Working as an autonomous practitioner to be legally and professionally responsible and accountable for the Orthoptic investigation, diagnosis and management of new and follow up patients of all ages referred to the Orthoptic department from various agencies in the Trust, including Ophthalmology, Maxillo-Facial, Neurology and Paediatrics. The patient groups comprise acquired and congenital ocular motility defects, visual acuity defects, anomalies of binocular single vision, complex congenital and acquired cases, including neurological abnormalities, genetic disorders and associated ocular abnormalities. To formulate effective individual management and treatment plans using clinical reasoning and a wide range of treatment skills, communicating these plans effectively with patients, parents and carers to gain informed consent. To use professional judgement to make adjustments to treatment plans in the light of clinical evidence, referring back to the Ophthalmologist when appropriate and planning timely and effective discharge, using available guidelines. To be a source of expertise within the department for complex Orthoptic problems, advising on the most appropriate investigation and management of complex cases, using clinical experience and evidence-based practice to provide informed decisions. To provide Orthoptic diagnosis and clinical management decisions for children referred into the Direct Access Orthoptic Service from GPs, Health Visitors and Optometrists. To undertake pre-operative measurements of strabismus in order to advise and discuss the surgical options and timing of surgery with the Ophthalmologist. To identify post-operative risks and to discuss these with all involved. To undertake post-operative assessment of strabismus and to assist the surgeon in measurement/assessment during any adjustable suture procedures. To be responsible for prioritising own clinical workload and for keeping accurate, contemporaneous records of testing. To communicate effectively with patients and carers to elicit a detailed case history that may include highly emotive or contentious information in a tactful and sensitive manner. To discuss and communicate treatment options and decisions to patients and carers in such a way as to ensure their understanding and consent to management. Barriers to communication will need to be overcome on a daily basis due to the varying nature of patient disorders e.g. loss of hearing, loss of vision, pre-verbal children, patients with stroke or learning difficulties or in families where English is not their first language. To communicate effectively with other members of the Orthoptic and Ophthalmic team for example, Ophthalmologists, nursing staff, Optometrists, clerical support staff. To communicate effectively with professions and agencies external to the service e.g. Paediatricians, Teachers for the Visually Impaired, providing either written or verbal information as requested (in line with Trust policies on confidentiality of information) to provide a high quality seamless service for the patient. To attend case conferences as part of a multi-disciplinary team and to provide relevant information and advice to that team on patients under discussion, within the professional scope of the Orthoptic role. To deal with the day-to-day administration of the Orthoptic clinics associated with patient care e.g. verbal and telephone enquiries, writing and sending correspondence, re-appointing/discharging patients who do not attend (in accordance with Trust and departmental guidelines). Accessing electronic records appropriately for this purpose. To attend and contribute to monthly Orthoptic Team and Clinical Governance meetings. To take proactive steps to keep abreast of Trust wide issues by reading and if necessary, responding to Trust communications e.g. Team Brief, My News etc To be pro-actively involved in clinical audit and research for the department and to provide advice and guidance to other staff in this area. To actively maintain professional skills and knowledge by seeking to use research and information from professional bodies to ensure that practice is evidence based and best current practice. To participate in the annual appraisal process identified by the Knowledge and Skills Framework and in conjunction with the Head Orthoptist help to identify personal training needs and to comply with the training identified in the Personal Development Plan to progress through the KSF framework. To participate in any ongoing internal or external training identified necessary in order to fulfil the job requirements of the post and to participate in any competency training/evaluation deemed necessary to meet national and local requirements. To maintain professional skills and knowledge by ensuring that the HCPC requirements of Continuing Professional Development for Orthoptists is adhered to. To disseminate knowledge and skills gained to other members of the team as appropriate. To undertake the clinical teaching of other health professionals, e.g. Optometry students, medical students, nursing staff.