Consultant Musculoskeletal Physiotherapist

The Deputy Head of Service will be responsible to the Head of Podiatry & Orthotics Services to assist in provision of day-to-day operational and managerial support to the Podiatry & Orthotics Services.

This will include line management of designated band 7 Podiatrists and surgical appliances officers, prioritisation and scheduling of staffing based on service demands and risk, complaint and incident investigation, as well as taking overall responsibility for the operational management of the orthotics services at QEH and UHL.

As Deputy Head of Podiatry & Orthotics you will deputise for the Head of Podiatry at divisional and trust meetings and those relevant to podiatry outside the Trust.

In a position of leadership you will be expected to role model the Trust values and behaviours, whilst being responsible for the provision of care to a high risk caseload including patients with wounds, demonstrating a high level of knowledge and skills to ensure the provision of high quality care, whilst observing and implementing policies, guidelines and procedures of Lewisham & Greenwich NHS Trust.

3. Key Responsibilities

Managerial

a) As Deputy Head of Service using highly developed specialist knowledge and experience you will provide a range of management and operational support to the Head of Service and the Podiatry Team, whilst taking lead responsibility for the operational management of the Orthotics Services at QEH & UHL.

b) Reporting to Head of Service you will take direct responsibility for the timetabling and scheduling of Podiatry staff based on service waiting times, clinical risk and staffing capacity. This will also include prioritisation of resources and workload presented by unplanned absences at short notice.

c) Reporting to the Head of Podiatry and working closely with the clinical governance lead, you will be responsible for the upkeep of the service business continuity plans

d) Having responsibility for the Orthotics budget (£450k), and working closely with the surgical appliances officers you will ensure value for money is being achieved from the orthotics contract by the regular review and reporting of relevant KPIs

e) To assist in the resolution of any conflicts within the clinical area, resolving informal complaints locally and leading in the investigation of and response to formal complaints as required/designated.

f) To investigate accidents and incidents, identifying and implementing corrective action where necessary, in conjunction with the Head of Podiatry. Promoting, monitoring and maintaining best practice in health, safety & security

g) For the Orthotics Service you will have lead responsibility for the development, ratification and implementation of relevant service policies, procedures and guidelines.

h) For the Orthotics Service you will have lead responsibility for maintaining effective recording systems, utilising available IT systems to ensure service is as paper light as possible and work with Data Analysts and Surgical Appliances officers to manage complex facts requiring analysis and interpretation to support achievement of Key Performance Indicators (KPIs).

i) To support the Head of Podiatry in the recruitment, induction and preceptorship processes, managing leavers ensuring associated processes are completed on time.

j) To provide appropriate guidance and support to staff in line with the Trusts disciplinary and sickness procedures. To support the implementation of HR policies and participate in formal procedures as requested by the Head of Podiatry.

k) Provide and receive highly complex, sensitive or contentious information drawing on motivational skills to encourage collaborative working to improve services/performance where there may be resistance to change.

l) Undertake the line management of 2 surgical appliances officers and up to 3 band 7/6 Podiatrists

m) To lead on the production of designated performance reports required for monthly reporting.

n) To represent the Podiatry Service in the absence of the Head of Podiatry at appropriate Trust wide groups/meetings and to actively participate in relevant Trust wide networks of practice.

0) To be proactive in identifying areas for improvement and implement remedial action as necessary.

p) Facilitate the cascade of information ensuring awareness of Division, Trust and NHS Initiatives supporting staff discussion and responding to feedback.

Clinical

a) To be responsible and accountable for an agreed caseload and undertake the complex assessment, diagnosis and treatment of new and existing patients with a wide variety of Podiatric complaints. This includes:

systemic diseases

immunosuppressive disorders

vascular and neurological disorders

dermatological disorders

chronic pathologies

emergency treatments

wound management

minor nail surgery

musculo-skeletal disorders

paediatric conditions

deformities

nail and skin pathologies.

b) To use clinical reasoning, critical thinking, reflection and analysis to support the assessment, diagnosis and treatment planning process.

c) To utilise evidence based material to assess, treat, implement, evaluate and document podiatric provision.

d) To use highly developed physical skills where a high degree of precision or speed and high levels of hand, eye and sensory co-ordination are essential when undertaking scalpel work in wound and skin care, and when using sharp specialist nail nippers on pathological nails, frequently on clients at high risk of amputation.

e) To provide Podiatric care plans tailored to the patients medical needs with regular review and the ability to identify and co-ordinate further interventions. To ensure timely and appropriate referrals to other specialists from within the department and outside (for example GPs, District Nursing, Hospital Acute Foot Clinic, Social services and voluntary organisations), facilitating safe and appropriate discharge where indicated.

f) To treat a wide variety of patient groups including those with special needs, housebound, children, elderly, adults, vulnerable groups and those from different cultural backgrounds with the possibility of communication barriers.

g) To demonstrate sound clinical expertise and knowledge in the management of serious and high risk pathologies for example: infected foot ulcers

h) To undertake specialist diabetes and high-risk sessions for the assessment and treatment of patients where duties will include:

- Undertaking Diabetic foot assessments

- To identify risk factors and to prioritise patients into risk categories

- Management of the diabetic foot

- Management of foot ulcers

- Swabbing of wounds and management of infection

- To arrange timely referral and on occasion emergency admission into hospital when indicated

i) To undertake the assessment and treatment of patients with lower limb musculo-skeletal pathologies, where duties will include:

- The prescription, fabrication and evaluation of chair-side insoles/orthotics

- The prescription and evaluation of an appropriate exercise and stretching regime

- Evaluation, prescription and casting for bespoke orthoses

j) To make frequent use of technology, where available, for measurement, monitoring and treatment using specialist complex equipment such as Doppler ultrasound

2. Communication and Working Relationships

a) Working closely with the Head of Podiatry & Orthotic Services

b) Communicate effectively and on a regular basis with the Podiatry and Orthotic teams including clinical, administrative staff and all other service users (Patients, Carers, Medical Practitioners, Nursing staff, Allied Health Professionals, Social & Voluntary services) as well as outside contractors for orthotics, providing information to all in an appropriate manner. This may include communication with people about challenging matters in challenging situations

c) To liaise and communicate effectively with other colleagues within the Trust including employee relations and recruitment teams, purchasing, performance, finance and the Patient Advice and Liaison Team. This will involve matters relating to service delivery, staff support, performance, recruitment and financial issues.

d) To attend and contribute to the Podiatry team meetings on a regular basis. This will include supporting preparation for meetings, agenda setting and in the absence of the Head of Podiatry act as Chair.

e) To lead and co-ordinate Orthotics service team and contractor meetings. This will include setting the agenda and contracting monitoring.

f) Reporting to the Head of Podiatry, when undertaking complaint/incident investigations you will liaise with clinicians, patients and carers working closely with PALS and Complaints service.

g) There will also be a variety of complex and sensitive situations and complex information that you will be expected to manage, both at patient and staff level.

h) To inform, educate and advise other health care professionals involved in the care of the patient, utilising influencing and negotiating skills to ensure a holistic approach to effective patient management.

Financial

To be responsible for the QEH & UHL Orthotics budget (approx. £450k)

To achieve financial balance of the Orthotics budgets, reporting any cost pressures to the Head of Podiatry in a timely manner, so that appropriate mitigation plans can be agreed and put in place.