2. JOB PURPOSE To assess differentially diagnose and manage complex communication, swallowing, cognitive and emotional impairments related to a wide range of conditions in all acute medical pathways. Utilise highly specialist knowledge in line with local policies/protocols and professional guidelines to manage risk and improve function. Provide specialist second opinions on request to other health and social care professionals. Build links with allied agencies across primary and secondary care improving local and regional care pathways across acute, outpatient and community settings. 3. JOB DIMENSIONS The post holder will: 3.1 Provide clinical leadership across acute medicine, general medicine, major trauma, elderly and surgical pathways 3.2 Provide highly specialist SLT input across the above pathways for patients presenting with swallowing and/or communication breakdown 3.3 Treat and manage highly complex communication, swallowing, cognitive and emotional impairments within the Speech and Language Therapy remit 3.4 Work as part of relevant multidisciplinary teams 3.5 Fully comply with NICE guidance 3.6 Manage own case load and support junior SLTs and ward staff 3.7 Provide equitable, evidence based SLT interventions 3.8 Provide in-service training to a wide range of healthcare staff 3.5 Be a key member of relevant multidisciplinary teams providing integrated SLT care. 3.6 Show initiative in assisting/supporting Acute Medicine SLT service as required KNOWLEDGE, SKILLS AND EXPERIENCE REQUIRED 5.1 BSc (Hons) Clinical Language Sciences or equivalent degree accredited by RCSLT. 5.2 HCPC Registered to practice as a SLT. 5.3 Post Graduate Qualification in Dysphagia. 5.4 Willing to undergo training as required. 5.5 Awareness of SLT drivers, evidence base and NICE guidance 5.6 Able to work within a team, demonstrate initiative, excellent time management and organisational skills. 5.7 Good written, oral and interpersonal communication skills. 5.8 Good presentation skills in delivering training to large multidisciplinary groups of staff or members of the public (this may involve groups of more than 50 people). 6. CORE VALUES 6.1 Comply with professional codes of practice, professional guidelines and departmental policies and procedures. 6.2 Maintain strict confidentiality in accordance with Trust policies and HPC standards. 6.3 Be compassionate and ethical in the provision of SLT care. 6.4 Demonstrate a commitment to personal and professional development. 7. CORE BEHAVIOURS AND SKILLS 7.1 Demonstrate good office practice in accordance with departmental policies and procedures. 7.2 Be a pro-active team member of the SLT department at LTHT by participating in departmental development projects, attending and participating in departmental meetings and clinical updates. 7.3 Demonstrate the ability to communicate highly complex, specialised and sensitive information with empathy and understanding. 7.4 Demonstrate the ability to provide highly complex Communication and Swallowing counselling to patients requiring cognitive behavioural therapy skills and use of advanced reassurance, motivational and negotiation skills to overcome barriers to change. 7.5 Demonstrate the ability to analyse clinical and non-clinical information to form accurate therapy care plans in specialised areas. 7.6 Demonstrate analytical skills in prioritising the best course of SLT treatment in patients with highly complex clinical conditions, where therapeutic goals may conflict with other ongoing physical, emotional, psychological and medical problems. 7.7 Ability to use a range of specialist equipment with precision and accuracy during communication and swallowing assessments. 8. CORE KNOWLEDGE AND UNDERSTANDING 8.1 Ability to perform specialised SLT assessments, interpret and plan relevant SLT care programmes for patients with highly complex communication and swallowing needs and multiple medical conditions. 8.2 Advanced knowledge of diagnosis and management of communication and swallowing problems related to -the caseloads covered in this post and associated treatments. 8.3 Demonstrate advanced knowledge in interpretation of complex clinical information to develop, monitor and complete swallowing and communication care plans in specialised areas 8.4 Responsible for safe discharge planning. 8.5 Demonstrate the ability to evaluate practice using evidence based practice and critical appraisal. 8.6 Ability to advise and suggest suitable dietary and fluid modifications to facilitate safe swallowing. 8.7 Knowledge of clinical governance, quality of care and evidence based practice in specialist areas. 8.8 Awareness of national guidance and driving factors in specialist areas. 9. PRINCIPAL DUTIES & AREAS OF RESPONSIBILITY 9.1 Clinical 9.1.1 Be an autonomous practitioner, clinically, legally and professionally responsible for own caseload. 9.1.2 Work as a member of MDTs as required 9.1.3 Assess, diagnose and treat patients for swallowing and communication breakdown providing highly specialist advice and support regarding potential short and long term effects of treatment. 9.1.4 Provide ongoing psychosocial support to patient and/or carers and facilitate communication with other members of the MDT in meetings which they attend 9.1.5 Advise on the risk of aspiration with reference to the need for enteral feeding ie NG, PEJ or PEG as appropriate if at high risk of aspiration on oral intake. 9.1.6 Refer and participate in specialist assessment of swallowing ie Video fluoroscopy/FEES. 9.1.7 Facilitate effective communication via therapy or aided/unaided augmentative communication including communication aids as appropriate. 9.1.8 Liaise with other SLTs in the team regarding patient management, transfer of care,pathways etc. Triage patients into appropriate treatment streams. 9.1.9 Develop clear care plans based on best practice. 9.1.10 Negotiate with carers, clients and others around individual case management and to adapt practice to meet individual patient/client circumstances. 9.1.11 Treat, manage and support patients and carers of patients with highly complex communication and swallowing disorders. 9.2 Education and training 9.2.1 Provide education, advice, information and support for patients, carers and allied health/social care teams. 9.2.2 Help develop rehabilitation services as appropriate building links with allied agencies, carers, nursing homes, GP's etc and improving transfer of care (seamless service) between acute and community teams. 9.2.3 Provide communication and swallowing training to relevant MDT's, qualified/non-qualified staff, GP surgeries, District/Specialist Nurses and local/regional health care professionals as appropriate. 9.2.4 Support carers and patients with acquired complex communication/ swallowing disorders. Train families, carers and nursing teams to enable effective communication and facilitate safe feeding with this client group. 9.3 Managerial 9.3.1 Work with and manage direct reports, establishing and maintaining ongoing contact and regular meetings to set and monitor objectives, performance and discuss personal development. 9.3.2 Effectively lead staff in order to deliver results; inspiring others to be positive in their support of continuous improvement. 9.3.3 Ensures cover for the team at all times and all coordinates as appropriate, engaging temporary support staff as required in accordance with LTHT Policies and Procedures ensuring induction, supervision and delegation of workload. 9.3.4 Provides a leadership style which is underpinned by values around equality, diversity and openness; effectively builds and maintains relationships with direct report(s) and other key individuals across the organisation. 9.3.5 Ensures that individual objectives are clearly defined within the wider Workforce Directorate framework and in line with LTHT objectives, using the appraisal and KSF processes as vehicles for this. 9.3.6 Promotes diversity and equality in people management techniques and leads by example. 9.4 Organisational 9.4.1 Promote safe and effective transfer of care from acute to community settings. 9.4.3 Act as a key worker. This role involves the coordination of services, provision of consultative advice to hospital and community teams including education to other healthcare professionals working with this client group. 9.4.5 Liaise with therapists, SLTs and Heads and relevant MDTs regarding shared patient management. 9.4.6 Promote continuous service development utilising the latest evidence based practice to maximise clinical effectiveness. 9.4.7 Liaise with SLT line managers and keep them informed of fluctuations in workload, and other significant factors which affect the delivery of service. 9.4.8 Comply with professional codes of practice, professional guidelines, departmental policies and LTHT policies, standards and procedures. 9.4.9 Maintain strict confidentiality in accordance with Trust policies and HPC standards COMMUNICATION & WORKING RELATIONSHIPS 11.1 Responsible for communicating complex and sensitive information in an understandable form to patients including adaptation of oral and written advice appropriate to the individual. This may include communicating unwelcome news in a sensitive way or giving advice/information which is hard to accept eg eating/drinking restrictions, requirement for enteral tube feeding. 11.2 Responsible for motivating patients to accept and adhere to highly complex treatment where there may be significant barriers to understanding and acceptance of dietary change where developed counselling, motivational and negotiation skills are required.