Clinical responsibilities To perform highly specialist assessments of patients with diverse presentations and complex physical and psychological conditions, to provide a clinical diagnosis and develop and deliver an individualised treatment programme. To undertake a comprehensive highly specialist assessment of patients including those with diverse or complex presentations/multi pathologies; use advanced clinical reasoning skills, interpretation of available test results and assessment techniques to provide an accurate diagnosis of their condition. To offer advice and support in recommending and interpreting VFS and FEES of patients who experience swallowing difficulties. To take responsibility for patients requiring complex rehabilitation within intensive care, and deputise for the SALT Clinical Lead in critica. To formulate and deliver a highly specialist individual SLT programme based on a sound knowledge of evidence-based practise and treatment options using clinical assessment. To provide and receive complex information relating to patients diagnosis, treatment and long term rehabilitation outcomes to patients, carers and the MDT. To actively contribute to relevant clinical and management meetings such as MDT, Regional network groups, critical care core group. To demonstrate empathy with patients, carers families and colleagues ensuring that effective communication is observed. To plan, provide and monitor structured communication and swallowing programmes and strategies for carers, therapy support workers and other professionals. To assess the need for, and teach patients and carers in the safe and effective use and application of communication aids e.g Low tech eye gaze, partner assisted spelling. To be available regularly for second opinions within the SLT team with reference to patients with complex presentation. To advise, support and facilitate other professionals e.g with regards to Patient management issues relating to swallowing and communication difficulties e.g To work with patients and advise MDT of the impact of ventilator on weaning and, swallowing and communication. To adhere to Trust and professional policies and procedures regarding own extended scope role, for example radiology IRMER regulations, PPE. To advise and assist with complex ethical decisions e.g negotiating with consultants and team on suitability of nasogastric tube versus Peg insertion. Be able to persuade, motivate, negotiate and problem solve with patients, SLT team members, MDT and other professionals on a daily basis. To take responsibility of management and discharge of own caseload and refer on to other agencies if required. Leadership and Management Deputise for Clinical Lead which may include taking operational management of the team in the Clinical Lead absence. Develop line management skills for Band 6/5 SLTs. To participate in the recruitment and selection process when required. To demonstrate highly developed negotiation, influencing and problem solving skills. Demonstrate strong self motivation and motivation of others. Supervise junior members of staff, students and support workers. Service development Work collaboratively with the SLT management team to evaluate activity, outcomes and effectiveness to ensure the service delivery is of the highest standard (audit, policies, guidelines, service development). To contribute to issues of service delivery including shortfall, service pressures in the adult SLT service and attend relevant meetings. Demonstrate and disseminate best practice. Attend and contribute to regular SLT Critical Care team meetings. Attend Regional and National meetings, CENS, conferences. To contribute to implementation and change of policies/procedures, in line with up to date evidence based practice. To contribute to and implement evidenced based emerging assessment and therapy techniques in swallowing and communication. To contribute to research/clinical governance/audit projects within area of specialism. To contribute to any research, audits, data collection being undertaken within the specialist areas- this could be locally or as part of the East Midlands critical care Network. Use therapy outcome measures to evaluate service. To assist Clinical lead in developing and implementing training needs for the SLT team and wider MDT, and work with the SLT management team to develop training needs analysis. To contribute in the development, implementation and evaluation of multidisciplinary policies and procedures and integrated pathways. To provide education and training to MDT, SLT team and students. Achieve FEES competencies. Professional To work autonomously within the broad scope of national and local standards and guidelines relating to professional practice. To be responsible for maintaining own competency to practise through CPD activities and maintain a portfolio which reflects personal development. Maintain and develop current knowledge of evidence-based practice in the areas of specialty. To engage in a structured programme of professional and personal development based on a system of performance review (i.e appraisal). To adhere to the code of ethics and professional standards of RCSLT and HPC. Participate in management and clinical supervision Freedom to Act To interpret and implement national policy relevant to adult SLT critical care service. Manage highly complex caseload independently. To monitor and evaluate own highly specialist service delivery and that of others in the team and ensure this is communicated as appropriate. To be accountable for own and others professional actions and recognise professional boundaries through interpretation of clinical/professional policies. To ensure that self and others within the SLT critical care service, act within defined national protocols/policies and professional code of conduct. To maintain a working knowledge of relevant procedures/ statutory requirements including safe guarding and other legal frameworks. To have responsibility for the implementation of health and safety policies ensuring regular audit and review of subsequent changes. To negotiate with team/others around service issues and caseload management. To lead the operational management of SLT team, ensuring appropriate referral pathways across teams are cohesive and interface to ensure smooth transition of clients between acute and community services. To lead on the development and implementation of objectives or projects relating to the service, ensuring that these reflect local health and social care priorities, in conjunction with SLT team manager. To support staff to implement team objectives and projects, To monitor own and others service delivery and report to SLT manager/management team. To advise SLT team manager on issues of service delivery including shortfall, service pressures, etc. To assume delegated tasks as requested by SLT team manager, including leading working groups, policy development groups within area of clinical and or management expertise. To contribute to inter agency/multi-disciplinary team building and policy development, assuming a lead where appropriate. To adhere to and ensure that team plans and policies are implemented. To use specialist knowledge to inform service/policy development as appropriate.