JOB DESCRIPTION
Division: Specialist Services
Department: Clinical Genetics
Job Title: Genetic Counsellor
Band: 7
Hours: 37.5
Responsible to: Principal Genetic Counsellor
Accountable to: Via the Lead/Consultant Genetic Counsellor, to the Director of Nursing and Midwifery
Responsible for: Contribution towards training and supervision of junior staff
JOB PURPOSE
To contribute to the provision of a comprehensive, high quality, specialist genetic counselling service for a population of 2.8 million in the Cheshire and Merseyside Region. To ensure that families referred receive a service which is caring, and scientifically and diagnostically up-to-date.
To act as a significant educational resource, both to the wider health care system and to trainees in clinical genetics and genetic counselling.
To contribute to mainstreaming clinical genetics.
To practice within the ethical guidelines of the Genetic Counsellor Registration Board (GCRB) and, where appropriate, the Nursing and Midwifery Council (NMC).
To carry out the duties and responsibilities of a genetic counsellor with the aim of helping patients and families:
· comprehend the medical facts, including the diagnosis, probable course of the disorder and the available management;
· appreciate the way heredity contributes to the disorder, and the risk of recurrence in specified relatives;
· understand the options (including genetic testing) for dealing with the risk;
· choose the course of action most appropriate for them;
· make the best possible adjustment to the disorder/risk of the disorder.
MAIN DUTIES AND RESPONSIBILITIES
Patient/Client Care
1. See patients and their families in clinics across the Cheshire and Merseyside region both in clinics, and in exceptional circumstances, at the patient’s home. Patient consultations may also be carried out over the telephone.
2. Provide autonomous genetic counselling in generic (to include prenatal, cancer, predictive and general) genetic counsellor clinics, conferring where necessary with senior or medical colleagues.
3. Contribute to consultant geneticist clinics to ensure their effectiveness and efficiency for the patients, and continuity of care for them and their families.
4. Arrange screening investigations by referral to radiology, surgical and other relevant services.
5. Order genetic tests as clinically appropriate and according to agreed guidelines.
6. Arrange relevant prenatal diagnostic tests, (and, when requested, termination of pregnancy following abnormal results) including liaison with obstetric, midwifery and laboratory colleagues to ensure continuity of care for patients.
7. Endeavour to achieve for all families seen a good understanding of complex genetic information and the best possible adjustment to the presence of genetic disease in their family.
8. When appropriate, refer patients to other healthcare professionals, relevant patient-led organisations, and other support services.
9. Phlebotomy in the genetic clinic and, exceptionally, in patients homes.
10. Ensure that the views of patients, or those speaking on their behalf, are well received; and that complaints, both formal and informal, are received courteously and dealt with promptly according to Trust guidelines.
11. Take individual responsibility for managing issues arising regarding safeguarding adults and children within the clinical genetics caseload in accordance with Trust policy.
12. Ensure that standards of care are maintained and that effective procedures exist to assess and review the quality of services offered regularly.
13. Maintain confidentiality of information about patients, staff and other health service business in accordance with the Data Protection Act of 1998.
14. Maintain the safety and wellbeing of patients (and staff) in accordance with the health and safety policy and ensure that all accidents/incidents are reported, documented and acted upon.
Communication
15. Dictate and send detailed, personalised clinic summary letters to patients and their doctors.
16. Dictate and send letters to referring doctors and other professionals related to individual patient and extended family members’ care.
17. Communicate complex genetic information in a way which is comprehensible to families.
18. Give normal, uncertain, and abnormal test results to patients and health care professionals.
18. Elicit the concerns and expectations of patients and relatives.
19. Elicit and accurately document detailed family history information.
20. Expertly communicate highly sensitive and potentially distressing information to patients and relatives, (aged from late childhood to elderly), about their genetic status with implications for biological and social family relationships.
21. Advise on factors that can influence risk (e.g. use of high dose folic acid in pregnancy, cancer screening and prevention).
22. Communicate with, and support, patients who are recently bereaved including parents after the loss of a child or termination of pregnancy for abnormality.
23. Use counselling skills to facilitate decision-making and promote adjustment in patients and family members.
24. Use specialised counselling skills to communicate sensitively in the presence of language, cultural or ethical issues (including patients with learning difficulties or psychiatric disorders).
25. Identify and respond to emerging issues for the patient or family, over an open-ended time period.
26. Manage conflict when patients’ demands are incompatible to professional responsibilities and resources.
27. Liaise with laboratory colleagues to communicate clinical information necessary to ensure appropriate genetic testing is carried out, and to discuss complex text results that are difficult to interpret.
28. Take responsibility for facilitating communication between medical, genetic counsellors, clerical and laboratory staff within the department to ensure the best possible service to families.
29. Maintain effective communication with professionals – e.g. medical, nursing, social work – outwith the department, both for the benefit of individual families as well as to promote general awareness of the genetic counselling service.
30. Liaise regionally, nationally and internationally with other genetic centres, laboratories, and a range of clinical departments (including fetal medicine, obstetrics, paediatrics, surgery, histopathology) to obtain and provide information.
Analysis and Judgement
1. Deal with urgent and prenatal patients as allocated by the Principal Genetic Counsellors.
2. Ensure the best possible standard of work by applying scientific and clinical understanding and counselling expertise to unique clinical situations.
3. Confirm diagnostic information from clinical records
4. Interpret highly complex and possibly conflicting genetic test results.
5. Calculate risks for a range of genetic disorders, including carrier risks, recurrence risks for pregnancy, and risk of becoming affected, for patients and their relatives. This can involve making decisions where expert opinion differs or where limited information is available.
6. Identify and assess the relevance of new scientific information for patients and their relatives, over time.
7. Identify and manage conflict within families created by sensitive genetic information.
8. Assess patients to determine where there is a need for specialist therapeutic counselling or psychiatric assessment, and make appropriate referrals.
Planning and Organisation
9. Prioritise work, particularly assessing the urgency of clinical work.
10. Based on each family member’s specific risk of developing/carrying a condition, develop a programme of care for the patient. This may involve referring to multiple specialties. Provide information on the care of other family members, to identify at risk relatives and advice on how they could obtain genetic counselling or screening.
11. Contribute to the setting up of new clinics and the delivery and planning of new service models, liaising with and training staff across different Trusts.
Information resources
12. Maintain a full and accurate, contemporaneous record of clinical work undertaken (including pedigrees, telephone and home visit reports, correspondence and other notes) in both manual and computerised records and preserve their confidentiality.
13. Act as an information resource on genetics for primary and secondary care colleagues.
14. Use in-house databases to access and up date patient information.
15. Search external information databases to access up to date scientific and clinical information relevant to patient care.
16. Occasionally create databases or spreadsheets.
17. Record and circulate summaries of meetings, on a rota basis.
Policy and Service Development
18. Propose changes to working practices within the genetic clinic, for the benefit of patients and staff.
19. With guidance from senior colleagues, within area of speciality, design and update evidence based protocols and policies.
20. Contribute to the establishment of new services for patients. Provide and establish effective liaison between clinical genetics and other designated services. Contribute to the development of networks, care pathways and teaching to develop staff and facilitate the mainstreaming of clinical genetics.
Research, development and audit
21. Contribute to departmental research.
22. Participate in audit and projects within clinical genetics services to maintain clinical governance and the audit profile of department.
23. Present findings of research, audit or projects to groups of staff or members of the public within the Trust, regionally, nationally or internationally.
24. Access and interpret literature reviews relating to clinical practice and may be involved in multidisciplinary research projects.
Education ,Training and Human Resources
25. Participate in the delivery of genetics training courses with particular reference to mainstreaming genetics.
26. As a registered genetic counsellor act as a mentor for MSc students, and support new members of staff contributing to their trainings packages.
27. Participate in the teaching of genetics to medical students, medical, nursing and other health care professionals, and members of the public. Acting as an educational resource for personnel attached to the clinical genetics team.
28. Appraise and present articles from the scientific literature in departmental study days and the regional genetic counsellors’ development study days.
Professional Development
29. Demonstrate a commitment to maintaining professional registration.
30. Contribute to national professional development (eg through contribution to AGNC activities).
31. Aim to improve the service by continuously updating his/her knowledge of the scientific, medical and psychological aspects of clinical genetics.
32. Take personal responsibility for continuing professional development in accordance with GCRB/NMC guidelines.
33. Attend departmental seminars/teaching sessions and national meetings.
34. Regularly attend and participate in team and individual counselling supervision to enable reflective practice and requirements of professional registration and continuing professional development.
Freedom to Act
35. Undertake an equitable proportion of the total genetic counsellors’ workload whilst maintaining an appropriate quality of work.
36. Take responsibility for his/her own work, conferring where necessary, with more senior genetic counsellors, clinical geneticists and laboratory colleagues to assess the appropriateness and range of clinical contact and investigations to be undertaken.
37. Discuss cases with ethical complexity with colleagues where appropriate.
Value Based Behaviours:
Value / Linked behavioursCare: we show we care about people / Listens and acts to the concerns of others to bring about improvements for people (patients and staff).
Shows empathy to others and a caring attitude to people (staff, patients and the public)
Ambition: we want the best for people / Motivates and coaches others to support them to develop their own capabilities and skills.
Links individual development needs with service goals.
Has the resilience to keep going in adversity and shows a can do attitude to deliver improvements for others.
Strives to ensure the role or service they deliver is the best
Respect: we value the differences and talents of people / Notice the suggestions of others even if you may not agree.
Provide constructive feedback.
Show appropriate professional standards at all time.
Concentrates on what is right rather than who is right.
Engage: we involve people in how we do things / Seeks feedback and input into decision making and service improvement for all people involved (patients, staff and the public).
Actively takes others views into account.
Shows a positive outlook to delivering the best service possible, and leads others by example.
Learn : we learn from people, past, present and future / Checks outcomes against plan.
Uses evidence and experience of others to inform improvements to services for patients and staff
Values, generates and uses evidence to lead future improvements
Mandatory Statements
1. This post is subject to an enhanced CRB check.
2. Liverpool Women’s NHS Foundation Trust is committed to achieving equal opportunities in employment and has an Equality and Diversity Policy. You are expected to observe this policy in your behaviour towards: patients, work colleagues and the public.
3. In the course of your duties you may acquire or have access to confidential information which must not be disclosed to any other person unless in the pursuit of your duties or with specific permission given on behalf of the Trust.
4. You must ensure that you handle personal information in accordance with the requirements of the Data Protection Act 1998.
5. You are reminded that, in accordance with the Health & Safety at Work Act 1974, and subsequent legislation, you have a duty to take reasonable care to avoid injury to yourself and to others by your work activities, and are required to co-operate with the Trust in meeting statutory requirements.
6. In the interests of your development you will be expected to take a positive role in the Performance and Development Review (PDR) Process.
7. You must ensure that you adhere to the Trust Infection Control policies and procedures at all times. You have a duty of care under the Health Care Act to prevent the spread of infection.
8. Within the NHS, good patient care is reliant on the availability of complete, accurate, relevant and timely data. The quality of information will limit the capability to make operational decisions about the way care is planned, managed and undertaken. Poor information quality leads to poor decision making and may put service users at risk. High quality information means better, safer patient care. Where you are required to record data on any system, regardless of the type of media, you must ensure that is it up to date, accurate, complete and timely. Ensure that you feel sufficiently knowledgeable about the system you are asked to use and what is required of you in order to fulfil your task accurately. Where an error is created or discovered by yourself on any system which you cannot rectify, you must contact the relevant helpdesk / system owner or your Line manager. Please read the Data Quality Policy located on the Intranet and ensure you understand your responsibilities.
9. You must comply with all Trust policies and procedures and attend all necessary mandatory training.
10. This document provides an outline of the main responsibilities of the post. It is not intended to be an exhaustive list of duties. Your job description will be subject to regular review with your Line Manager.
PERSON SPECIFICATIONBand 7 Genetic Counsellor
ESSENTIAL / DESIRABLE
Qualifications
Current Genetic Counsellor Registration with the GCRB
Where appropriate current Registration with the NMC / · Evidence of formal training in teaching
Experience
· Acheivement of AGNC core competencies whilst working under supervision in a Regional Clinical Genetics Centre.
· Able to demonstrate relevant progress through the Knowledge and Skills Framework.
Skills/Ability & Knowledge
· Ability to work autonomously and manage an independent clinical caseload.
· Ability to demonstrate initiative
· Proven ability to work as part of a team and to build up and maintain positive working relationships.
· Good interpersonal skills
· Sensitivity to confidential and/or difficult situations
· Flexibility.
· Ability to work under pressure
· Ability to analyse research findings to inform practice development.
· A knowledge of genetics obtained through graduate/post-graduate courses.
· Knowledge of a broad range of genetic conditions.
· Experience of teaching
· Familiarity with databases and word processing.
· Current Driving Licence and car owner.
· Good record of attendance
· Phlebotomy / · Evidence of participation in research & audit projects
SIGNATORIES
This Job Description has been agreed by the following parties: