Key clinical responsibilities To manage a highly complex caseload of patients on the critical care unit and support outpatient clinics as appropriate, act as clinical lead and co-ordinate service improvement projects in this area. To manage a highly complex caseload of patients requiring parenteral nutrition, assisting in service improvement projects in this area. To provide leadership across the critical care and medical team working to ensure the delivery of an effective, high quality, evidence based dietetics service. This will involve working collaboratively with the gastroenterology and surgical dietetics team lead. To have an in-depth understanding of and provide leadership to ensure the effective running of the critical care and medical dietetics service. To accept clinical responsibility for a designated caseload of patients within your own scope of practice and organise this effectively and efficiently with regard to clinical priorities and use of time. To work as an autonomous practitioner by planning and prioritising own workload according to locally agreed priority coding and supporting dietetic assistant practitioners and less experienced dietitians to do the same. To undertake a comprehensive assessment (interpretation of biochemistry, anthropometrics, clinical condition and diet history) of patients including those with highly complex presentations/multi pathologies and use advanced clinical reasoning skills to set nutritional goals for each patient. Develop individual treatment plans for patients by calculating the nutritional requirements and support the prescription of feeds where required. To give expert opinion on highly complex nutrition related issues where numerous social, ethical, psychological and medical factors have to be considered and where there may be conflicting ideas from the multidisciplinary team. To negotiate and agree dietary interventions with patients and their carers, using appropriate counselling and motivational skills to optimise their nutritional status. To make recommendations for appropriate prescription of nutritional products according to local guidelines regarding the use of nutritional supplements and enteral feeding products. To ensure adequate monitoring and review of patients. To assess the suitability of incoming referrals according to the agreed referral criteria and liaise with the dietetic assistant practitioner if further information is required prior to acceptance. To co-ordinate appropriate follow up, discharge arrangements and outward referrals to other services in order to facilitate the safe and timely discharge/transfer of care. To be responsible for safe discharge planning including co-ordination of patients requiring home enteral feeding. To have insight to recognise and act appropriately if vulnerable patients are at risk or deemed to be in need. To be responsible for maintaining accurate and comprehensive patient records in line with BDA, HCPC, Trust and department standards. To take appropriate action using highly advanced problem solving skills to assist patients, health and social care professionals and members of the public with queries relating to your own clinical areas. To work flexibly to support the critical care and medicine dietetics team. To provide cover for other Dietetic teams at short notice to cover unplanned and planned absences within the post holders competency and skill level. Please see attached job description for further details