Diabetic Retinal Screener and Grader, Band 5

To provide a high quality systematic screening and grading service as part of the Diabetic Retinopathy Screening Programme for the whole of Gloucestershire against National Service Framework and National Quality Assurance Standards, to ensure the early detection of sight-threatening diabetic retinopathy and the reduction of blindness. To support the activities of the department to ensure that National Quality Standards and the Priorities and Planning Framework and other targets are met. To maintain the reputation of the department as an award winning enterprise, which is high-profile being under the overall direction of the National Coordinator for the Diabetic Retinopathy Screening Programmes in England., Proven competence to work autonomously and effectively without access to supervision, in General Practice surgeries, requiring the ability to plan travel time appropriately and to plan and organise own clinic time, screening on average 24 patients per day under current workflows. To maintain a good throughput of patients in the event that workflow practices change. Capacity to work accurately whilst maintaining intense periods of concentration and competing claims on time. To be accountable and make clinical decisions involving patients within local guidelines, without direct supervision from medical staff.
Proven competence in digital retinal photography and effective use of a direct ophthalmoscope sufficiently confidently, to recognize and diagnose and refer to clinic, advanced cases of diabetic retinopathy that requires urgent treatment. Retinal photographs should be of sufficient quality to meet the National Quality Assurance Standard.
Competence to grade unsupervised, sustaining high levels of concentration over extended periods, to analyze and interpret diabetic retinopathy, accurately diagnosing small details of diabetic disease and other ocular lesions and ensuring timely referral to an ophthalmologist when appropriate, grading a minimum of 1000 patients' image sets per annum as directed by National Screening Quality standards.
Responsibility for maintaining internal quality assurance processes for grading during primary diagnosis of disease/no disease. Responsibility for secondary level grade of image sets with disease, and unless there is discrepancy between graders, with no further referral to a medical clinician.
To remain calm and focused during screening clinics in particular during adverse conditions such as IT failure.
To communicate effectively with health professionals and frequently with patients, sometimes in distressing and sensitive circumstances, using empathy and reassurance in the management of information regarding diabetes management, diabetic retinopathy, diabetic eye disease and loss of sight.
To safely administer mydriatic eye drops within the Procedure for the Ordering, Prescribing and Administration of Medication Guideline and following department Patient Specific Protocols.
Proven competence to deliver effective one-to-one patient education, using their retinal images as a teaching tool, in a motivating and persuasive manner so as to encourage effective diabetes management and reduction in the risks of diabetic eye damage whilst encouraging annual screening attendance.
Competence of accurate image and data handling, including image capture and retrieval, to ensure timely image grading and generation of results to GP's and referral to an Ophthalmologist for treatment as appropriate.
Carry out proficiently and safely the frequent movement of a digital fundus camera (87kgs) and equipment between county-wide surgeries, being aware of and acting in accordance with Trust manual handling protocols.
Adhere to all Trust policies and procedures and maintain accurate patient records.
Competence to train new screener/graders in all aspects of the job, and to develop and maintain professional links with colleagues at all levels in both the primary and secondary care setting.
Proactively seek and maintain up to date information and training to ensure that professional skills are sustained to a high standard.
COMMUNICATION & WORKING RELATIONSHIPS
To develop and maintain communication and commitment with all members of the immediate team and other eye screening programmes in the UK.
Multidisciplinary team within the Trust.
Ophthalmologists and members of the diabetes team
Patients.
General Practitioners, Practice Nurses, Practice Managers and other surgery staff.
National Screening Committee for Diabetic Retinopathy
Trust IT department
Outside agencies for IT, camera and software support.
MOST CHALLENGING PART OF THE ROLE
Ability to work autonomously and unsupervised in General Practice, often under pressure, in the absence of guidance from department and clinical managers, whilst maintaining a high standard of patient care, education and time management. Responsibility for handling patient images and data and prioritising time to ensure timely grading and effective Quality Assurance Standards. To remain focused and resourceful in adverse working conditions so that technical problems can be analysed and solved.
PHYSICAL EFFORT AND WORKING CONDITIONS
Will be required to work within recognised Manual Handling guidelines.
Will be required to occasionally manoeuvre equipment up to 86kg, using specially designed trolleys, often in confined spaces and in and out of vans to deliver to county-wide practices.
Will be required to conduct screening clinics in a darkened room, using a VDU and specialist equipment, often in confined spaces. Image grading is also conducted in a darkened room using a VDU.
Ability to work where there is a requirement to concentrate for prolonged periods e.g. during patient image grading.
Will be required to follow Policies and Procedures pertaining to infection control and COSHH regulations.
The health and wellbeing of our staff and patients remains the priority of the Trust. Vaccination remains the best chance we have of conquering COVID and the Trust encourages everyone to take up this offer.
Please note, this vacancy may close as soon as sufficient applications have been received, so please apply as soon as possible if you are interested. The Recruitment Team are unable to accept any applications after the position has closed on NHS Jobs.

Registered General Nurse qualification, or Ophthalmic photographic experience or Degree in relevant subject and National Qualification in Diabetic Eye Screening
Detailed knowledge of all aspects of diabetic retinopathy disease, sufficient to enable post holder to make accurate diagnosis both of the presence of disease and the level.
Good all round knowledge of diabetes and associated risk factors.
Ability to communicate effectively within a multidisciplinary team both Trust-wide and nationally and with diabetic patients in a calm, sensitive, reassuring and persuasive way.
Enhanced levels of dexterity and accuracy pertaining to clinical skills including the use of diagnostic equipment i.e. fundus cameras and direct ophthalmoscopes in the direct examination of patients' eyes.
Ability to work autonomously, efficiently and professionally in county-wide General Practice Surgeries.
Enhanced IT skills including experience of windows based software, capture and grading software for diagnostic purposes and Microsoft word.
An up to date knowledge and understanding of key professional developments and recommended good practice
Demonstrate understanding of research based practice, and participate as required in audit.
Ability to respond flexibly, resourcefully and autonomously in emergencies, e.g. when equipment fails in outreach clinics whilst maintaining a calm environment for patients present.

NHS AfC: Band 5
Join us at an exciting time for Gloucestershire Hospitals NHS Foundation Trust! We have an ambitious plan for our journey to Outstanding and are looking for aspirational, committed individuals to join us, making a real difference to both staff and patients.
As a former winner of England for excellence award: Tourism destination of the year, the beautiful city of Gloucester and the scenic regency spa town of Cheltenham are fantastic places to work and live.
As a hospital Trust we are currently involved in over 100 clinical trials and studies, whilst also providing acute elective and specialist services to a population of over 620,000.
By joining Gloucestershire Hospitals NHS Foundation Trust new colleagues can look forward to a warm welcome and a future full of opportunities and support., Gloucestershire Hospitals NHS Foundation Trust is the largest employer in the county and with over 8,000 staff, we are one of the largest NHS trusts in the UK. We offer a generous annual leave allowance, excellent bank rates, access to the excellent NHS Pension Scheme, discounts for local shops, restaurants and services, access to our health and well-being hub, access to our two on-site nurseries, flexible working options, discounted public transport, reward and recognition schemes, exercise and activity classes and membership to our popular hospital choir.
Gloucestershire Diabetic Eye Screening Programme has the purpose of ensuring the early detection of sight-threatening diabetic retinopathy and the reduction of blindness. We are an award-winning team with an excellent professional reputation.
The department is closely linked with Research, Ophthalmology and Medical Photography to form a diverse and enthusiastic team.