TB Nurse Specialist

Contract - Permanent - Full time - 37.5 hours per week

Working for our organisation, Whittington Health serves a richly diverse population and works hard to ensure that all our services are fair and equally accessible to everyone. We aim to employ a workforce which is as representative as possible of this population, so we are open to the value of differences in age, disability, gender, marital status, pregnancy and maternity, race, sexual orientation, and religion or belief. The Trust believes that as a public sector organisation we have an obligation to have recruitment, training, promotion and other formal employment policies and procedures that are sensitive to these differences. We think that by doing so, we are better able to treat our patients as well as being a better place to work.

Main duties of the job

• To work as part of the Tuberculosis (TB) nursing team and the wider multidisciplinary team to provide an accessible and responsive high quality TB nursing service across the North Central London TB Network.
• To facilitate high quality, individualised care to patients (adults and children), their contacts and the wider community in collaboration with the multi-professional team and with other agencies, in accordance with national guidelines and locally agreed protocols.
• To deliver expert patient centred nursing care and advice as the case manager for a caseload of patients being treated for TB and latent TB (LTBI).
• To undertake nurse led clinics offering follow up of active cases, LTBI treatment and follow up, screening, rapid access services and advice in a variety of settings including clinic, community and prisons, providing support and referring patients to appropriate services as necessary.
• To have an active role in developing the strategic direction of the TB service in line with national and local targets, working closely with the Senior TB Nurses and Clinical Team Lead.

Clinical Responsibilities

• Ongoing responsibility for the assessment and progress of individuals receiving treatment for TB and LTBI, including adults and children and those infected with HIV and MDRTB.
• Manage a caseload of patients including complex cases requiring enhanced case management, with support from the wider TB team, to ensure high treatment completion rates.
• Develop specialist programmes of care in collaboration with the wider TB team to provide individualised care, education and support to meet the needs of patients with TB/LTBI diagnosis.
• Demonstrate role model excellence in nursing practice to other staff and act as an expert TB resource within the acute and community setting.
• Assess the likelihood of adherence before/during treatment and, if necessary, provide/coordinate directly observed therapy or video observed therapy.
• Manage and undertake nurse led clinics offering screening, contact tracing, rapid access, LTBI treatment and support, advice and referral of patients to appropriate services as necessary.
• Ensure the needs of the patient are placed at the centre of care delivery.
• Make community visits to non-attendees where there are concerns regarding treatment adherence or contact screening.
• Offer contact screening to close contacts in the community setting in line with local protocol.
• Carry out community visits to all patients being treated for pulmonary TB or those assessed as requiring enhanced support.
• Provide nurse‑led clinics and walk‑in clinic within agreed protocols, also to assess and determine need for unplanned medical review.
• Select, carry out and interpret the results of specific tests; e.g., Mantoux test, IGRA, induced sputum, routine blood tests, visual acuity and BCG vaccination (by intradermal injection) under patient group direction, within agreed local protocols and in accordance with national guidance.
• Prepare and dispense TB medication (oral, IM and IV) in accordance with local protocols and where appropriately trained, prescribe TB medication.
• Investigate microbiology results, abnormal radiology referrals, assess urgency and need for medical review.
• Discuss patient prognosis with the patients and their relatives, dealing with the stigma associated with TB, TB/HIV including dealing with distressing and emotional circumstances.
• Act as a patient advocate when required to ensure that their needs are met and refer patients to specialist services and professionals within other agencies if necessary.
• Assist and investigate cases/outbreaks of TB and carry out risk assessment, contact identification, tracing and coordinate mass community screening in conjunction with the United Kingdom Health Security Agency (UKHSA).
• Liaise with infection control/occupational health in the management of inpatient ward exposure incidents.
• Record clinical activities and outcomes accurately.
• Communicate effectively with patients/clients, relatives/carers, colleagues both verbally and in writing.
• Assist in the development of a non-tuberculosis mycobacterium nursing service.
• Maintain accurate and timely patient records, worthy of medico‑legal scrutiny.
• Undertake any activity requested by the Sector Lead Nurse/Clinical Team Lead and deemed within the expectations of the role.
• Provide agreed incentives to patients as per care plan.

Management Responsibilities

• Co‑ordinate and lead the TB service in own base in the absence of senior TB Nurse.
• Ability to work independently under the guidance of the Senior TB Nurse.
• Supervise and monitor students and junior members of staff as required.
• Seek support from the Senior TB nurse on clinical issues as appropriate to ensure clinical governance.
• Carry out delegated duties from the senior team members.
• Participate in the induction and training of new members of staff.
• Work closely with the Senior TB nurse specialist in implementing Health and Safety policy and action plans derived from risk assessments carried out for patients and places where services are being delivered.
• Ensure that adult safeguarding and child protection procedures and NHS policies are followed for this vulnerable client group.
• Work closely with the Senior TB nurse specialist to participate in the update and continued assessment as necessary of clinical protocols and policies for the diagnosis, treatment and management of patients/clients with TB and those vulnerable to TB.
• Promote and maintain a safe clinical environment for patients/clients and staff.
• Identify clinical risk and ensure that appropriate action is taken, in accordance with the Trust’s Risk Management/Infection Control Policy, in order to prevent the transmission of TB.
• Maintain accurate databases, collect and interpret data on caseloads, add and edit records onto LTBR providing information for UKHSA.

Partnership Working

• Report through the cohort review process.
• Be an active member of the London TB workforce group.
• Maintain and develop existing links with prison healthcare staff to develop the TB service for the prison community, ensuring a high standard of nursing practice that is responsive to the needs of the patient using national guidelines and evidence base.
• Works within MDT, case review, team meetings, participates in and actively contributes.
• Maintain proactive and effective communication channels with key professionals across the NHS (e.g., colleagues, primary healthcare staff and GPs, specialist team staff, public health, stakeholders and voluntary organisations).
• Ensure patient experience feedback is collected and incorporated into service development.

Promoting Health and Preventing Ill Health

• Participate in the training, education and ongoing support of health professionals about the needs of TB patients, their families and close contacts.
• Assist in the development and implementation of sustainable programmes to raise awareness and reduce stigma amongst high‑risk groups and those people who work with them, teachers and the public.
• Participate in trust wide and national study days.
• Actively seek out opportunities to participate in formal and informal teaching and training of all members of the multidisciplinary team.
• Provide Mantoux, BCG training and support for appropriate health care professionals.

Professional Practice

• Keep up to date with a working knowledge of relevant NMC guidelines and demonstrate this in clinical practice.
• Take an active role in monitoring and ensuring standards of care at own base and developing awareness of clinical governance issues.
• Pursue a programme of continuous education to achieve and maintain expertise for the post.
• Maintain and develop a lifelong learning portfolio.
• Demonstrate good knowledge regarding BCG vaccination and children affected by TB.
• Demonstrate a good understanding of the public health strategies and issues relating to this patient group.
• Participate in own 1:1 meetings.
• Identify own clinical competency, strengths and deficits through participation in the Trust’s appraisal process.
• Complete all statutory training requirements relevant to the post.
• Participate in clinical supervision and act as a clinical supervisor.
• Keep up to date with a working knowledge of NMC and demonstrate this in clinic practice.

Audit

• Ensure clinical audit and clinical governance are integral to the TB Nursing Service.
• Share and disseminate knowledge and expertise through formal and informal teaching.
• Develop, maintain and update relevant information and health promotion materials on all aspects of TB.
• Participate and contribute to network research studies as required.

Management of Resources

• Be aware of contracting issues and budgetary constraints in order to manage resources effectively.
• Be responsible for the safekeeping and use of equipment.
• Assist with the distribution of patient information.
• Use Trust resources effectively and encourage others to do the same.

Person specification

• First level Registered Adult Nurse
• Degree level or willingness to work toward
• Evidence of continuing professional development
• Teaching/Mentoring course
• Specialist TB Nursing course
• History taking/physical assessment qualification

Skills & Abilities

• Sound knowledge of current nursing and health care issues
• Ability to be self‑directed but also participate as a team member
• Demonstrate the ability to prioritise own workload to pressure and meet deadlines
• IT literate
• Excellent written and verbal English demonstrated through written and verbal communication
• Teaching and presentation skills
• Excellent interpersonal and communication skills

Knowledge & Experience

• Extensive post registration experience, e.g. one year as a Band 5/6 in acute medicine/community working with vulnerable adults or children (e.g. homelessness, substance misuse, mental health, immigration problems)
• Sound knowledge of current nursing and health care issues
• Awareness of key challenges in TB nursing/TB control in the UK
• Supervising junior staff/multi‑professional working

Personal Qualities

• Effective role model demonstrating values of innovation, care, respect and pride
• Polite, helpful and diplomatic

Other

• Willingness to travel and work across sites

SAFEGUARDING CHILDREN AND ADULTS

• To comply with the Trust’s Safeguarding Children and Adults policies, procedures and protocols. All individual members of staff (paid or unpaid) have a duty to safeguard and promote the welfare of children, young people and vulnerable adults. This will require you to:
• Ensure you are familiar with and comply with the London Child Protection Procedures and protocols for promoting and safeguarding the welfare of children and young people.
• Ensure you are familiar and comply with the London Multi‑Agency Safeguarding Vulnerable Adults Pan London Procedures.
• Ensure you are familiar and comply with local protocols and systems for information sharing.
• Know the appropriate contact numbers and required reporting lines.
• Participate in required training and supervision.
• Comply with required professional boundaries and codes of conduct.

Whittington Health is committed to safeguarding all children and vulnerable adults and expects all staff and volunteers to share this commitment.

Right to work in the United Kingdom

You must already have the right to work in the United Kingdom or fully meet the eligibility criteria for sponsorship under the Skilled Worker visa route. Applications that do not meet these requirements cannot be progressed. We welcome the application of candidates from underrepresented groups in the organisation.