Candidate Information Pack

www.nhsggc.org.uk

 Guidance for Completion of Application Form  About NHS Greater Glasgow and Clyde

 NHS Scotland Summary Terms and Conditions for this position  Job Description and Person Specification (please retain a copy)

Candidate

Information

A NOTE ON THE NEW SOUTH GLASGOW HOSPITALS

As you may be aware, the new South Glasgow University Hospital and the new Royal Hospital for Sick Children located on the current Southern General site are due to open Spring 2015.

With this in mind, please note that positions based within the following sites: Victoria Infirmary, Mansionhouse Unit, the Western Infirmary and the current Royal Hospital for Sick Children at Yorkhill will change location and move to the new South Glasgow hospitals. Gartnavel General Hospital and Glasgow Royal Infirmary will also have some services affected by moves to the new Hospitals.

These changes means that your base may change after joining us and you will be informed as soon as possible prior to any change of base.

THE APPLICATION PROCESS

• Please ensure you read the Job Description and Person Specification along with the guidance notes on Completing Your Application Form thoroughly. Shortlisting an application for interview is based on its content therefore it is in your best interests to ensure you submit a fully and appropriately completed Application. You can find answer to frequently asked questions on the application process on our website. Click this Link

• You will receive confirmation that your application submission has been received when you submit you’re On Line Application form. When we begin to process your application you will receive an email from NHS Greater Glasgow and Clyde (NHSGGC) confirming receipt. If you have not received a confirmation email within 3 days working days from the closing date please contact us on 0845 3000 831.

• We regret due to the volume of applications NHS GGC receives we are unable to write to applicants who are not successfully shortlisted for interview. Accordingly if you have not received an invitation for interview within 6 weeks of the closing date please assume on this occasion you have been unsuccessful. We hope this will not deter you from applying again. • We will use a number of methods of communication to advise you of each stage of the recruitment process this includes email, letter, SMS text, or phone. It is essential that you regularly check your emails and your phone to see if we have been in contact with you to update you on the progress of your application. Please ensure your email account does not treat NHSGGC emails as spam by resetting your spam filter. Use the help function in your email account or Click Here for instructions on how to do this.

• Please ensure you retain a copy of the job description and person specification for the post you are applying for – you will need this to help you prepare if you are selected for interview.

• Please retain details of the Job Reference Number – you will need this if contacting the NHS GGC Recruitment Team.

• Should you require further information or assistance in relation to your application please visit www.nhsggc.org.uk/recruitment or email your enquiry to [email protected]

lease state clearly the Job Title and Job Reference Number for the post . P

 What happens to my application? - After the post closes, all applications received will be passed to the recruiting manager / appointments panel who will assess each application against the criteria and person specification specified in the job description and decide who to select for interview. This part of the process is known as shortlisting.

GUIDANCE FOR COMPLETING YOUR APPLICATION FORM

• Completion of the application form is the first stage in the recruitment process, and if you are successful, will form the basis of your employment record. Complete and accurate information is essential. Please note: If you knowingly withhold or provide false or misleading information, this may result in your application being rejected, or if appointed, may result in dismissal from your post

• Your Application form plays a vital role in the recruitment and selection process .The information you provide us with in your form will be used to decide whether you are shortlisted to attend an interview. Only those applicants who can clearly demonstrate in their application form how they meet the minimum essential requirements for the post as specified in the job description and person specification will be considered for interview selection.

 Applicants should read the candidate information pack and job description for the post prior to completing the online application form.

 When completing the online application form applicants should read the instructions in each section and note the following:

o On all pages - the application form has a time out therefore you should click on the "Save" button as you go through the form or copy and paste from another document, to avoid losing content.

o On all pages - Please do not use any symbols eg £,#, & when completing your application form except @ for email addresses

o On page 4 - Role Purpose/Summary of Responsibilities is limited to limit of 1000 characters including spacing, circa 10 lines. Text over-running this limit will be cut off. o On Page 5 - Supporting Statement should be NO LONGER than 1 x A4 page - circa 50

Lines. If limit is exceeded, Text in the Supporting Statement will be cut off.  

 It is recommended that you complete all relevant sections of the application form. It does not matter how long ago your last employment was, if you have an employment history please list it.

 If you have not previously been employed please use the “Present or Most Recent Post” section to detail what you have been doing: Full time Student/Parent/Carer .

 Please note that you can list unpaid work including work placements and volunteer work in your employment history.

 We do not accept Curriculum Vitaes (CV) unless a CV has been requested as part of the the recruitment process.

• By completing an application for this post you give your consent to pre employment checks, including reference checks, to be initiated once your formal conditional offer of employment is made to you. Click Here for more information .

Completion of the Application form Parts A, B and C

• The Job Description provides information about the main duties and responsibilities of the post being advertised. It also describes the purpose of the post. Please ensure that your application form clearly demonstrates how your skills/knowledge/experience can be utilised in the role.

• The Job Description and Person Specification also specify the requirements or criteria (knowledge, skills, experience, abilities and qualifications) that are essential or desirable to perform the duties outlined. Please ensure in your application that you demonstrate how you meet the minimum essential criteria and where applicable, the desirable criteria for the role.

• Certain posts in NHS Scotland are exempt from the 1974 Rehabilitation of Offenders Act (Exclusions & Exceptions) (Scotland) Order 2003. Click Here for more information. If the advertisement for this position has declared that we require a Disclosure Scotland PVG Scheme Membership/Disclosure Scotland Check, you must declare any previous convictions, classed as either “spent” or “unspent”, including criminal convictions received outside the United Kingdom.

• The Asylum & Immigration Act 1996 states that it is a criminal offence to employ a person who is not entitled to work in the United Kingdom (UK) . As a consequence, before NHS

GGC offers employment, the prospective employee must provide evidence, that he/she is entitled to work in the UK. All applicants regardless of nationality will be asked to provide evidence of eligibility to live and work in the UK.

• NHS Scotland operates a Job Interview Guarantee Scheme for disabled applicants. Candidates who have declared a disability and who meet the minimum essential criteria outlined within the job description/person specification will be guaranteed an interview. • You must provide full and complete employment references including a work email

address (personal email address for employment references may not be acceptable) covering a minimum period of the last three years. Employment referees should be listed in chronological order – that is the most recent first. If you have had more than two employers in the last three years we will require additional references. Character referees should only be used in the event that you cannot provide two employer references covering the last three years.

• Any gaps in employment history must be detailed within your supporting statement and will be explored carefully with you at interview.

• If you have an employment history of less than three years, you should provide full details of an academic referee or other person who is not a friend, is not related to you or involved in any financial arrangement with you to provide a personal reference.

• If you have had no previous employment or have been self-employed you should provide details of two personal referees as outlined above and where applicable evidence to confirm your status (e.g. letter from Job Centre Plus, Academic Record or evidence from

Customs and Revenue) if you are selected for interview. HM

 Statement in Support of Application –This section is one of the most important in the application form as the information that is provided here will be evaluated and used to decide if you are invited to attend interview . This section gives you the opportunity to describe and demonstrate the particular qualifications, skills, abilities, knowledge and relevant experience and other qualities that make you a good candidate for the post.

Completing Part D – Equal Opportunities Questionnaire

This part of the form is optional and the information you provide in this section forms no part of the selection process. It is treated in confidence and only Recruitment or Human Resources staff can access for the purpose of recording and compliance monitoring to ensure our workforce is balanced and represents the best candidates from all parts of society regardless of age, disability, gender reassignment, marriage or civil partnership, pregnancy or maternity status, race, religion or belief, sex, sexual orientation and/or socio-economic status.

DATA PROTECTION ACT 1998 ~ TREATMENT OF INFORMATION PROVIDED ON APPLICATION FORMS

The information you provide on your application will be treated in confidence. Only those NHS GGC staff involved in the selection process and processing your application will see your application form. If you are the successful applicant your application form will be retained and used to create your employee record file. Your application form will be held for 12 months, from the date of your application, within the NHSGGC recruitment system, after which period it will be deleted from the system.

When you create your Online Application Account it is hosted on the NHS Scotland Web Server and NHSGGC staff have no access to this account. You account remains active for a maximum period of 90 days. This means that in order to keep your application form live on the online system you will need to log into your account at least once every 90 days. If you do not, the application information held in your account will be deleted and you will need to complete a new application form the next time you wish to apply for a post.

WORKING FOR NHS GREATER GLASGOW AND CLYDE About us

NHS Greater Glasgow and Clyde (NHSGGC) is the largest health board and provider of healthcare in Scotland and one of the largest health care providers in the UK.

NHS Greater Glasgow and Clyde’s purpose is to:

“Deliver effective and high quality health services, to act to improve the health

of our population and to do everything we can to address the wider social determinants of health which cause health inequalities.”

The Board works in close partnership with other NHS organisations, local authorities and other agencies including the third sector to ensure that social work, education, housing, employment and environmental services unite effectively and efficiently with the NHS in tackling inequalities and underlying health problems in local communities.

NHSGGC is going through a period of unprecedented workforce change and redesign as we prepare for the opening of the new South Glasgow University Hospital and the Royal Hospital for Sick Children in South Glasgow and the proposed integration of Health and Social Care Services. The development of the new Adult and Children’s Hospitals in South Glasgow are on schedule for opening in spring 2015. The new South Glasgow Hospital campus will be one of the largest and most advanced in Europe and will require new ways of working. Click here for more information on our hospital developments

The future shape of health and social care provision is changing with the move to establish new statutory Partnerships between NHS and Local Authorities, responsible for the planning and delivery of Health and Social care for local populations. This requires the development of very different relationships between primary care, mental health services, community and acute services.

NHS GGC serves a population of 1.2 million (over 1/5th of the population of Scotland) with services provided by 40,000 staff (head count).

The geographical area covered includes: Glasgow City, West Dunbartonshire, Inverclyde, Renfrewshire, East Renfrewshire, East Dunbartonshire, and North Glasgow (Stepps- Moodiesburn corridor).

Our Services

NHS Greater Glasgow and Clyde provides a full range of Secondary and Tertiary Clinical services , Primary Care, Mental Health and Community services included in which are a number of world-class specialist services.

Services are currently delivered from within the following organisational structure: Acute Services:

 Diagnostics

 Surgery & Anaesthetics  Women & Children’s Services  Emergency Care & Medical Services  Rehabilitation and Assessment  Regional Services

Community Health Partnerships:

 Glasgow City Community Health Partnership

 East Dunbartonshire Community Health Partnership  West Dunbartonshire Community Health & Care  East Renfrewshire Community Health & Care  Renfrewshire Community Health Partnership  Inverclyde Community Health & Care Partnership  Oral Health

Corporate:

 Facilities and Capital Planning  Corporate Planning and Policy  Finance

 Human Resources  Public Health

 Health Information and Technology  Communications

 Board Administration

In addition to the above, there are a number of services which cross over organisational boundaries; Prescribing and Pharmacy Policy, Clinical Governance and Inequalities.

Find out more about NHS Greater Glasgow and Clyde at www.nhsggc.org.uk

If you want to know more about the NHS in Scotland then please visit www.show.scot.nhs.uk.

More About Our Services

If you are successful in you application to join us you will be working within one of our Acute, Primary and Community Care Services. These services are in turn supported by a range of Corporate Service functions including Administration, Health Information and Technology, Finance, Human Resources, Public Health, Corporate Planning, Facilities and Estates.

 Click Here to find out more about our Community Services

 Click Here to find out more about our Mental Health Services

 Click here to find out more about the services in your area

Find out more about NHS Greater Glasgow and Clyde at www.nhsggc.org.uk

NHS Greater Glasgow and Clyde Employee Benefits We offer all our staff excellent benefits including;

 NHS Superannuation pension scheme,  Child Care Vouchers,

 Bursaries to support education and training,

 Interest free loans to purchase Zonecards for trains, buses, underground and some ferries  Cycle to work Interest free Loans to purchase bicycles and equipment

NHS GREATER GLASGOW AND CLYDE SUMMARY OF TERMS AND CONDITIONS

The terms and conditions of service are those approved and amended from time to time by the National Agenda for Change Terms and Conditions Agreement.

Job Title: Specialist Orthoptist

Job Reference Number:

Please ensure you quote the following reference number on your application form and retain it for future reference: 0000037514G

Closing Date: This post closes on 17/07/2015 applications received after that date may not be processed.

Vacancy Enquires To:

For questions specific to the role (working pattern, duties etc) contact; Marie Cleary 0141 211 2053

AFCBand/Grade : Band 6

Salary: £26302.00 to £35225.00

per annum (pro rata where applicable)

Please note that candidates new to the NHS should expect to start at the

entry point of the payscale shown. Click Here for more information

Hours: 37.50

Base: Gartnavel General Hospital

Contract Type: Permanent

Annual Leave:

The basic annual leave entitlement in a full year commencing 1st April to 31st March is 27 Days on appointment rising to 29 Days after five years and 33 Days after 10 years. Leave entiltlement is pro rata where applicable.

Superannuation: All employees are automatically enrolled it the NHS Superannuation Scheme.

Click Here for more information

Confirmation of Eligibility to work in the United Kingdom:

NHSGGC has a legal obligation to ensure that all it’s employees, are legally entitled to work in the United Kingdom. ALL APPLICANTS are required to confirm their right to work in the UK in their application form

Criminal Records Checking

If the advertisement for the post specified a requirement for PVG Scheme membership or a Disclosure Scotland Check you must provide details of any criminal convictions spent and unspent including convictions from overseas in your application form. This information is NOT made available to hiring managers unless you are selected for interview.

Statutory Registration and Professional Membership : Healthcare Support Workers

Jobs that require the post holder to have statutory registration or professional membership will state this within the advertisement or job description. If required

please provide complete and accurate details. The detail you provide will be

confirmed with the relevant regulatory/professional body.

All NHS Scotland postholders that are not governed by a regulatory or professional body are considered to be healthcare support workers. On appointment you will be expected to comply with the new NHS Scotland Mandatory Induction Standards and Code of Conduct for Healthcare Support Workers. Click here for more information

Smoke Free Policy: NHS Greater and Clyde operates a Smoke Free Policy on all premises and

grounds. Click Here for more information

Equal

Opportunities:

NHS Greater Glasgow and Clyde is as an equal opportunities employer. Click Here for more information

NHS GREATER GLASGOW AND CLYDE

1. JOB IDENTIFICATION

Job Title: Specialist Orthoptist

Responsible to: Head of Orthoptic Service / Deputy Head

Department(s): Orthoptic Department, Gartnavel General Hospital Directorate: Surgery and Anaesthetics

2. JOB PURPOSE

To be a specialist Orthoptist working within Orthoptics & Ophthalmology, providing a quality evidence-based service to patients referred to their service.

 To provide a service for patients referred to the Orthoptic department from Acute and Community sectors. This involvesassessment, diagnosis and management of

complex visual and ocular motility disorders, and provision of visual field assessment in order to meet service needs

 To act as a source of expertise on the diagnosis and management of strabismus and ocular motility disorders to patients, consultants, other health care professionals, and general practitioners

 To undertake pre-school vision screening and refer appropriately based on agreed criteria

 To provide clinical training and education for undergraduate orthoptists, medical staff and students, pre-registration optometrists, and nursing staff

 To be involved in audit of Orthoptic practice and contribute to the setting of standards in order to provide a quality service which is evidence-based

3. ROLE OF THE DEPARTMENT The Orthoptic Department

The Orthoptic department at Gartnavel General Hospital is the largest orthoptic department in Greater Glasgow & Clyde Health Board, with 11.96WTE HCPC registered staff and 2 Support Workers. The department serves children living in the South and West of Glasgow, and provides a pre-school vision screening service based on Health for all

Children Report recommendations. We are also a tertiary referral centre for Adult Motility

and Neuro-ophthalmology referrals.

We offer around 25, 000 patient appointments per annum. Most of the workload is out-patient based. Adjustable strabismus surgery cases are seen weekly as day cases.

Our neuro-ophthalmology service includes weekly referrals from neurology, neurosurgery, stroke wards and physically disabled rehabilitation unit (PDRU), and occasionally in-patients are referred from the Beatson oncology centre, ENT and medical wards.

Our patients span a wide range of ages, with approximately half being adults. Adults:

We work as autonomous practitioners, supporting a large ophthalmology service which has a wide range of sub-specialties (see section below re-Ophthalmology), including an

acute ophthalmology referral centre. We investigate, diagnose and manage patients with defects of visual development, binocular vision and abnormalities of eye movement.

Working alongside an adult motility specialist, we receive tertiary referrals for expert opinion. We support the ophthalmologist in adjustable strabismus management, during the immediate post-operative phase, to optimise the surgical outcome.

We diagnose and manage eye movement and visual field defects in patients who have suffered a stroke, contributing to their rehabilitation.

We also provide orthoptic services to Regional Services which receives neurology, neuro-ophthalmology and maxillo-facial referrals from the West of Scotland. Our early assessment of trauma cases informs surgical planning. We carry out perimetry and eye movement assessments in the neuro-ophthalmology clinics, contributing to differential diagnosis and monitoring of pathology. We have contributed to the development of shared care orthoptic-neurology clinics for patients with myasthenia and idiopathic intracranial hypertension, applying extended roles within these.

Children:

Gartnavel Orthoptic department works in partnership with the Royal Hospital for Sick Children, Yorkhill, in receiving paediatric referrals, whose postcode is in West and South Glasgow. A shared-care service with optometrists is provided for all new paediatric cases, as part of our service level agreement with Yorkhill Hospital, and this has eliminated the need for ophthalmology input for the majority of children.

Base and Glasow Sites

The department and post are based at Gartnavel General Hospital which is north of the river Clyde. We also run daily clinics from the New Victoria Hospital and New South Adult Hospital.

Pre-school screening is carried out in nurseries throughout the west and centre of the city, and at Southbank child development centre. Neurology and neuro-ophthalmology clinics are held in the Institute of Neurological Sciences on the South Glasgow site.

.

From an organisational perspective, the Orthoptic department sits with Ophthalmology and Optometry, within the Surgery and Anaesthetics Directorate.

Gartnavel General Hospital – Ophthalmology Department

There has been a long tradition of sub-specialist Ophthalmology based at The Tennent Institute of Ophthalmology in Gartnavel General Hospital. As the major teaching and research department in the West of Scotland the department provides tertiary referral services for a number of ophthalmic subspecialties for the West of Scotland and beyond. These include vitreo-retinal surgery, glaucoma, oculoplastics, ocular oncology, age related macular disease, cornea, retinitis pigmentosa, diabetic eye disease, neuro-ophthalmology, uveitis and ocular motility. This unit has also been responsible for the development of new treatments of eye cancers.

The optometry service provides a regional service in both Low Visual Aid assessment and for medically indicated contact lenses. There is also an expert artificial eye service.

The electrophysiology service has an international reputation. It has developed new diagnostic techniques and established new standards in others.

Acute Services Division of NHS Greater Glasgow and Clyde

hospitals in Scotland. We provide a range of services from community-based care to a full array of general hospital services.

We enjoy close links with Glasgow’s three universities and make a significant contribution to teaching at both undergraduate and postgraduate level. Research also has a high profile within the organisation.

Employing more than 44,000 staff, we serve a core catchment population of 1.2 million. Our patients not only come from Greater Glasgow and Clyde but from the West of Scotland, and for our national services, from the whole of Scotland.

We have eight hospitals north of the River Clyde: Glasgow Royal Infirmary, Western Infirmary, Stobhill Ambulatory Care Hospital, Gartnavel General Hospital, Glasgow Dental Hospital and School, Drumchapel Hospital, Blawarthill Hospital and Lightburn Hospital. South of the river are the Southern General Hospital, the Victoria Infirmary and the new Victoria Ambulatory Care Hospital. The Royal Alexandra Hospital is in Paisley, the Inverclyde Royal Hospital is in Greenock and the Vale of Leven District General Hospital in Alexandria.

As part of the Acute Services review, Ophthalmology in-patient services will be concentrated in Gartnavel General Hospital with services being delivered in a “hub and spoke” model.

The Directorate of Surgery & Anaesthetics is responsible for: General surgery, urology,

endoscopy, ENT and Outpatients, Orthopaedics, Ophthalmology and Theatres. 4. ORGANISATIONAL POSITION

5. SCOPE AND RANGE

The post-holder will be expected to manage a specialist caseload of patients using evidence based/ patient-centred approach to assessment, diagnosis, planning and

Healthcare Assistant / Support Workers Specialist Orthoptists Including Post-holders Specialist Services Myasthenia Idiopathic Intracranial Hypertension

Stroke Oculoplastics Professional responsibility to Managerial responsibility to Lead Orthoptists For specialist services Business Manager Clinical Services Manager Head Orthoptist Includes Lead for Specialist Service

Orthoptists Consultant

Ophthalmologist/ Neurologist responsible for specialist service

Glaucoma

Healthcare Assistant / Support Workers Specialist Orthoptists Including Post-holders Specialist Services Myasthenia Idiopathic Intracranial Hypertension

Stroke Oculoplastics Professional responsibility to Managerial responsibility to Lead Orthoptists For specialist services Business Manager Clinical Services Manager Head Orthoptist Includes Lead for Specialist Service

Orthoptists Consultant

Ophthalmologist/ Neurologist responsible for specialist service Consultant Ophthalmologist/ Neurologist responsible for specialist service

implementation of treatment. Most adults are managed in partnership with the ophthalmologist or neurologist.

Adults

The post-holder will see referrals from a range of referral sources*, usually as part of the adult motility, neuro-ophthalmology, dysthyroid eye disease service and acute eye referral centre.

They will be responsible for:

- assessment including detailed case history, differential diagnosis and management of patients presenting with visual disturbances, strabismus, binocular vision anomalies, eye movement disorders and nystagmus.

- considering the likely aetiological factors for each individual case, including developmental, trauma, a range of medical and neurological disorders

- inform the ophthalmologist / neurologist of the clinical findings and advise appropriate investigations and management based on these

- in patients with orbital trauma, determine the impact of any trauma or fracture on the eye movements and likely prognosis for recovery. This information is essential to the surgeon in planning any intervention

- formulate a management plan in partnership with each patient, explaining risks and benefits, e.g. strabismus surgery or botulinum toxin, in socially-debilitating strabismus - implement immediate treatment which will alleviate debilitating symptoms, e.g. prisms for diplopia, which will help with patient mobility and may allow to return to driving

- motivate patients to comply with treatment, for instance orthoptic exercises by educating - determine urgency of ophthalmologist appointment / onward referral to another specialty based on clinical signs and symptoms, and co-existing medical conditions. This applies particularly to ARC referrals.

- monitor the patients visual status, eye alignment and eye movements, and alert the appropriate medical professional where failure to improve or progression may indicate progressive pathology, which could be sight-threatening or even life-threatening

Referral sources: GPs, community optometrists, ARC, maxillo-facial surgeons, stroke

services, endocrinology, neurology. Internal referrals also come from other ophthalmology sub-specialties or other specialties), In-patient referrals to the neuro-ophthalmology service come from neurology, neuro-surgery and PDRU (physically disabled rehabilitation unit.

Children

Most children are referred by their GP, community optometrist or from the pre-school vision screening service. Some are also referred by their paediatrician, school eye service or educational psychologist because of visual and / or learning / reading difficulties. Most children are under 5 years and some are under 6 months of age.

The post-holder will be responsible for:

- assessment including case history, diagnosis and management of children presenting with strabismus or suspected strabismus, reduced vision, binocular vision anomalies, eye movement disorders, nystagmus and other ocular disorders.

- Instilling eye drops according to the Patient Group Directives

- In partnership with the optometrist, making a decision about the prescription of spectacles, based on clinical findings and professional guidelines

- Monitoring vision, eye alignment and binocular status during the developmental period to ensure full potential is achieved

- Implementing appropriate treatment, in partnership with the parents / carer / child according to local and national professional guidelines and best evidence.

- Monitoring the risks and benefits of any treatment, and adjusting according to individual response, e.g. risk of diplopia in occlusion treatment

- Discussing the timing of surgery with parents / carers and children and referring to the ophthalmologist where this is appropriate

- Recognising clinical signs and symptoms which are outwith the expertise of the orthoptic service, and refer in a timely manner to the appropriate specialist, e.g. failure of visual development

- Be aware of Child Protection Legislation including the DNA policy and alert the appropriate personnel where there is any cause for concern identified, and document this appropriately

- Discharging the child to the care of the community optometrist at the appropriate time Teaching

All orthoptists with 2 years or more clinical experience are involved with undergraduate supervision and teaching and undertake mandatory clinical tutor training, according to objectives set by the universities. Undergraduates come from the 3 UK Universities with Orthoptic undergraduate programmes: Glasgow Caledonian, Liverpool and Sheffield Universities. Supervision and clinical teaching of other health professionals visiting the orthoptic department is a core part of the job, including junior medical staff and medical students, pre-registration optometrists, and nursing staff.

Audit and Research

The post-holder will participate in audit to promote clinical governance and evidence-based practice.

The department has been involved in amblyopia research with Glasgow Caledonian University and Glasgow University, and a multi-centre trial of Thyroid Eye Disease treatment. The post-holder will be encouraged to gain experience in collaborative research.

6. MAIN TASKS, DUTIES/RESPONSIBILITIES Clinical Duties & Responsibilities:

Unless otherwise stated, the following duties and responsibilities are undertaken on a daily basis.

AT BASE

 To be responsible as an autonomous practitioner for the evaluation and measurement of visual acuity and visual behaviour in patients referred to the Hospital Eye Service. This includes babies and infants with strabismus (squint), amblyopia (reduced vision), congenital or developmental abnormalities, children and adults with significant learning and comprehension difficulties. The post-holder will be responsible for the diagnosis, management and communication of prognosis in the majority of paediatric cases (approximately 75% of cases)

 To be responsible as an autonomous practitioner for the assessment, diagnosis,

management and communication of prognosis in all cases of ocular motility defects and binocular vision disorders in patients referred to the Hospital Eye Service. This

encompasses patients of all ages, with complex congenital and acquired conditions, including neurological abnormalities, genetic disorders and associated ocular

 To act as a source of expertise in the diagnosis, management and prognosis of ocular motility and visual development disorders to patients, members of the ophthalmic team including consultants, junior doctors, optometrists, nursing staff, other health care professionals, general practitioners, health visitors, primary care, education and social services

 To be responsible for primary pre-school visual screening (3.5 to 4.5 year olds) of children living in postal code areas assigned to Gartnavel General Hospital, and refer to the hospital eye service as protocol determines. The screening takes place in nurseries on a weekly basis and in hospital clinics of children not attending nursery or who

missed their nursery test.

 To participate in the diagnosis and management of patients with suspected reading difficulties as directed by the lead for this service, with onward referral to an external specialist reading difficulties / visual stress clinic as appropriate

 To take sole responsibility in formulating relevant discharge plans for patients including provision of discharge summaries for those patients still requiring follow up with

community optometrists

 To be responsible for planning, implementing and monitoring individual specialist orthoptic treatment plans/care pathways for patients of all ages using advanced clinical reasoning and evidence based practice, taking into account the patient’s general health and social circumstances. Treatments include orthoptic exercises, occlusion therapy (patching), modification of glasses strength and prismatic correction. Pharmaceutical therapy may be advised, but can only be prescribed by a medical practitioner or appropriately qualified optometrist.

 Make timely and appropriate referrals to the ophthalmologist, optometrist or other health professionals, and recommendation of onward referral to relevant specialities e.g. Neurology.

 Assessment, diagnosis and management of complex adult motility cases e.g.

endocrine, maxillo-facial, myasthenia, retinal, contact lens, acute eye referral centre, oncology, diabetic, vascular disease and stroke.

 In accordance with the patient group directives, to be responsible for the installation of eye drops for diagnostic and refraction purposes.

 To advise on manipulation of spectacle correction to promote best visual acuities, ocular alignment and binocularity

 In addition to taking a detailed case history, to record any associated observations and findings e.g. gait, speech pattern; generalised / facial weakness which may be

indicative of generalised disease, and alert the ophthalmologist to these

 To work as a part of a multi-disciplinary eye care team consisting of ophthalmologists, optometrists, medical technicians, nurses, clerical assistants, etc., having sole

responsibility for the provision of orthoptic information.

 To take the lead in the decision, timing and aims of ocular motility surgery and discuss surgical options with the surgeon based on orthoptic findings and investigation.

 To undertake pre-operative assessment and measurements of strabismus, eye movements and binocular functions, to identify risks and contra-indications and to discuss these with the patients, carers and surgeon.

 To participate in adjustable strabismus case management during the immediate post-operative phase, either in theatre or in the ward setting, in order to optimise ocular alignment and binocular vision outcome, and minimise symptoms

 To undertake post-operative assessment and measurements of strabismus, eye movements and binocular functions, and to communicate the outcome to the patients,

carers and surgeon

 To assess patients’ post-operative outcome and modify treatment accordingly

 To undertake visual field assessment using the Goldmann and Octopus perimeters at the neuro-ophthalmology clinics, once appropriate training has been undertaken in order to inform diagnosis and monitoring of neuro-ophthalmology conditions

 To maintain dated legible and comprehensive patient records of each patient visit, including investigation, diagnosis and management plan

Administrative and Managerial Duties Visual Screening

To be responsible for:

 Checking of consent forms

 Accurate and legible completion of test results using relevant forms, include indicating appropriate urgency of referral

 Collation of statistics pertaining to individual screening sessions,

 Passing on of visual screening results for session to the orthoptic visual screening lead or orthoptic assistant

 Completion of appropriate GP letter for children referred to the Hospital Eye Service  To generate discharge letters for the community optometrist and GP when the patient

is discharged from the Hospital Eye Service

 In-putting of results to appropriate computer systems for the purpose of audit Yorkhill Contract

 Ensure all patients have up-to-date letters sent to GP and other relevant professionals  To input data into departmental databases pertaining to the paediatric service

 To create informative letters to GPs, paediatricians and other professionals where appropriate

 To generate discharge letters for the community optometrist and GP when the patient is discharged from the Hospital Eye Service

GENERAL

 To deal with enquiries that arise during the working day pertaining to individual patient care and take appropriate action

 To be responsible for the care of orthoptic equipment and reporting of faults to medical physics /Head Orthoptist

 To be aware of departmental stock and state of orthoptic equipment sundries, and notify the appropriate staff member of any shortages.

 To utilise the Datix system to document any incidents or near misses

 To ensure that copies of appropriate documentation / orthoptic reports are sent to Yorkhill hospital for children listed for strabismus surgery

 To arrange transfer of care to another Orthoptic department, ensuring completion of appropriate paperwork

 To maintain and utilise departmental information systems currently in use, including patient databases

 To liaise with the Head Orthoptist regarding any problems in service delivery  To carry out any other tasks or duties delegated by the Head of Department Teaching Duties

ORTHOPTIC STUDENTS

The Orthoptic department is an approved Practice Placement for Orthoptic

undergraduates from all 3 UK Universities, taking block 2 to 4 week placements for 16 weeks per annum and daily local placements during each semester:

 To teach theory and practice of Orthoptics to undergraduate orthoptic students in a clinical setting, and to assess performance against set criteria.

 Ensure completion of daily assessment forms for all student teaching/supervision experiences.

 Prepare and deliver tutorials and undertake other clinical teaching roles to meet student learning needs.

 Deliver informal verbal and written feedback to individual students throughout the placement.

 Act as a professional role model to undergraduate students POST-GRADUATE TEACHING

Informal Teaching Duties

 Occasionally be involved with the clinical teaching of pre-registration optometrists, junior medical staff (working towards professional examinations), and other health professionals.

Professional Orthoptic Duties

 To maintain an up-to-date knowledge of techniques and technology, and attend appropriate training events in line with CPD requirements

 To participate in annual KSF and Personal Development Planning (PDP’s)  To attend and contribute to Orthoptic departmental staff meetings

 To promote best practice using results of departmental audit and current literature  To comply with Infection Control Policies and practice, e.g. completion of daily SOPs,

wearing of appropriate uniform and dress code

 To observe safe working practices and equipment procedures, complying with legislative requirements under Health & Safety regulations, e.g. Fire, Moving and Handling, Notification of Absence, etc.

 To comply with Health & Safety regulations and report any issues to the Head of Department / Health & Safety rep., and notify estates of any essential work in a timely fashion

 To respect patient and staff confidentiality at all times  To comply with Data Protection policy

 To provide formal verbal and written reporting of attendance at professional meetings to colleagues.

 To participate in departmental audit and / or research for the purposes of promoting evidence-based practice

The duties and responsibilities contained within this job description are indicative but not exhaustive. The post holder will be fully involved and consulted as changes occur. 7a. EQUIPMENT AND MACHINERY

 As an autonomous practitioner to develop individual care packages while being cognisant of general professional and departmental guidelines.

including investigations, diagnosis and management plan. Equipment

Use of various complex pieces of equipment, which require specialist knowledge of optics. Responsibility for reporting of faults to the medical physics and / or head of department with responsibility for maintenance of general orthoptic equipment.

Specialist orthoptic equipment

- Lees screen (quantifying eye muscle / nerve defects)

- Aimark perimeter (to assess area of binocular field or range of eye movements in individual cases)

- Visuscope / Professional ophthalmoscope (to assess point / area at back of the eye use for vision which has prognostic value for visual function)

- Synoptophore (for assessing and measuring binocular functions, ocular motility defects and squint)

- Focimeter (to measure the strength of glasses)

- Other orthoptic equipment – for age-appropriate vision testing, binocular function and squint assessment

- Goldmann perimeter - Octopus visual field analyser 7B. Systems

Microsoft Word – for correspondence; staff minutes Microsoft Access – patient dBases

Microsoft Excel – patient dBases

Microsoft Powerpoint – for case presentations / posters

Internet/Intranet, NHS e-library – for audit, research and CPD purposes Clinical Portal and Trakcare

8. DECISIONS AND JUDGEMENTS On a daily basis:

 To act as an autonomous practitioner in determining the diagnosis, prognosis and management in patients with binocular vision abnormalities, amblyopia (reduced vision in one or both eyes) and / or eye movement disorders, working within professional and departmental guidelines and codes of conduct.

 Where clinical signs and symptoms do not fall into particular categories, to provide specialist opinion on differential diagnosis where aetiology is unclear or information limited.

 To liaise closely with the ophthalmologist and indirectly with the maxillo-facial team as regards need and timing of surgery, and follow-up.

 To formulate and implement specialist individual management and treatment plans using clinical reasoning and a wide range of treatment skills, in partnership with patients and carers. These include orthoptic exercises, occlusion therapy (patching), correction and modification of glasses strength, prismatic correction, coloured

overlays (in the treatment of specific learning difficulties) and pharmaceutical therapy (eye drops or ointment)

 Effective communication skills are essential in order to assess patient and/or carers capacity to comprehend treatment plans, obtain informed consent and ensure

compliance, with explanation of the risks and benefits of proposed treatments.  Make timely and appropriate referrals to the ophthalmologist, optometrist or other

health professional, e.g.:

- changes in eye movements or visual status which may indicate development of new disease or disease progression;

- decision of timing and type of surgery (to discuss surgical options with the surgeon based on orthoptic findings and measurements).

- to be aware of failure to meet normal milestones, in terms of development, behaviour and vision.

 To assess on an individual patient basis suitability for discharge and the need for long-term follow-up with Community Optometrists, and provide a discharge summary to this effect.

 To independently discharge patients from the Orthoptic Department.

 To frequently deal with a range of verbal and written enquiries from patients and other health professionals, triage these, and advise the enquirer.

 To recognise contra-indications to the routine use of eye drops for the purpose of diagnoses and refraction and document as appropriate.

 Appropriate time-management of non-clinical sessions to meet service and individual professional development needs.

On an occasional basis:

 To recognise the need for peer opinion in complex cases. 9. COMMUNICATIONS AND RELATIONSHIPS

Communication with: 1. Patients 2. Parents 3. Carers 4. Consultant Ophthalmologists 5. Junior Ophthalmologists 6. Hospital Optometrists 7. Pre-registration Optometrists

8. Ophthalmology nursing & ancillary staff 9. Ophthalmology Photographers 10. Maxillo-facial surgeons 11. Community Optometrists 12. GP’s 13. Health Visitors 14. School Nurses

15. Orthoptic colleagues in other hospitals 16. Other Allied Health Professions

17. Clerical & secretarial staff

18. Other health professionals, including medical staff from different disciplines 19. Orthoptic undergraduates

20.The general public / visitors

21. Other hospital staff eg. Library; Maintenance; Catering; Cleaning 22. Interpreters

Type & Purpose of communication Type

 verbal face-to-face or by telephone: individual and small group.  written

 via an interpreter

 by practical demonstration Purposes

 To show empathy and communicate tactfully complex and sensitive information in an understandable form to patients, parents and carers, answering their questions and taking account of their concerns and wishes. This may involve giving unwelcome or difficult information, eg poor eyesight which impacts on educational needs, job choices and the ability to drive.

 To motivate and persuade patients, parents / carers to comply with investigations where there may be significant barriers to understanding, such as autism or cognitive problems.

 To gain acceptance for treatments and motivate and persuade patients, parents / carers to comply with these.

 To communicate the initial potential diagnosis, which may be of a distressing nature.  To produce informative reports and discharge summaries for other professionals

involved in the patient’s care.

 To communicate effectively with patients and carers in order to establish a detailed case history and determine patient concerns and wishes / needs

 To gather information and contribute to the patients care effectively as part of a multi-disciplinary team

 To deal with verbal and written enquiries from patients/parents/carers and other professionals and action these accordingly.

 To request appropriate appointment intervals for patient follow-up and to request patient case records from clerical staff.

 To communicate the theory and practice of orthoptics to various student and staff groups, tailoring the content and level of information to the needs of the students.  To order or request repair of Orthoptic equipment or general estates maintenance.  To develop individual or group knowledge eg. via departmental presentations of

literature reviews or case presentations.

 To contribute as part of a uni-disciplinary or multi-disciplinary team for the purpose of audit & research.

 To promote understanding of the profession among the general public and other health professionals.

 To provide directions to members of the public and visitors to other departments within the base hospital site.

Difficulties encountered

Barriers to communication and comprehension are frequently encountered. These barriers may be due to patients / carers:

 who are pre verbal.  with poor understanding.  who are anxious.

 who have learning difficulties.

difficulties.

 do not have English as their first language.  who have cognitive impairment.

The post-holder will have to deal with a high proportion of children who require to be encouraged and motivated to co-operate with assessment. Treatment is often highly stressful, such as occlusion (patching) at home / school. This may include the necessity to explain and instill cycloplegic, (dilating drops).

The post-holder will require to take into account the patient’s other medical and social conditions when developing their individual care plan.

The post-holder will require highly developed communication skills to explain complex medical conditions, with sensitivity to the individual patient’s level of comprehension, in an understandable format where patients or parents/carers have no knowledge of the ocular defects or associated medical conditions.

The post-holder will require developed communication and persuasive skills where patient or parents/carers have difficulty accepting the diagnosis and/or prognosis. This include repetition of advice or explanation where the patient is concerned or there is a lack o understanding, using different terminology to aid understanding.

10. PHYSICAL, MENTAL, EMOTIONAL AND ENVIRONMENTAL DEMANDS OF THE JO 10.1 Physical Skills

 Good manual dexterity, and hand-eye co-ordination for all clinical assessments  Often work with children who have poor concentration, therefore highly specialised

task.

 Accurate use of visuscope / ophthalmoscope requires high level of skill and precision

 Speed and manual dexterity is essential for instillation of eye drops, particularly in children

 Adaptation to assessment environment, which is regularly unsuitable for examination, eg. clinical areas with fixed chairs, ward and recovery area  Keyboard skills, eg. for entering patient data into databases

 Driving between sites as required 10.2 Physical Effort

 Patient examination regularly requires uncomfortable working positions including leaning forwards and sideways, kneeling, bending and twisting to assess infants, working whilst maintaining an awkward posture to ensure working at eye level with the patient, eg. for squint measurement, visuscopic examination, whilst

manipulating equipment. These positions require to be maintained for

approximately 80-90% of the working day. Approximately 60% of work is with children, therefore continual adjustments to testing position are required. In addition, the clinical environment may not always be suitable for orthoptic

assessment. The clinical and staff area temperatures are frequently excessive, and lack natural daylight

 Combination of walking, sitting, standing and kneeling continually.

 Occasional manoeuvring patients in wheelchairs to best testing position.  Occasional moving of equipment.

 Frequent requirement to set patients up at machines correctly involves standing, bending and twisting.

10.3 Mental Demands

 All sessions require continual concentration and significant mental effort to ensure appropriate investigation, diagnosis and management

 Regularly being the first point of contact for patients with recently acquired signs and symptoms of ophthalmic, neurological and systemic disease and responding to their questions and anxieties

 Dealing with emotional and distressed patients, parents, carers

 Maintenance of concentration during clinical sessions despite regular interruptions eg telephone inquiries.

 Dealing with disruptive and / or aggressive behaviour from patients / parents and relatives. The job-holder will usually assess patients in individual separate clinical rooms with a degree of vulnerability.

 Significant mental effort is required when participating in clinical supervision/teaching

 Significant mental effort is required when participating in clinical audit and research 10.4 Environmental Demands

 The orthoptic deparment is extremely hot and poorly ventilated, which can cause staff and patient discomfort

 The orthoptic department office is extremely small and there is limited access to computers

 The orthoptic department has little natural lighting

 Working conditions are often unpleasant with exposure to fleas, lice, childhood illnesses, MRSA, odours, body fluids, etc.

 When performing visual fields the orthoptist must work in the dark throughout the assessment, which can take up to 20 minutes. The orthoptist may be carrying out fields continually during a 7.5 hour working day, with little exposure to daylight  When performing Goldmann visual fields or uniocular fields of fixation, the

orthoptist is working in a confined space

 The post holder is in regular contact with soiled dressings (eg eye pads and patches), occlusive tapes and fresnel prisms

 The orthoptic department is situated beside the hospital canteen, therefore there are frequent smells emanating from this area

11. MOST CHALLENGING/DIFFICULT PARTS OF THE JOB

 All sessions require continual concentration and significant mental effort to ensure appropriate investigation, diagnosis and management. This is required when dealing with emotional and distressed patients, parents, carers, e.g. parents who are unaware of their or their child’s visual deficit and prognosis, and adults who cannot drive because of their diplopia. The post-holder will regularly be required to advise and counsel patients with progressive conditions e.g. Dysthyroid Eye

Disease, Myasthenia Gravis, Chronic Progressive external Ophthalmoplegia (CPEO).

 The post-holder is regularly the first point of contact for patients with recently acquired signs and symptoms of ophthalmic, neurological and systemic disease. These patients are confused, anxious and scared, requiring reassurance and empathy. The post-holder will also be expected to deliver unwelcome news to patients and carers with regard to prognosis. Frequently the post-holder will manage patients with complex health and social needs

 Advanced orthoptic skills are required for the accurate assessment of patients, and advance communication skills are required to liaise effectively with patients and/or carers. Vision is a significant factor in functional abilities regarding education, employment, independent living and quality of life therefore advanced clinical reasoning skills are required in order to integrate orthoptic management into a holistic health and social care package.

 Patients, including children, with significant sight defects require a considerable degree of empathy and family support. In adults the diagnosis of acute onset ocular motility defects requires a significantly high level of anatomical and

neurological knowledge when there may be a need to make a differential diagnosis between clinical conditions.

 The post-holder will have to prioritise their workload during busy times in terms of clinical and administrative duties, including infection control measures

 The post-holder must keep up to date with hospital and departmental protocols.

12. KNOWLEDGE, TRAINING AND EXPERIENCE REQUIRED TO DO THE JOB Essential

To possess a BSc in Orthoptics, B MedSci (Orthoptics) and/or a Diploma of the British Orthoptic Council (DBO).

To be state registered with the Health Professions Council (HPC). To possess minimum of 5 years post-graduate clinical experience To have evidence of up-to-date CPD activity

To have good interpersonal and communication skills with patients, and to maintain a good rapport with colleagues and staff at all levels.

To demonstrate the ability to work with a large cross section of the population including children, elderly patients and those with learning difficulties.

To have experience of working effectively as part of a multi-disciplinary team or independently.

To demonstrate understanding of professionalism in relation to patient confidentiality. To be aware and comply with organisational and departmental policies and procedures. To have experience of clinical teaching and supervision, and have undertaken appropriate post-graduate practice education training, or be willing to undertake this.

Desirable

To have experience of working with patients with neurological disorders

To demonstrate a knowledge and understanding of professional issues locally and nationally.

To have experience of audit.

To have the ability to accept responsibility beyond that of the post To hold a current UK driving license and have own transport

The post holder is expected at all times to practice competencies that demonstrate insight, understanding and mutual respect of patients, their families, carers and work colleagues. Whether in a clinical or non clinical role the post holder is expected at all times to be an exemplar of person centred care, embracing their Code of Conduct to a high standard as part of an integrated health professional team.