding equipment and supplies. To inform Head of department of any stock/equipment requirements and place orders on appropriate systems for authorisation by the head of Head of department. RESEARCH & AUDIT To contribute to research within the department Evaluate service delivery, identify areas for improvement by use of active clinical audit and reflective practice. Disseminate findings to colleagues and other relevant medical professionals, enabling improvement in clinical practice throughout Ophthalmic medical care.