Dysphagia Lead Speech and Language Therapist

Job description

Job summary

Are you an experienced Speech and Language Therapist with a passion for dysphagia and a desire to shape and develop excellent services?

We have an exciting opportunity for a highly skilled and enthusiastic SLT to join our team as a dysphagia lead at Worcestershire Acute Hospitals NHS Trust.

This is an opportunity to combine highly specialist clinical practice with clinical leadership, education, quality improvement and service development. You will have the opportunity to influence dysphagia care across the Trust, supporting colleagues and multidisciplinary teams to deliver safe, evidence based and person centred care.

As our dysphagia lead, you will provide Trust wide clinical experience and specialist expertise for adults with complex swallowing difficulties.

Instrumental assessment is an important part of the role, and you will support the development of FEES and VF services. You will also provide specialist input for patients with tracheostomies. Training and support can be given in these areas if needed.

Alongside your clinical work you will have the opportunity to make a real difference to how dysphagia care develops across our hospitals. You will lead and contribute to clinical pathways, guidelines, competency frameworks, audit, quality improvement and dysphagia related education and training.

We are looking for an experienced SLT who can bring enthusiasm, clinical expertise and leadership to this role.

Main duties of the job

1. To provide Trust-wide clinical leadership and highlyspecialist expertise in the assessment and management of adults with complexdysphagia, acting as an autonomous practitioner and expert clinical resource.

2. To lead the development, delivery, evaluation andcontinuous improvement of safe, effective and evidence-based dysphagia practiceacross Worcestershire Acute Hospitals NHS Trust.

3. To provide highly specialist instrumental assessment ofswallowing, including Fibreoptic Endoscopic Evaluation of Swallowing (FEES) andvideofluoroscopy, interpreting complex findings and formulating appropriatemanagement recommendations.

4. To provide expert assessment and management for patientswith complex dysphagia, including patients with tracheostomies and thosereceiving critical care.

5. To provide specialist clinical advice, second opinions,supervision and competency support to Speech and Language Therapists workingwith dysphagia.

6. To lead dysphagia-related clinical governance, audit,quality improvement, policy and pathway development, supporting theidentification, escalation and reduction of clinical risk.

7. To lead and coordinate dysphagia education and trainingfor relevant staff across the Trust.

8. To work collaboratively with patients, carers and themultidisciplinary team, influencing complex clinical decision-making andsupporting safe transfer of care for patients with ongoing dysphagia needs.

About us

Worcestershire Acute Hospitals NHS Trust is a largeacute and specialised hospital trust that provides a range of local acuteservices to the residents of Worcestershire and more specialised services to alarger population in Herefordshire and beyond.

The Trust operates hospital-based services fromthree sites in Kidderminster, Redditch and Worcester

Our workforce is more than 7,000 strong, and ourcaring staff are recognised as providing good and outstanding patient-centredcare. You could be one of them.

We are committed to recruiting the best people towork with us. Our values, which we ask all staff to demonstrate, underpin oureveryday work and remain firmly at the heart of all we do.

Being open and honest

Ensuring people feel cared for

Showing respect to everyone

We are committed to developing a culture of continuous improvement by embedding the principles of our Improvement System.

We are proud to have achieved Timewiseaccreditation - this means we are committed to embedding flexible workingwithin our organisation as a flex positive employer.

DBS Checks and Costs

Any applicants who are offered posts requiring aDBS check as part of their employment check will have the cost of this check(at the current rate) deducted from their salary. Please see link in SupportingInformation section for more details on DBS checks and costs.

Job description

Job responsibilities

Clinical

1. Work as an experienced autonomous practitioner,professionally and legally accountable for all aspects of own practice and formaintaining a high standard of patient-centred care.

2. Undertake comprehensive specialist assessment,differential diagnosis and management of patients with complex dysphagia,integrating clinical history, examination findings, instrumental assessment andrelevant medical information.

3. Analyse and interpret highly complex and sometimesconflicting clinical information to formulate individualised management plans,including recommendations regarding oral intake, rehabilitation, compensatorystrategies and onward referral.

4. Undertake FEES and videofluoroscopy within own scope ofcompetence, contributing to diagnosis, treatment planning and review, andsupporting safe governance of instrumental swallowing assessment.

5. Provide highly specialist dysphagia assessment andmanagement for patients with tracheostomies and patients in critical care,working closely with the multidisciplinary team.

6. Provide expert clinical advice and second opinions forcomplex, high-risk or unusual dysphagia presentations and support appropriateescalation where clinical risk is identified.

7. Assess capacity and obtain valid informed consent inaccordance with relevant legislation and Trust policy, contributing tobest-interest and risk-management discussions where appropriate.

8. Communicate complex and sensitive information regardingswallowing, aspiration risk, nutrition and hydration and management options topatients, relatives, carers and professionals, including situations where thereare barriers to understanding or differing views.

9. Work collaboratively with ward and community teams tosupport safe transfer of care, ensuring clear communication of swallowingrecommendations and onward referral where required.

ClinicalLeadership and Service Development

1. Act as the Trust clinical lead and expert resource fordysphagia, providing professional leadership and promoting consistently highstandards of dysphagia care.

2. Lead the development, implementation and review ofdysphagia pathways, clinical guidelines, standard operating procedures andcompetency frameworks in line with current evidence, professional guidance andTrust governance requirements.

3. Identify opportunities for service improvement and leador contribute to quality improvement initiatives that improve patient safety,experience, outcomes, efficiency and equity of access.

4. Work collaboratively with the Operational Lead SLT andrelevant team leads regarding service pressures, clinical priorities anddysphagia-related risks. Routine staffing, caseload allocation and coverarrangements remain the responsibility of operational/team leads.

5. Influence multidisciplinary practice and decision-makingrelating to dysphagia, including the management of complex clinical risk.

6. Support the development and evaluation of instrumentaldysphagia services, including FEES and videofluoroscopy, promoting equitableand clinically appropriate access.

7. Maintain effective professional networks with relevantinternal and external services, professional groups, universities and researchnetworks.

ClinicalGovernance, Quality and Risk

1. Lead dysphagia-related clinical governance activity,including audit, service evaluation, quality improvement and the use ofrelevant outcome measures.

2. Monitor and evaluate the quality, safety andeffectiveness of dysphagia practice and use data, feedback, incidents and auditfindings to inform improvement.

3. Contribute specialist dysphagia expertise to the reviewand investigation of relevant incidents, complaints and clinical risks,identifying learning and supporting implementation of actions.

4. Promote evidence-based practice by critically appraisingnew evidence and national/professional guidance and translating relevantfindings into local practice.

5. Ensure dysphagia-related policies, procedures andclinical resources are reviewed and updated appropriately.

6. Promote safe practice in relation to infectionprevention and control, equipment, record keeping, information governance andrisk management.

Education,Training and Clinical Supervision

1. Lead and coordinate a programme of dysphagia educationand training for SLTs and relevant members of the wider multidisciplinaryworkforce across Trust sites.

2. Provide clinical supervision, specialist advice andcompetency support to SLTs developing or maintaining dysphagia skills.

3. Support competency development in specialist areasincluding instrumental assessment, tracheostomy and complex dysphagia wherethis falls within the post holder's scope of practice.

4. Contribute to undergraduate and postgraduate education,including supervision and teaching of Speech and Language Therapy students.

5. Support induction and development of new staff andcontribute to multidisciplinary education relating to dysphagia.

6. Maintain own continuing professional development andspecialist competencies, reflecting on practice and maintaining anevidence-based professional portfolio in accordance with HCPC and RCSLTrequirements.

7. Participate in annual appraisal/PDR as an appraisee and,where formally delegated, contribute to PDR or development review processes forother staff.

Communicationand Collaborative Working

1. Establish and maintain effective communication networksfor dysphagia across the Trust and with relevant community and externalservices.

2. Communicate highly complex, sensitive or contentiousinformation effectively, adapting communication to the needs of patients,carers and colleagues.

3. Work collaboratively with medical, nursing, dietetic,pharmacy, therapy, radiology, critical care and other colleagues to ensurecoordinated multidisciplinary dysphagia care.

4. Promote awareness of the role and contribution of Speechand Language Therapy in dysphagia management and patient safety.

5. Build constructive relationships across professional andorganisational boundaries and contribute specialist expertise to relevantmeetings, working groups and service-development forums.

Organisationand Management

1. Prioritise and manage own specialist clinical workloadeffectively, responding appropriately to clinical urgency and risk.

2. Use resources responsibly and contribute to serviceplanning by identifying dysphagia-related demand, capacity, risk anddevelopment needs.

3. Contribute to recruitment and selection whereappropriate.

4. Contribute to the review of referral criteria andpathways for dysphagia services.

5. Collect and interpret relevant activity, outcome andquality data to support service evaluation, governance and planning.

6. This post provides clinical leadership for dysphagia.Routine line management, day-to-day staff deployment and operational coverarrangements are not inherent responsibilities of the role unless separatelyand explicitly delegated.

Job description
Job responsibilities

Clinical

1. Work as an experienced autonomous practitioner,professionally and legally accountable for all aspects of own practice and formaintaining a high standard of patient-centred care.

2. Undertake comprehensive specialist assessment,differential diagnosis and management of patients with complex dysphagia,integrating clinical history, examination findings, instrumental assessment andrelevant medical information.

3. Analyse and interpret highly complex and sometimesconflicting clinical information to formulate individualised management plans,including recommendations regarding oral intake, rehabilitation, compensatorystrategies and onward referral.

4. Undertake FEES and videofluoroscopy within own scope ofcompetence, contributing to diagnosis, treatment planning and review, andsupporting safe governance of instrumental swallowing assessment.

5. Provide highly specialist dysphagia assessment andmanagement for patients with tracheostomies and patients in critical care,working closely with the multidisciplinary team.

6. Provide expert clinical advice and second opinions forcomplex, high-risk or unusual dysphagia presentations and support appropriateescalation where clinical risk is identified.

7. Assess capacity and obtain valid informed consent inaccordance with relevant legislation and Trust policy, contributing tobest-interest and risk-management discussions where appropriate.

8. Communicate complex and sensitive information regardingswallowing, aspiration risk, nutrition and hydration and management options topatients, relatives, carers and professionals, including situations where thereare barriers to understanding or differing views.

9. Work collaboratively with ward and community teams tosupport safe transfer of care, ensuring clear communication of swallowingrecommendations and onward referral where required.

ClinicalLeadership and Service Development

1. Act as the Trust clinical lead and expert resource fordysphagia, providing professional leadership and promoting consistently highstandards of dysphagia care.

2. Lead the development, implementation and review ofdysphagia pathways, clinical guidelines, standard operating procedures andcompetency frameworks in line with current evidence, professional guidance andTrust governance requirements.

3. Identify opportunities for service improvement and leador contribute to quality improvement initiatives that improve patient safety,experience, outcomes, efficiency and equity of access.

4. Work collaboratively with the Operational Lead SLT andrelevant team leads regarding service pressures, clinical priorities anddysphagia-related risks. Routine staffing, caseload allocation and coverarrangements remain the responsibility of operational/team leads.

5. Influence multidisciplinary practice and decision-makingrelating to dysphagia, including the management of complex clinical risk.

6. Support the development and evaluation of instrumentaldysphagia services, including FEES and videofluoroscopy, promoting equitableand clinically appropriate access.

7. Maintain effective professional networks with relevantinternal and external services, professional groups, universities and researchnetworks.

ClinicalGovernance, Quality and Risk

1. Lead dysphagia-related clinical governance activity,including audit, service evaluation, quality improvement and the use ofrelevant outcome measures.

2. Monitor and evaluate the quality, safety andeffectiveness of dysphagia practice and use data, feedback, incidents and auditfindings to inform improvement.

3. Contribute specialist dysphagia expertise to the reviewand investigation of relevant incidents, complaints and clinical risks,identifying learning and supporting implementation of actions.

4. Promote evidence-based practice by critically appraisingnew evidence and national/professional guidance and translating relevantfindings into local practice.

5. Ensure dysphagia-related policies, procedures andclinical resources are reviewed and updated appropriately.

6. Promote safe practice in relation to infectionprevention and control, equipment, record keeping, information governance andrisk management.

Education,Training and Clinical Supervision

1. Lead and coordinate a programme of dysphagia educationand training for SLTs and relevant members of the wider multidisciplinaryworkforce across Trust sites.

2. Provide clinical supervision, specialist advice andcompetency support to SLTs developing or maintaining dysphagia skills.

3. Support competency development in specialist areasincluding instrumental assessment, tracheostomy and complex dysphagia wherethis falls within the post holder's scope of practice.

4. Contribute to undergraduate and postgraduate education,including supervision and teaching of Speech and Language Therapy students.

5. Support induction and development of new staff andcontribute to multidisciplinary education relating to dysphagia.

6. Maintain own continuing professional development andspecialist competencies, reflecting on practice and maintaining anevidence-based professional portfolio in accordance with HCPC and RCSLTrequirements.

7. Participate in annual appraisal/PDR as an appraisee and,where formally delegated, contribute to PDR or development review processes forother staff.

Communicationand Collaborative Working

1. Establish and maintain effective communication networksfor dysphagia across the Trust and with relevant community and externalservices.

2. Communicate highly complex, sensitive or contentiousinformation effectively, adapting communication to the needs of patients,carers and colleagues.

3. Work collaboratively with medical, nursing, dietetic,pharmacy, therapy, radiology, critical care and other colleagues to ensurecoordinated multidisciplinary dysphagia care.

4. Promote awareness of the role and contribution of Speechand Language Therapy in dysphagia management and patient safety.

5. Build constructive relationships across professional andorganisational boundaries and contribute specialist expertise to relevantmeetings, working groups and service-development forums.

Organisationand Management

1. Prioritise and manage own specialist clinical workloadeffectively, responding appropriately to clinical urgency and risk.

2. Use resources responsibly and contribute to serviceplanning by identifying dysphagia-related demand, capacity, risk anddevelopment needs.

3. Contribute to recruitment and selection whereappropriate.

4. Contribute to the review of referral criteria andpathways for dysphagia services.

5. Collect and interpret relevant activity, outcome andquality data to support service evaluation, governance and planning.

6. This post provides clinical leadership for dysphagia.Routine line management, day-to-day staff deployment and operational coverarrangements are not inherent responsibilities of the role unless separatelyand explicitly delegated.

Person Specification

Qualifications

Essential

• Degree or equivalent recognised qualification in Speech and Language Therapy
• Current HCPC registration as a Speech and Language Therapist
• Evidence of relevant postgraduate education and training in adult dysphagia
• Evidence of ongoing CPD relevant to highly specialist dysphagia practice

Desirable

• Postgraduate study at Master's level or equivalent
• Leadership/service improvement training
• Clinical educator/supervision qualification or training

Experience

Essential

• Significant post-registration SLT experience, including substantial experience in adult dysphagia
• Highly specialist knowledge and experience in assessment and management of complex adult dysphagia
• Demonstrable competence in clinical dysphagia assessment and management at a highly specialist level
• Experience of managing complex clinical risk and making autonomous clinical decisions
• Experience of working within an acute hospital multidisciplinary environment
• Experience in assessment and management of patients with tracheostomy
• Competent in videofluoroscopic assessment of swallowing or evidence of advanced progress towards independent competence with ability to achieve full competence within an agreed timeframe
• Independent competence in FEES, or evidence of advanced progress towards independent competence with ability to achieve full competence within an agreed timeframe
• Knowledge of relevant professional guidance and evidence relating to dysphagia

Desirable

• Experience across a range of acute specialties, e.g. stroke, critical care, respiratory, frailty, neurology
• Experience of developing or expanding an instrumental assessment service
• Advanced tracheostomy experience
• FEES supervisor/mentor level competence
• Experience of complex shared decision-making/eating and drinking with acknowledged risks
• Experience across organisational boundaries/community interfaces

Knowledge and Skills

Essential

• Sound knowledge of clinical governance, patient safety, risk management and evidence-based practice
• Experience of clinical audit/service evaluation and implementing improvements arising from findings
• Experience of quality improvement/service improvement
• Ability to critically appraise evidence and translate evidence/guidance into clinical practice

Desirable

• Experience contributing to investigation of incidents or complaints
• Formal QI methodology training
• Research experience, publication or presentation
• Experience presenting audit/QI work beyond own service

Personal Qualities

Essential

• Highly developed verbal and written communication skills
• Ability to communicate complex, sensitive and potentially contentious information to patients, carers and professionals
• Evidence of effective multidisciplinary working and ability to influence clinical decision-making
• Ability to manage differences of professional opinion constructively and advocate for safe, patient-centred dysphagia care
• Demonstrates advanced clinical reasoning and sound professional judgement
• Able to work autonomously and take responsibility for complex clinical decisions within scope of practice
• Demonstrates clinical leadership, professional credibility and ability to act as a positive role model
• Able to prioritise competing demands and respond appropriately to clinical risk
• Able to work collaboratively and build effective professional relationships
• Demonstrates commitment to equality, diversity, inclusion and person-centred care
• Demonstrates behaviours consistent with Trust values: being open and honest, ensuring people feel cared for, and showing respect for everyone

Desirable

• Previous formal clinical lead experience
• Experience of business case or service redesign work
• Formal leadership/management development

Person Specification
Qualifications

Essential

• Degree or equivalent recognised qualification in Speech and Language Therapy
• Current HCPC registration as a Speech and Language Therapist
• Evidence of relevant postgraduate education and training in adult dysphagia
• Evidence of ongoing CPD relevant to highly specialist dysphagia practice

Desirable

• Postgraduate study at Master's level or equivalent
• Leadership/service improvement training
• Clinical educator/supervision qualification or training

Experience

Essential

• Significant post-registration SLT experience, including substantial experience in adult dysphagia
• Highly specialist knowledge and experience in assessment and management of complex adult dysphagia
• Demonstrable competence in clinical dysphagia assessment and management at a highly specialist level
• Experience of managing complex clinical risk and making autonomous clinical decisions
• Experience of working within an acute hospital multidisciplinary environment
• Experience in assessment and management of patients with tracheostomy
• Competent in videofluoroscopic assessment of swallowing or evidence of advanced progress towards independent competence with ability to achieve full competence within an agreed timeframe
• Independent competence in FEES, or evidence of advanced progress towards independent competence with ability to achieve full competence within an agreed timeframe
• Knowledge of relevant professional guidance and evidence relating to dysphagia

Desirable

• Experience across a range of acute specialties, e.g. stroke, critical care, respiratory, frailty, neurology
• Experience of developing or expanding an instrumental assessment service
• Advanced tracheostomy experience
• FEES supervisor/mentor level competence
• Experience of complex shared decision-making/eating and drinking with acknowledged risks
• Experience across organisational boundaries/community interfaces

Knowledge and Skills

Essential

• Sound knowledge of clinical governance, patient safety, risk management and evidence-based practice
• Experience of clinical audit/service evaluation and implementing improvements arising from findings
• Experience of quality improvement/service improvement
• Ability to critically appraise evidence and translate evidence/guidance into clinical practice

Desirable

• Experience contributing to investigation of incidents or complaints
• Formal QI methodology training
• Research experience, publication or presentation
• Experience presenting audit/QI work beyond own service

Personal Qualities

Essential

• Highly developed verbal and written communication skills
• Ability to communicate complex, sensitive and potentially contentious information to patients, carers and professionals
• Evidence of effective multidisciplinary working and ability to influence clinical decision-making
• Ability to manage differences of professional opinion constructively and advocate for safe, patient-centred dysphagia care
• Demonstrates advanced clinical reasoning and sound professional judgement
• Able to work autonomously and take responsibility for complex clinical decisions within scope of practice
• Demonstrates clinical leadership, professional credibility and ability to act as a positive role model
• Able to prioritise competing demands and respond appropriately to clinical risk
• Able to work collaboratively and build effective professional relationships
• Demonstrates commitment to equality, diversity, inclusion and person-centred care
• Demonstrates behaviours consistent with Trust values: being open and honest, ensuring people feel cared for, and showing respect for everyone

Desirable

• Previous formal clinical lead experience
• Experience of business case or service redesign work
• Formal leadership/management development

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the .

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. .
UK Registration

Applicants must have current UK professional registration. For further information please see

Additional information
Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.
Certificate of Sponsorship

Applications from job seekers who require current Skilled worker sponsorship to work in the UK are welcome and will be considered alongside all other applications. For further information visit the .

From 6 April 2017, skilled worker applicants, applying for entry clearance into the UK, have had to present a criminal record certificate from each country they have resided continuously or cumulatively for 12 months or more in the past 10 years. Adult dependants (over 18 years old) are also subject to this requirement. .
UK Registration

Applicants must have current UK professional registration. For further information please see

Employer details

Employer name

Worcestershire Acute Hospitals NHS Trust
Address

Charles Hastings Way

Worcester

Worcestershire

WR5 1DD

United Kingdom

Employer's website