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HSST role descriptor physiology


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            Role descriptor for Consultant Healthcare Scientists in
                           Physiological Sciences
The Consultant Healthcare Scientists (HCS) will be able to lead the scientific contribution
across a comprehensive range of Physiological Sciences. They would be involved in
performing, interpreting and reporting complex investigations and some therapies see
patients referred direct from their GPs, and some would require prescribe specific drugs.
They will have a very high level of expertise in their specific area(s) and may develop an
expert interest in one specialist area providing consultant level advice with regard to
diagnostic planning, clinical management, data interpretation, clinical results and
implications which directly affects patient management. They would be expected to provide
clinical and scientific leadership and be able to lead on education and research programmes
and work closely with other specialties such as paediatrics, medical physics and senior
managers. In some specialisms the Consultant Healthcare Scientist would carry their own
caseload of complex cases where an assessment of neurosensory function[s] or assistive
technology needs are required.

More specific examples in some of the areas are given below.

Example of role in Audiology

Consultant Audiological Scientists will be able to provide scientific leadership within or
across the whole of the discipline, being responsible for the operational management,
governance and clinical effectiveness of audiology services.

They are directly responsible for the day-to-day running of an audiology department. They
may hold budgetary responsibilities and ensure performance objectives are met by liaising
with Trust Senior managers. They will set the strategic direction of the service within the
framework of the needs of the local organisation, national priorities and established
standards of practice.

They identify opportunities for clinical developments, thereafter advising others on the
potential for audiological investigations/interventions and best use of scientific assets across
the client group. This will include advising and liaising with other health professionals and
agencies/organisations (e.g. Suppliers/Manufacturers, Third-Sector, Education and Social

Individually they may carry their own case-load of complex cases and hold clinical authority
providing expert hearing and audio-vestibular assessment of function and rehabilitation
involving both outpatient and in-patient adults and children, accepting referrals from GPs,
health visitors, school nurses, teachers of the deaf, speech and language therapists and
medical and educational staff.

Some areas in which they may work and provide expert consultant level advise, include the
assessment and management of
    Patients with multifaceted hearing problems such as auditory processing disorders,
    Complex paediatric cases ,
    Patients with balance difficulties Patients being considered for or having had
      implantable hearing devices
    Patients with tinnitus and hyperacusis

They may interpret and report complex audiology studies and will provide expert advice on
the use of audiology equipment.

Most will be involved in teaching, audit and clinical governance of their own and junior staff
including leading research, its evaluation and application of it into clinical practice.

They will direct the clinical research and development of the service they have responsibility
for. This will involve identifying research opportunities (liaising with others e.g. colleagues in
the academic and commercial research community), promoting, instigating and coordinating
research and development activity in pursuit of improved patient outcomes.

Example of role in Neurophysiology:

A Consultant Neurophysiological Scientist would provide consultant level advice regarding
the findings of Neurophysiological investigations, and suggest additional investigations to aid
patient management.        They will have a detailed knowledge and understanding of
syndromes, symptoms and disease processes across whole body systems. They will take
detailed clinical history and perform a clinical examination to form a diagnostic plan. They
will assess the outcomes of the investigations and may propose a differential diagnosis.
They will be able to interpret imaging/pathology reports in the clinical context of the patient.

They may have advanced clinical skills in independently performing, reporting and
interpreting in the following:-

       Complex peripheral neurophysiology and EMG including
          o Needle and surface EMG
          o Repetitive stimulation
          o Quantitative EMG
          o Single fibre EMG
          o Quantitative Sensory testing

       Advanced EPs including
           o Intra-operative monitoring
           o Magnetic stimulation
           o Detailed investigation of visual, auditory and somatosensory systems

       Ictal and inter-ictal EEGs including
            o ITU recordings
            o Paediatric/Neonatal EEGs
            o LTM
            o Invasive EEG monitoring

       Polysomnography and other sleep recordings

They may develop a specialist interest in one modality depending on needs of local services.

They would provide scientific leadership across the whole of the discipline and offer expert
advice on the use of Neurophysiological equipment.
They would lead on education and training, and initiate or lead research programmes and
innovation projects.

Example of role in Ophthalmic and Vision Science:

A Consultant Ophthalmic and Vision Scientist would provide consultant level advice
regarding the performing and the interpretation of the findings of Ophthalmic and Vision
Science investigations. They will have a detailed knowledge and understanding of visual
system anatomy and physiology and of the diseases and disorders that can cause visual
system dysfunction. They will also have a detailed knowledge of systemic disorders with
possible associated visual system dysfunction. They will be able to devise a diagnostic
strategy based on the results of clinical examination and history supplied to them by referring
clinicians. They will be able to interpret investigational data in the clinical context of the
patient.to enable a (differential) diagnosis.

They may have advanced clinical skills in independently performing, reporting and
interpreting one or more of the following:-

            o   Complex psychophysical assessment of vision function;

            o   Ultrasonography of the eye, orbit and related structures

            o   Advanced imaging techniques such as fundus autofluorescence imaging
                (FAF), optical coherence tomography (OCT) and imaging with adaptive optics

            o   Electrophysiology including electro-retinography (ERG), electro-oculography
                (EOG), visual evoked potentials (VEP). This may also include closely related
                psychophysical investigations such as dark adaptometry and formal colour
                vision testing.

They would provide scientific leadership across the whole of the discipline and offer expert
advice on the appropriate use of Ophthalmic and Vision Science services.

They would lead on education and training, and initiate or lead research programmes and
innovation projects.

Appendix 1

                       Role Descriptor Template

    Scientists who are on the Higher Specialist Register for Scientists

        •   will be eligible to compete for consultant level appointments
        •   undertakes roles which:
                  provide clinical and scientific expertise and leadership
                  provide consultant level advice within the context of direct patient care
                  give strategic direction, innovation and highly developed and specialised
                    skills to the service
                  develop and provide substantial management responsibilities
                  initiate or lead formal research activities
                  lead education and training activities
                  initiate innovation projects

        Scientific & Technical practice

        Requires expert knowledge and understanding of relevant clinical, scientific and
        technical principles and practice and their application to broad areas of patient care
          Provide a high personal level of scientific and professional expertise applied to
            critical problem solving.
          Ability to act as a source of specialist scientific advice to medical staff , allied
            health professionals, professional bodies, medical industry and academic
          Is responsible for quality and delivery of clinical and scientific services across a
            broad range of patient care
          Perform accurate and skilled investigations using complex and/or specialist
          Perform scientific and clinical validation of analytical results.
          Compile and authorise standard and complex reports for patients and other
            healthcare professionals.
          Provide result interpretation and reach conclusions on implications for patient
            care and management
          Provide consultant level advice in area of practice

        Clinical Practice
        • Requires expert knowledge and understanding of physiology and
            pathophysiology as applied to a broad range of clinical situations
        • Provide consultant level clinical advice on a range of investigations and therapies
            and on complex results and their implications for patient care and management.
        • Perform, interpret and accurately report a range of complex investigations
        • Direct and promote evidence-based practice and use of relevant clinical protocols
        • Direct and report on relevant clinical audits
        • Responsible for provision of appropriate testing strategies and development of
            matching clinical protocols

        Patient contact and care

           Undertake more complex patient cases with a higher level of patient interaction
            required with regard to responsibility for obtaining and assessing history and
            interpreting results in light of clinical information.
           Develop and implement a multidisciplinary ‘holistic’ approach to patient
            management, and the impact of their contribution
           A greater scope of responsibility for imparting results to and discussing with
            patients where outcomes may be highly sensitive, emotive or have serious
           Responsible patient care and contact across scientific service.

        Management and Leadership
         Manages/ Directs clinical and/or research service
         Lead and motivate staff to ensure effective delivery and achievement of service
          objectives in a changing healthcare environment
         Lead strategic service development planning across a broad service
         Direct programmes of clinical and scientific projects as appropriate
         Direct the operation of a broad service to ensure compliance with local and
          nationally accepted standards
         Be accountable for budget setting and monitoring expenditure for a broad service
         Has overall accountability for ensuring compliance with the governance and risk
          management requirements for a broad service
         May provide leadership within an area of practice at a national or international
         Demonstrable ability to successfully initiate, manage and sustain change

        Communication and working with others
         Communicate complex clinical, scientific and technical information in a wide
          range of settings and formats
         Liaise with peers and clinical users of the service on all aspects of service
         Work effectively with senior colleagues in MDT’s and other cross-professional
         Communicate research and development findings in written and oral formats to
          local, national and international audiences

        Teaching, training and assessing others
         Coordinates training programmes for junior doctors and registrars and all
           scientists from HCSA to Senior Scientists with ASE.
         May advise on national training requirements and curriculum for all these grades.
        • Assess and make provision for the teaching and training requirements of staff,
           professional colleagues and users of the service
        • Participate in clinical, scientific and technical teaching and training of peers,
           undergraduates, post graduates and other healthcare professionals within
           relevant areas of practice
        • Actively maintains a progressive learning environment for all grades of technical
         • Promotes a multidisciplinary approach to education utilising and valuing the
            expertise of other health care professionals and ensuring the positive
            contribution of the technical expertise to this process.
        • Evaluate the quality of teaching and training provided and make
           recommendations for improvement
        • May develop teaching programmes in area of specialist practice

        Research and development
        • Direct and plan the introduction, evaluation and application of improved scientific
           and operational procedures to continually develop the service
        • Evaluate published research and innovation and make recommendations for
           future service provision
        • Stimulate innovation and appropriate research initiatives within the department
           and a wider multidisciplinary field
        • Initiate and direct R&D programmes including original and translational research
        • Ensure compliance with ethical and financial research governance requirements
           for a service

        Personal and Corporate Governance
        • Ensure effective Clinical Governance according to Trust clinical governance
        • Ensure service complies with all relevant quality and governance procedures
        • Ensure delivery of high standard of health & safety and working environment
        • Make sure your conduct at all times justifies the trust of patients and colleagues
           and maintains the public’s trust in the scientific profession
        • Responsible for own clinical practice during diagnostic testing and theraputic
        • To challenge current practice, promoting service innovation or different ways of
           working. Building/supporting business cases for capital and staffing cost
        • To introduce measures to actively manage and reduce risk to patients. Ensure
           the formal reporting and recording of any adverse incidents, in line with Trust


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