Band 6 Bladder & Bowel Clinical Specialist

Detailed Job Description and Main Responsibilities

They will undertake the clinical assessment, supervised diagnosis, planning, implementation, and treatment of patients with bladder and bowel dysfunction and evaluate individualized programmes of care for patients with mild to moderate bladder and bowel care needs. They will be clinically supported in the management of patients with complex benign and neurological bladder and bowel dysfunction.

They will be required to take responsibility for prioritizing their own workload and caseload along with identifying and reporting areas of risk management concerns.

Work in accordance with the NMC code of professional conduct or similar professional body.

The Bladder and Bowel Specialist Clinician will be responsible and accountable for the direct delivery of a clinical caseload in either a clinic setting or the community.

Undertake holistic assessments of patients with bladder and bowel dysfunction using up-to-date knowledge and skills, including physical examination and bladder ultrasonography and interpretation of results in planning care.

Plan, implement, and evaluate care ensuring patient safety at all times.

Ensure patient/carers are provided with relevant written information regarding their plan of care.

Provide clinical care that is evidence-based and appropriate to the needs of the patient.

Refer to other professionals for any specialist support that the patient may require as appropriate.

Be able to promote patient autonomy through education and support so that an individual can make informed decisions about their care.

Act as the support and contact for individual patient care management between other agencies.

Communicate effectively and support clients and their carers when dealing with embarrassing and distressing situations caused by their bladder and/or bowel dysfunction. Demonstrating sound empathic interpersonal and communication skills in dealing with patients and carers through the patient pathway.

Adhere to trusts medicines management guidelines when independently prescribing medication and appliances.

The Specialist Bladder and Bowel Dysfunction Clinician with the support of the Advanced Bladder and Bowel Clinical Lead and team will work towards developing skills in order to:

1. Triage patients with undiagnosed causes for their bladder or bowel dysfunction onto the caseload.
2. Make a differential diagnosis.
3. Assess, treat, and evaluate a variety of bladder and bowel dysfunctions.
4. Assess the impact of dysfunction on patients and/or carers.
5. Assimilate and interpret clinical findings to make appropriate decisions in relation to diagnosis and treatment of dysfunction.
6. Set appropriate treatment goals in collaboration with the patient.
7. Assess the condition of skin and identify need for onward referral.
8. Accurately measure bladder volume and nature of dysfunction using recognised bladder diaries.
9. Assess the degree and extent of bowel dysfunction using recognised tools.
10. Assess the symptom profile to accurately identify the type of bladder dysfunction as described by the International Society for Incontinence.
11. Assess the degree and extent of bladder and bowel dysfunction and plan appropriate care in line with NICE approved pathways.
12. Identify any complex factors which may predispose the patient to the bladder and bowel problems or affect treatment outcomes.
13. Assess the level of patient quality of life and symptom severity score using recognised tools i.e. global outcomes, ICIQ symptom specific scores.
14. Provide specialist intervention for patients requiring condition-guided treatment.
15. Perform vaginal examinations and teaching of pelvic floor exercises including use of biofeedback and electrostimulation.
16. Teach self-catheterisation to patients and carers if required.
17. Teach and support patients and carers with rectal irrigation and bowel management regimes.
18. Prescribe appropriate medication to patients requiring treatment with anticholinergic therapies, antibiotic treatment.
19. Implement skin care measures to prevent infection and maintain integrity of the patient's skin.
20. Implement and monitor agreed protocols developed for rapid and effective treatment of acute and recurrent urinary tract infections.
21. Carry out female, male, and suprapubic catheterisation when patient condition requires this.
22. Assess patients for continence aids working alongside occupational health and physiotherapy services.
23. Where treatment is not appropriate assess patients for containment products to ensure patients' dignity and quality of life. Identify timely review and reassessment.
24. The above skills will be clinically accountable to the Team Manager and Clinical Lead.

Contribute to research as requested.

Be confident and competent to actively participate with and fulfil all data collection requirements.

Maintain own CPD in relation to knowledge of bladder and bowel research and developments.

Act as a role model and provide mentorship to junior staff and those undergoing training.

Be proactive in teaching service users techniques to self-manage their bladder and bowel dysfunction.

Participate in the induction of new trust staff.

Provide advice and guidance to other professionals within the scope of your knowledge, skill, and experience.

Support the Bladder and Bowel Clinical Lead and team in the delivery of trust-wide teaching programs.

Meet competencies as identified in the PDR/KSF as discussed with Lead Bladder and Bowel Clinician Specialist for your team.

Be prepared to undertake a disease-specific course; further training if necessary in relevant areas related to bladder and bowel dysfunction and keep up to date qualification review requirements.

The Bladder and Bowel Dysfunction Specialist Nurse must possess a prescribing qualification, have completed the Trust Continence Care course, and be working towards recognised bladder and bowel dysfunction qualifications.

To undertake other duties commensurate with this grade of post in agreement with the relevant line manager.

To establish effective working relations with community and acute trust multi-disciplinary teams, General Practitioners, Community Nurses, AHPs particularly physiotherapy and occupational health, residential care home staff.

Person Specification

Essential Criteria

• NMC or HCPC registered
• 12 months plus significant experience
• Completed the BCHC Bladder & Bowel training or equivalent
• Worked within IMT/community nursing
• Worked in relevant field i.e. gastroenterology or urology

Desirable Criteria

• Further relevant post-graduate development
• Has a teaching qualification
• Has extended bladder and bowel experience/knowledge
• Has worked within a clinician-led service

Disability Confident Employer and Guaranteed Interview Scheme

BCHC offers a guaranteed interview to any candidate who is Disabled, Neurodiverse, has a hidden or long-term health condition as recognised under the Equality Act 2010, providing they meet the essential criteria of the job role, as set out in the person specification. We encourage applicants to submit their applications and to request any reasonable adjustments where required.

Equality, Diversity and Inclusion

Birmingham is a fantastic place to live and we serve a wide range of people and communities. BCHC are an advocate of diversity and strive to mirror the community we serve as much as possible.

We are committed to and actively promote equality of opportunity for all staff and applications from individuals from all areas of the community who meet the specific criteria are encouraged regardless of age, disability, sex, gender reassignment, sexual orientation, pregnancy and maternity, race, religion or belief, and marriage/civil partnerships.

Promoting Workforce Equality

In response to data held by BCHC which demonstrates that individuals from particular protected characteristics are under-represented, BCHC are striving to redress these imbalances. In order to do this, the Trust is committed to the employment and career development of individuals with these protected characteristics.

Flexible Working

Birmingham Community Healthcare NHS Foundation Trust (BCHC) supports a variety of flexible working practices and, where possible, will actively consider requests made and support these where practically possible.

Benefits of Working for Us:

• Full NHS terms and conditions including extensive holidays, Agenda for Change pay with enhancements
• Attractive relocation payment if you relocate to the local area.
• Discounts for local and national retailers
• Dedicated well-being services for all employees
• Flexible working where possible

Applicant Requirements

You must have appropriate UK professional registration.

This post is subject to the Rehabilitation of Offenders Act 1974 (Exceptions) Order 1975 (Amendment) (England and Wales) Order 2020 and it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service.

Documents to Download

• Job description and Job specification (PDF, 248.4KB)
• Driving Directions to Priestley Wharf (PDF, 173.2KB)
• BCHC Local benefits (PDF, 99.6KB)