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Directorate of Human Resources Recruitment Team Flat 3 Willow Drive Kirkcaldy Fife, KY1 2LS Tel 01592 643355 Fax 01592 204611 www.show.scot.nhs.uk/faht Date As per postmark Your Ref Our Ref Please see below Enquiries to Recruitment Extension 1765 Direct Line Email: firstname.lastname@example.org Dear Sir/Madam POST REFERENCE: HH625/03/11 CLOSING DATE: 12 NOON ON 8TH APRIL 2011 Thank you very much for your interest in the above post. I have pleasure in enclosing an application pack which includes, a job description, application form, terms and conditions, person specification and procedure for the disclosures of criminal records. Please be advised that the application form must be completed in full as unfortunately we cannot accept a CV enclosure. When providing referees on the application form please be aware we require references to cover a minimum of a three year period. If the period of time both referees have known you is less than three years you will be required to provide additional referees. This can be indic ated on an additional sheet of paper and where possible please give us email addresses for contact. Should you wish to make an enquiry to the Recruitment Team regarding a vacancy please ensure that you quote the reference number. Please be advised that if you do not hear from us within 4 weeks of the closing date then you have been unsuccessful in your application. May I take this opportunity to thank you for the interest that you have shown in NHS Fife. Yours faithfully Recruitment Team Recruitment Team Enc. TERMS AND CONDITIONS OF SERVICE Post: OPTOMETRIST SPECIALIST Reference Number: HH625/03/11 Pay Banding: 7 - £30,460 - £40,157 PRO RATA Hours of Duty: 15 Contract Type: PERMANENT Annual Leave: 27 days on commencement 29 days after 5 years service 33 days after 10 years service Public Holidays: 8 fixed public holidays The leave year extends from 1 April to 31 March. Part time staff will receive a pro-rata entitlement for annual leave and public holidays combined as per the Agenda For Change agreement. Reckonable service may be credited for annual leave purposes in accordance with the Agenda for Change Agreement. Sick Pay Entitlements to Statutory Sick Pay and Occupational Sick Pay will be determined in accordance with the Agenda for Change Agreement. Reckonable service may be credited for Sick Pay purposes providing there has been no break in service of 12 months or more at time of appointment in accordance with Agenda for Change Agreement. Superannuation On commencement with the organisation staff will be asked if they wish to join the scheme although they may choose to join or leave the scheme at any time. Contribution rates will vary from 5% to 8.5% depending on pensionable earnings. If an employee opts not to join the scheme they will automatically contribute to the State Earnings Related Pension Scheme (SERPS) unless excluded from doing so or have arranged a Personal Pension. Occupational Health Clearance Any offer of employment is subject to satisfactory Occupational Health clearance. Should you be invited to interview you will be asked to complete a Pre-Employment Health Questionnaire which you should bring to interview. The Occupational Health Service (OHSAS) will make an assessment on your fitness to carry out the post based on the information contained within the questionnaire. In certain circumstances further information is required before clearance can be given and OHSAS may contact you by telephone or request that you attend for an appointment. Clearance must be obtained before any new employee commences employment within NHS Fife. Clearance may be subject to you attending for a Post-Employment appointment and it is vital that you attend this appointment if required to do so. Rehabilitation of Offenders Act 1974 Under the terms of the Rehabilitation of Offenders Act 1974, many people need not refer to previous convictions which, after a certain period of time, are regarded as spent. Certain posts within the National Health Service, however, are excluded from the provisions of this Act. All potential employees must disclose on the application form any unspent convictions and certain potential employees are required to inform us of any previous convictions which, for other purposes, are “spent” under the provisions of this Act. Failure to disclose such information could result in dismissal or disciplinary action by the organisation. Any information given will be treated in the strictest confidence. Please refer to the NHS Fife Procedure for the Declaration of Criminal Convictions for further information. No Smoking Policy NHS Fife operates a No Smoking Policy and it is the case that staff are not permitted to smoke on the premises or during working hours. It is a condition of employment that you comply with these requirements. Agenda for Change Implementation and Variations to Contract of Employment Agenda for Change is a nationally agreed remuneration, job evaluation, personal development and terms and conditions framework which will apply to all NHS Scotland staff (except very senior managers and staff within the remit of the Doctors‟ and Dentists‟ Review Body). This means that you will be subject to the terms and conditions contained within this agreement and also any subsequent national or local agreements or variations made in respect of Agenda for Change. Such changes will automatically be applied to you and your contract of employment will be deemed to have been amended on this basis. Work Permits If a candidate who requires a work permit is appointed to a post a work permit application will be made by NHS Fife. However, current Home Office regulations dictate that employers are not in a position to offer employment to candidates requiring a work permit where it can be demonstrated that EEA candidates meet the minimum requirements for the post. Job Share Unless otherwise stated within the job advert applications for this post may be considered on a job share basis. Should you wish to apply on a job share basis please indicate this on a covering letter attached to the application form. REGULATION OF HEALTH CARE SUPPORT WORKERS Your performance must comply with the “Mandatory Inductions Standards for Health Care Support Workers in Scotland” 2009; and with the Code of Conduct for Health Care Support Workers, both as amended from time to time, which will be issued with your contract (further copies can be obtained at www.workinginhealth.com/standards/healthcaresupportworkers or from Human Resources. Failure to adhere to the Standards or to comply with the code may result in poor performance measures or disciplinary action and could lead to dismissal; or if you are self- employed, such failure will be deemed to be a breach of an essential term of your contract, allowing us to terminate with or without notice. Guidance for completing the NHSScotland application form If you need this, or any of the attached forms in large print or other formats please call our recruitment office on 01592 643355 ext 8706 or 7906. An electronic version is available at www.jobs.scot.nhs.uk General guidance If you have any questions or need some help with completing the form, please call 01592 643355 ext 8706 or 7906 or email email@example.com. Please have the job reference number handy if possible If you are using the „hard copy‟ version of our application form, please use black ink and write clearly in BLOCK CAPITALS. This makes the form much easier to read and clearer when we photocopy it The job reference number can be copied from the job advert or the application pack The job location will be on the job advert The candidate number will be written in by us once you have returned the form to our office The people who look through your completed form (short listing or short leeting team) to see if you have the skills and abilities needed for the job, will only see „Part C‟ of the form. They will only see your candidate number and all personal details will be anonymous Please do not send in a CV instead of, or as well as, the application form. We do not consider CVs during the selection process Please fill in all sections of the application form. If some parts are not relevant, write „not applicable‟ or „N/A‟ in that space If you need more space to complete any section, please use extra sheets of paper. Do not put your name or any identifying information on it as it needs to remain anonymous. Secure it to the relevant section, and we will add a candidate number to it when we receive it When you have completed all of the form, please send it to: Recruitment Section NHS Fife Flat 3 Willow Drive Kirkcaldy Fife KY1 2LS Personal Details section This gives us your contact details such as name and address. Under „title‟ you would put either Mr, Mrs, Ms, Dr or just leave blank if you prefer We may need to contact you at some time throughout the recruitment process. Please let us know the most suitable method of contacting you, for example email or phone call and the most convenient time Declarations Please refer to the enclosed Procedure for the Disclosure of Criminal Convictions. For certain posts you must tell us about all convictions and cautions regardless of how long ago the offence may have occurred. Convictions from other countries must also be notified. If in doubt please call our office at the help line number on page one of this guidance Please note that having a conviction will not automatically disqualify you from getting a job with us. Careful consideration will be given to the relevance of the offence to the particular post in question. However, if you are appointed, and it is found that you did not reveal a previous conviction your employment may be terminated Remember to read, consider and sign the declaration at the bottom of page 2 Qualifications section Please tell us of any qualifications you have. This can include school standard grades, GCSEs highers, or work based qualifications such as SVQs or NVQs Remember to write down any „non formal‟ qualifications or certificates that you think are relevant to the job you are applying for Present (or most recent) post section If you are currently out of work, please write this in the „job title‟ space Please write your start date in month/year format MM/YYYY Please tell us briefly about your duties (what you do or did in your job). You could tell us your role, the main tasks, and any responsibility for supervising others. There is not a lot of space here so continue on a separate sheet if you need to Employment History section This is where you write down all the jobs you have done previously Remember that if a job you have done in the past supports or is similar to the job you are applying for, please tell us more about it in your „support of application‟ statement on page 6 of the application form – use a separate sheet if you need more space References section Referees are people who know you at work. Please give the full names and addresses of 2 referees, one of whom must be your present or most recent employer and can confirm your job details Your referees must cover a three year time period and should where possible be work based references. Please where ever possible provide an email address for your referee. You should check that the people you have put on your form are happy to be referees Your referees will not be contacted unless you are a „preferred candidate‟ after interview. A preferred candidate is someone who is the preferred choice for the job, subject to satisfactory checks where appropriate Driving Licence You only need to complete this if the job requires you to drive. Please check the job description or person specification. For example, some jobs with the Ambulance Service require you to be able to drive class C1 and D1 vehicles Statement in support of your application This is one of the most important parts of the form. In here you say why it is you want this job, and can list all your skills and abilities that you think help to match up you against the „person specification‟. In here you could describe how something you have done in a non work setting (for example, planning and leading a group outing) shows planning skill and some leadership qualities Where did you see the advert section Please try to remember where you heard about this job, and tick the relevant box. The information you give will help us find out how good our advertising is Equal opportunities monitoring Please note that all details on this section (Part D) will remain totally anonymous. It will be detached from the rest of the form as soon as we get it and remain anonymous We want to ensure that there are no barriers to joining our workforce. As an employer, NHSScotland is as fully inclusive as possible. One way we can ensure this is to analyse all the data provided in this section and ensure that job opportunities are being accessed by as wide a community as possible. Please send the completed form to the following address: firstname.lastname@example.org or post your hard copy to: Recruitment Section NHS Fife Flat 3 Willow Drive Kirkcaldy Fife KY1 2LS Support into Work Have you experience of a mental health problem? Want help with the application process for a post with NHS Fife or Fife Council? Would you benefit from some support even after you start work? Are you unemployed and live in Fife? Then Support into Work can provide free, independent and confidential support through the whole process of applying for a job with either NHS Fife or Fife Council and, if successful, for the first few weeks after starting work. Support into Work is a two-year pilot funded by the Scottish Executive to increase access to employment for unemployed people experiencing mental health difficulties who live within Fife. The service is provided by Fife Employment Access Trust (FEAT) a well-respected voluntary organisation with 10years experience or supporting people with mental health problems into employment. FEAT is independent of both NHS Fife and Fife Council and the fact that someone has received support will not adversely affect the recruitment outcome. For more information on the support available or if you would like to take advantage of the service contact: Fife Employment Access Trust Collydean Cottage Pitmedden Loan Glenrothes KY7 6UG Tel: 01592 749880 Email: email@example.com Please do not send completed application form to this address PROCEDURE FOR THE DISCLOSURE OF CRIMINAL RECORDS 1. Introduction NHS Fife complies fully with the Code of Practice, issued by Scottish Ministers, in connection with the use of information provided to the registered person and other recipients of information by Disclosure Scotland Part V of the Police Act 1997, for the purposes of assessing applicants‟ suitability for positions of trust. We undertake to treat all applicants for positions fairly and not to discriminate unfairly against the subject of a disclosure on the basis of conviction or other information revealed. 2. Spent Convictions The Rehabilitation of Offenders Act 1974 enables some criminal convictions to become „spent‟ after a rehabilitation period. The length of the rehabilitation period depends on the sentence given and not the offence committed. For custodial sentences the rehabilitation period is decided by the original sentence and the length of time actually served is irrelevant. Custodial sentences of more than 2.5 years can never become spent. 3. Disclosing Spent and Unspent Convictions In line with the Rehabilitation of Offenders Act 1974 for any post within NHS Fife you are required to disclose any “unspent” convictions. If you are applying for any posts listed below you are also required to provide us with any information in relation to all “spent” convictions. Clinical Posts (including Nursing, Medical, Dental and AHP posts) Director of Finance & Heads of Finance Department Ward Clerks Public Health Posts Health Promotion Posts Porters Volunteers Hairdressers Catering & Domestic Posts within Inpatient Areas 4. Disclosure Scotland (SCRO) The aim of the Disclosure Scotland Service is to enhance public safety and to help employers nd voluntary organisations in Scotland to make safer recruitment decisions. Any offer of employment to a post identified as requiring “spent” convictions to be disclosed will be subject to a satisfactory Disclosure Scotland check. 5. Procedure for Disclosing Convictions If you have an unspent or spent conviction and you are required to disclose this to NHS Fife you should do this by completing the section “Convictions” within Part B of the application form giving details of the following:- The Nature of the offence The Sentence given The Date of the Offence 6. Interview If you are selected for interview, members of the interview panel will not be aware of any declaration you have made. Should you be selected as the preferred candidate following interview we will undertake to ensure an open and measured discussion on the subject of any offences or other matters that might be considered relevant for the position concerned. We guarantee that only those who need to see it as part of the recruitment process will only see this information. 7. Failure to reveal information Failure to reveal information that is directly relevant to the position sought could lead to withdrawal of an offer of employment. If you are offered employment such a failure may result in dismissal or disciplinary action. Having a criminal record will not necessarily debar you from working with NHS Fife. This will depend on the nature of the position, together with the circumstances and background of your offences. 8. Queries If you have any queries on this matter then please contact our recruitment office who will be able to assist you. JOB DESCRIPTION 1. JOB IDENTIFICATION Job Title: Optometrist Specialist Line Management Responsibility Senior Charge Nurse Professional Responsible to: Lead Clinician Department(s): Queen Margaret Hospital, Dunfermline and Victoria Hospital, Kirkcaldy Directorate: Ambulatory Care Band 7 Operating Division: Job Reference: No of Job Holders: Four Last Update (insert date): 22 June 2010. 2. JOB PURPOSE 2.1 To work closely with the Lead Clinician in order to deliver a comprehensive range of core Optometric services to the highest standards of quality and care that meet the changing needs of the Directorate and other outside agencies 2.2 Within the Ophthalmology team, the post holder works as an autonomous clinician providing an efficient and effective Optometric service being responsible for assessing, diagnosing, treating and managing patients 2.3 As a lead clinician providing specialist services the post holder will provide expert opinion and guidance for the multiple disciplines within Ophthalmology 2.4 As a clinical tutor the post holder will provide teaching and training at post graduate level both internally and externally as agreed with the Lead clinician 2.5 The post holder will participate in clinical trials, audit and research activities as agreed wi th the Lead Clinician 2.6 To maintain and develop personal and professional skills as required by the General Optical Council, British College of Optometry and NHS Fife Acute Service Division 2.7 To undertake administrative and teaching duties as agreed with the Lead Clinician 3. DIMENSIONS Direct and sole support with specialist optometrist skills of 6 Consultant Ophthalmologists and 6 orthoptists Responsible for managing interface between the hospital eye service and community optometrists within Fife (c. 100 optometrists) Providing tertiary specialist optometrist services for whole population of Fife, c. 375,000 The post holder works within professional guidelines (British College of Optometrists, Association of Optical Practitioners, General Optical Council- the latter requires £2 million professional indemnity insurance for registration) It is anticipated that the role will eventually include budgetary responsibility for fitting of specialist contact lenses c. £10k per annum 4. ORGANISATIONAL POSITION Directorate Nurse Manager Ambulatory Care ↓ Senior Charge Nurse Ophthalmology ↓ Optometrist Specialists 1.23 whole time equivalents ↓ Optometrist Specialist (this post) 5. ROLE OF DEPARTMENT To provide the highest quality optometry service the hospital eye service. The unique expertise brought to a department by the specialist optometrist improves the quality of care of certain specific groups e.g. children with squint, cataract and amblyopia and adults with corneal problems and diabetes, and adults and children with learning difficulties. An optometry specialist has skills allowing them to take on certain groups of patients who would ordinarily be seen by a consultant ophthalmologist. As a result more new consultant appointments become available addressing the waiting time issue. 6. KEY RESULT AREAS To work closely with the line manager to ensure professional standards are achieved and maintained at all times, for the provision of highest quality hospital Optometry services. The post holder works within professional guidelines (British College of Optometrists, Association of Optical Practitioners, General Optical Council- the latter requires £2 million professional indemnity insurance for registration) and NHS Fife‟s organisational policies and guidance provided by the Lead Clinician. Acts as an autonomous practitioner, investigating, diagnosing, treating and managing new and review out or in patients referred to the Optometric service from a wide range of sources. Patients can be adult or paediatric with learning difficulties, multiple disabilities or have stroke/ brain injuries: Clinical (duties are carried out on a sessional basis unless otherwise stated) A To undertake a broad range of core Optometry services which include: 6.1 Determining the ocular health externally and internally e.g. whether patient has conjunctivitis, keratitis, iritis, pupil defects, cataracts, age related macular degeneration, diabetes, glaucoma, retinal pathology, retinal detachment etc.: 6.1a Ophthalmoscopy (hand held instrument which allows the internal part of the eye to be seen- vitreous, retina, arteries, veins, optic nerve, maculae) 6.1b Slit lamp biomicroscopy (binocular microscope which enables detailed examination – up to x40 magnification) of the anterior and posterior segment including the adjunct use of specialised imaging lenses (60D, 78D 90D ) which require accurate positioning to focus on retinal structures. Also used for evaluation of contact lens fitting and aftercare to ensure no adverse responses. 6.1c Goldmann tonometry (attachment to the slit lamp) invasive technique for measurement of intra-ocular pressure. 6.2 Ocular investigation : 6.2a Retinoscopy – routine refraction to determine hyperopia, myopia, astigmatism or presbyopia, spectacles are issued as required (eyestrain or headaches – asthenopia). Complex diagnostic for amblyopia management -spectacles are issued as required based on cycloplegic refraction the interpretation of which can be vital to the child‟s visual development. Also used to determine whether visual acuity reduction is organic or inorganic. 6.2b Pupil examination (near, direct, consensual and relative afferent pupillary defect) which are used to detect neurological problems. 6.2c Distance and near vision and visual acuity measurement (Snellen, Logmar, contrast sensitivity) - providing legal visual standards requirements for the DVLA 6.2d Near vision and visual acuity measurement (Snellen, Logmar, contrast sensitivity) Reading difficulties assessment include dyslexia (coloured overlays and visual tracking techniques) 6.2e Binocular vision assessment – e.g cover test to identify squints, stereopsis measurement, Maddox rod, Maddox wing, fixation disparity, including the determination of prismatic power required (either incorporated in spectacle prescription or by attachment of Fresnel prism) and investigation of accommodation and convergence (RAF rule) 6.2f Ocular motility testing to detect muscle palsy or paresis – determining cause of double vision (diplopia) 6.2g Colour vision (Ishihara) for children (education and employment issues) and adults (pathology) 6.2h Visual fields assessment (confrontation, Visual Field Analyser) and interpretation to determine ocular pathology (acute or longstanding), differentiate ocular from cortical pathology, organic from inorganic and the possible mode of treatment 6.3 Specialist visual rehabilitation (Advanced understanding of visual optics is required): Medical contact lens management 6.3a To create complex and intricate technical design for adults (unusual corneal shapes caused by trauma) 6.3b Artistic design is required in cases of poor cosmesis (caused by disease or trauma) and the counseling of realistic expectations 6.3c Therapeutic contact lens design is needed for treatment of pain, photophobia and insuperable diplopia Visual impairment assessment: 6.3d Requires extensive knowledge of eye diseases and low visual aids (LVA) includi ng the assessment, prescribing, fitting and repair of appropriate aids and appliances. Communication and motivation is required to maximise the benefit of LVA use 6.3e Congenital and acquired visual disabilities are supported throughout the loss of vision journey. This may include patients with learning disabilities. The acquired loss may be sudden or chronic over years (often without treatment) and appropriate counselling will be given 6.3f Discussing the advantages of being certified as being partially sighted or blind and then filling in the relevant information on the form is a regular occurrence. This is often occurs within an emotionally charged atmosphere B To undertake a range of sub-specialty clinical services involving Optometric extended roles which include: 6.4Paediatric ophthalmic clinics held jointly with Paediatric ophthalmologist and orthoptist & independent optometry Clinics. Responsible for assessing ocular health and cycloplegic refraction in children (interpretation of which can be vital to the child‟s visual development and control of squint). The optometrist will contribute their knowledge and skills in the management of children with complex ophthalmic needs.The post holder will examine and treat children with squint and complex refractive error many of whom have learning difficulties. The post holder must be able to discuss a range of diagnoses and management with children and adults in a relevant and understandable way 6.5 Independent and joint Diabetic & Macular clinic with consultant ophthalmologist Requires specialist knowledge of types of diabetic retinopathy and macular degeneration and their management Patients who have been identified as having referable diabetic maculopathy by current screening programme are examined by the post holder and listed for treatment, reviewed or discharged after full ocular examination . Patients with untreated and treated macular degeneration who require accurate ophthalmology examination, OCT treatments and appropriate follow up including interpretation of fluorescien angiograms.Instillation of diagnostic stains, mydriatic, cylcoplegic and anaesthetic drugs are required. 6.6 Glaucoma Clinics Requires the ability for accurate disc analysis, anterior segment evaluation, gonuioscopy and contact tonometry. All clinics run with medical staff and none are run independently . Humphrey visual field interpretation required. Additionally knowledge of diagnosis making , treatment and follow up strategies required with medical support reqired. 6.7 General/Emergency clinics All of above skills required to support senior and junior medical staff in generic clinics that see patients with a wide range of chronic and acute ophthalmic problems that do not easily fit inot specialist clinics. Manageria/lAdministrative duties 6.9 Key staff member responsible for liaising between HES and community based optometric practices. A leading role in organising joint post graduate educational meetings 6.10 Answering telephone queries or written communicates from patients, medical staff, professions allied to medicine and external agencies . 6.11 Liaising with private practice Optometrists regarding patient‟s needs for the smooth transition into primary care 6.12 Responsibility to supply accurate information to the Lead clinician when requested in order to deal with complaints at a Departmental level. 6.13 The post holder must maintain patient confidentiality at all times & responsibility to ensure that all Health and Safety regulations are complied with. Teaching and training 6.14 To participate in a programme for the advanced development of personal clinical expertise, in accordance with individual performance objectives which are agreed with the lead clinician. This is with a view to constantly enhancing and further developing clinical knowledge and skills in order to undertake a broad range of extended clinical roles 6.15 To undertake teaching and training of nursing, orthoptic and medical students. To provide Optometric training of post graduate medical staff (i.e. specialist registrars) in preparation for The Royal College of Ophthalmologists examinations as delegated by the Head of Service 6.16 To undertake collaborative clinical research and present at scientific meetings . 6.17 To undertake clinical governance and clinical audit by systematic and critical analysis of the quality of Optometry care, including diagnosis, treatment, outcomes and quality of life for patients. . 7a. EQUIPMENT AND MACHINERY (many times daily when undertaking clinical activity) 7.1 Use of sophisticated medical equipment e.g retinoscope, ophthalmoscope, Goldmann tonometer, slit-lamp biomicroscope, 66D,78D and 90DVolk lenses and focimeter (measures the power of spectacles) 7.2 Manual handling of specialist contact lenses, LVAs and intricate repairs 7.3 Optical coherence tomography OCT (equipment provides a cross-sectional view similar to a histology section which requires a great degree of accuracy, precision and interpretation based on practical and theoretical knowledge and experience) 7b. SYSTEMS 7.4 The post holder is responsible for inputting clinical information into the patients written records. They will comply with the Data Protection Act and local policies regarding confidentiality and access to medical records 7.5 Orders contact lenses and low visual aids using non-stock requisition orders 7.6 Ability to access email 7.7 Ability to access intranet for organisational policies and procedures 7.8 Ability to access internet 7.9 Able to use computers - working knowledge of windows (word processing, spread sheets, power point) 8. ASSIGNMENT AND REVIEW OF WORK Organisational 8.1 The post holder may be required to work anywhere throughout Fife 8.1a Within outpatient clinics, wards, day case units, theatres, special care baby unit and Stroke units 8.1b External agencies such as Fife society for the Blind 8.1c Domiciliary visits (private and nursing homes) 8.1d Community orthoptic clinics (e.g. Dovecot, St Andrews memorial)) Clinical 8.2 To provide a full range of autonomous Optometric care to hospital based patients which includes the delivery of certain specialist optometric services 8.3 Professionally responsible and legally accountable for own Optometric care, however, must refer to or seek advice from consultant ophthalmologist colleagues with any patient management concerns 8.4 Ability to work as part of a multidisciplinary team with excellent interpersonal skills 8.5 To record personally generated information, maintain patient records and compile data for audit and reports 8.6 Responsible for the safe use of Ophthalmic equipment and security relating to PCs etc. 8.7 Supervisory and training role to unqualified and qualified students (Nurses, Orthoptists, Entry Level Optometrists) or medical staff (SHOs) . Budget 8.8 The post holder may be required to have direct budgetary responsibility.. They will have a responsibility for the delivery of cost effective care 9. DECISIONS AND JUDGEMENTS 9.1 Functions autonomously 9.2 Professionally and legally responsible for own Optometric care into individual patients, however, must refer to or seek advice from Head of Service with any patient management concerns 9.3 Ability to respond to the challenge of complex / demanding patient situations which changes daily and uses knowledge and experience to assimilate and evaluate information to advise on appropriate course of action . 9.4 Follows Departmental standards and guidelines 10. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB 10.1 Investigating, diagnosing and managing a complex variety of visual problems in children and adults, the individual patient demand varying on a cases by case basis which requires continual update of clinical knowledge base 11. COMMUNICATIONS AND RELATIONSHIPS Optometric services involve providing and receiving, sensitive and complex contentious information, where persuasive, motivational, negotiating, training, empathic or re-assurance skills are required. This may be because co-operation is required or because there are barriers to understanding. 11.1 Ability to deal with a wide range of socio-economic difficult situations and circumstances e.g. children in care, distressed or angry patients/carers or elderly patients with visual and other health problems living alone without families or friends support 11.2 Engages in effective communication with patients, relatives and external agencies (e.g. VIS social care workers). Provides support, empathy and re-assurance in the delivery of patient care and compassion and sensitivity when communicating life changing events to patients and carers. Frequent exposure to distressing or emotional circumstances 11.3 Able to cope with interruptions from patients, carers or team members whilst providing ongoing care 11.4 Supporting patients through the trauma of visual loss (breaking bad news and explanation of visual impairment) and creating management strategies tailored to individual need (as patients are regularly reviewed close professional trusting relationships are built up with patients over time). This includes informing the patient they can no longer drive (can be devastating). 11.5 Discussing the benefits of being registered partially sighted or blind and filling in the form on behalf of the Consultant Ophthalmologist 11.6 Discussing risks and benefits of treatment options e.g. atropine penalization, squint surgery or laser treatment for macular oedema. 11.7 Optimize individual patient care by providing appropriate information 11.8 Ability to impart complex information to patients and carers 11.9 Provide Optometric reports utilizing a wide range of media (letter/email/verbal) 11.10 Excellent telephone manner required– highly developed tact and diplomacy dealing with patient concerns or queries 11.11 To maintain harmonious working relationships and efficient communication with all staff throughout the Directorate, Trust and outside agencies (includes social services, private Optometrists and General Practitioners) 11.12 The post holder will have contact with other clinical and non clinical units within the hospital and therefore will be required to communicate and give support to the other staff within the organisation 11.13 Contribute to the development of Optometry services 12. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JOB (many times when undertaking clinical activity) These require frequent, prolonged periods of significant concentration and frequent exposure to distressing or emotional circumstances. Acquisition of clinical activities requiring highly developed skills involving highest levels of hand/eye and sensory co-ordination are essential. This often involves working in certain restricted positions/ posture that cannot easily be changed. High degree of precision and accuracy with narrow margins of error. A) Physical demands and skills 12.1 Frequent wheelchair manual handling skills required 12.2 Maneuver patients with range of conditions affecting mobility 12.3 Equipment moving e.g. slit lamp 12.4 Working around equipment within clinic room 12.5 Restrictive movement to treat patients – stooping 12.6 Examining confused/mentally or physically challenged patients of varying ages particularly children and adults with learning disabilities. Kneeling on the floor whilst child is playing in order to facilitate examination 12.7 Manipulation of fine tools requiring expert hand/eye coordination e.g. using a 90D (to observe the back of the eye) in one hand and focusing the slit lamp with the other, holding the retinoscope with one hand and trial lens with the other to determine the patient‟s prescription 12.8 Holding the ophthalmoscope whilst bent over twisting and turning to examine the whole of the back of the eye (blood vessels, optic nerve, retina, macula) requires concentration, cooperation and coordination 12.9 High degree of precision is required for OCT clarity and patient positioning 12.10 Manipulation of fine tools and materials whilst mending and cleaning intricate low visual aids 12.11 Carrying case notes which includes transfer between Hospital 12.12 Walking from clinic area to ward area regularly due to equipment being housed on level 5 12.13 Transferring patients from clinic to ward for examination 12.14 Insertion and removal of contact lenses in young babies and teaching the parents takes restrained force and expertise amidst a background of crying patients and parents 12.15 Insertion of eye drops adults and children (holding eyes open, crying children) 12.16 General key board skills will be used on a daily basis for administration, reports to Doctors, reports to external agencies, reports to patients and analysing data 12.17 Ability to drive is required for providing domiciliary visits or peripheral clinics throughout NHS Fife B) Mental and Emotional demands 12.18 Frequent, prolonged periods of significant concentration e.g. determining ocular health 12.19 High degree of precision and accuracy, within time constraints, required for each patient 12.20 Concentration required when checking documents/patients notes 12.21 Concentration required when observing patient behaviors which may be unpredictable 12.22 Ability to react swiftly and appropriately to sudden changes in patient clinical conditions, 12.23 Simple and complex discharge planning and ensuring multi professional/agency involvement 12.24 Concentration required when disclosing information relating to patients to third parties 12.25 Providing low visual aids to children and adults (Congenital, acquired, terminally ill, challenging behavior, learning disabilities, associated deafness, dementia, stroke) often after informing the patient there is no treatment to improve their visual loss or soon after receiving the diagnosis 12.26 Supporting patients with poor cosmoses, modifying expectations of visual improvement with prosthetic lens 12.27 Supporting/educating patients/relatives/significant others to participate in the planning and provision of care 12.28 Managing children / young adults in an adult environment within the clinic 12.29 Determining the pertinent facts from the history and symptoms reported by patients 12.30 Ensuring concentration is maintained whilst subjected to interruptions by other team members/ telephone calls or patient‟s relatives 12.31 Frequent exposure to distressing or emotional circumstances due to clinical assessment of the blind and partially sighted which includes the terminally ill 12.32 Ability in stressful and unpredictable situations (exposure to verbal aggression, patients with challenging behaviour- infrequent) to maintain a high level of professional behaviour 12.33 Clinical activities requiring highly developed skills involving significant levels of hand eye and sensory co-ordination are frequent. This often involves working in certain restricted positions/ posture that cannot easily be changed 12.34 Maintaining children‟s and adults (visual, hearing impairment, learning and multiple disabilities) cooperation during examination which require a high level of communications skills 12.35 Communicating sensitive information to worried/ anxious/distressed patients and/or carers with regard to aetiology, diagnosis and management of their ocular disease. 12.36 With the lifetime support of low visual aid users this creates significant demands on postholder 12.37 Appreciating limitations of ability and seeking advice from Head of Service or referring on to Consultant Ophthalmologists if required 12.38 A level of English language, competency and communication skills necessary to perform this role safely and effectively. C) Working conditions 12.38 Exposure to unpleasant working conditions e.g work within the dark, temperature, awkward positions and confined spaces, children (fleas, head lice, odours (poor hygiene, alcohol, tobacco, nappies) 12. 39 Near point contact with patients of all ages during ocular examination– exposure to bodily fluids (children sick, nose bleeds), infected tear fluids, naso-lacrimal discharge 12.40 Near point contact involving exposure to environmental risks at ward/clinic level and potential exposure to toxic pharmaceutical materials (infrequent). Safe working practices and safety precautions must be adhered to 12.41 Close contact with patients with MRSA, AIDS , Hepatitis A, B and C (infrequent) 12.42 Exposure to verbal aggression and physically aggressive behaviour (infrequent) 12.43 Use of VDU and telephone daily for administrative purposes 12.44 Frequent requirement to drive 13. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB 13.1 Entry qualification degree (BSc Hons Optometry, minimum 3 years) and subsequent registration examinations (minimum 1 year) with The College of Optometrists and Membership 13.2 Registration with the General Optical Council (maintenance and update of knowledge - continuing education and training or CET is required for continued registration) 13.3 Minimum of 3 years clinical experience 13.4 Advanced clinical training and experience specialist knowledge (theoretical and practical) to MSc level, so able to deal with a complex range of ophthalmic interventions 13.5 To provide core Optometric services as below: 13.5a Ophthalmoscopy 13.5 b Slit lamp biomicroscopy 13.5c Management of minor corneal abrasions (antibiotics e.g chloramphenicol, ocular lubricants e.g. viscotears) and allergic eye disease ( e.g. Sodium cromoglygate) associated with contact lens wear 13.5d Goldmann tonometry 13.5e Retinoscopy 13.5f Pupil examination 13.5g Specialist medical contact lens management 13.5h Teaching insertion and removal of contact lenses 13.5i Prescribe contact lens solutions via Pharmacy 13.5j Lid eversion and eye irrigation 13.5k Tear film assessment (instillation of fluorescein, Rose Bengal and Schirmer test) and lid hygiene and lubrication instruction 13.5l Binocular vision assessment 13.5m Visual acuity measurements 13.5n Colour vision assessment 13.5o Visual fields assessment 13.5p Visual impairment (congenital and acquired) assessment which requires extensive knowledge of LVAs and social service support system. 13.6 To provide sub-specialty clinics: 13.6a Paediatric ophthalmic assessments (Associate Specialist level) 13.6b Diabetic clinic (staff grade level) 13.7 Ability to work as part of a team with excellent interpersonal skills 13.8 Demonstrate organisational skills and flexibility with regard to work schedules 13.9 Ability to work effectively under pressure (time constraints and budget) 13.10 To work autonomously using own initiative with an unpredictable caseload 13.11 Ability to determine individual patients requirements and initiate appropriate care pathways 13.12 Ability to convey highly complex concepts in a clearly understood way 13.13 Ability to maintain harmonious working relationships and efficient communication with all staff throughout the Directorate, Acute Service Division, internal and external agencies 13.14 Ability to deliver teaching and training at postgraduate level for multiple disciplines e.g. Nurses, Orthoptists, and specialist registrars. 13.15 Ability to cope with frequent exposure to highly distressing or emotional circumstances 13.16 Working knowledge of standard computer programmes 13.17 Knowledge of general NHS Fife acute Service Division policies and procedures 13.18 Ability to travel throughout Fife (peripheral clinics) 14. JOB DESCRIPTION AGREEMENT A separate job description will need to be signed off by each jobholder to whom the job description applies. Job Holder‟s Signature: Date: Head of Department Signature: Date: RECRUITMENT AND SELECTION STANDARDS PERSON SPECIFICATION FORM Post Title/Grade: Optometrist Specialist Department/Ward: Ophthalmology Date: 21 March 2011 ESSENTIAL DESIRABLE MEASURE Experience Post Registration MSC Community Application form level experience or optometry and interview equivalent experience Qualifications/ BSc Hon Optometry Application form Training Member of College of Optometrists required with General Optical Council/CET or equivalent. Knowledge Confident with basic & Prior knowledge Application form broad ophthalmic of NHS Fife knowledge. COeRU service pathways & protocols. Skills Excellent communication. Skilled in OCT. Interview Research. Skilled in Retinoscopy, Fundoscopy and Contact Tonometry A level of English language, competency and communication skills necessary to perform this role safely and effectively. Aptitude Pleasant. Keen to work with Interview Forward thinking. glaucoma, IT literate. diabetic and macular patients in adults & children. Other Team Player. Interview e.g. Team Player, Able to travel throughout Be able to travel Fife.
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