Position: Lead Occupational Therapist

Position: Lead Occupational Therapist

Vacancy Information Pack

Position: Lead Occupational Therapist

Please apply using a Hospice Application Form (included in this pack)

Closing date: Friday 2 November 2012

Interview date: Friday 16 November 2012

St. Columba’s Hospice, Edinburgh


At St Columba’s Hospice we are committed to the highest standards of care for patients with active, progressive, far-advanced illness.

Lead Occupational Therapist

Band 7 £30,460 - £40,157 + Pension

Part time 30 hours per week

We are seeking a highly motivated and enthusiastic OT with significant experience in palliative care. Responsible for the management and delivery of a high quality occupational therapy service, you’ll be working across our in-patient unit, day hospice and community settings and assisting in the development of our outpatient services.

Working collaboratively as part of a highly specialist multi-disciplinary team you’ll be providing holistic centred care to patients with complex palliative care needs, offering symptom control, rehabilitation, discharge planning with an emphasis on quality of life.

A team player, you’ll be committed to providing excellent quality care to those with and affected by life limiting illness.

For an informal discussion about the post please contact Anne Gallagher, PA to Evelyn Howie, Clinical Services Director, on 0131 551 1381.

Download an application pack online at

or email , or call 0131 551 7722

Closing date: Friday 2 November 2012

Interview Date: Friday 16 November 2012



Job Title: Lead Occupational Therapist in Palliative Care
Band: 7
Responsible to: Clinical Services Director
Department: Occupational Therapy
Job Reference: STC-AHP-101
No of Job Holders: 1
Last Update: October 2012


  1. To take a lead role in the management and delivery of a high quality occupational therapy service, to patients with specialist palliative care needs attending the Hospice in-patient, day services, community and outpatient services.
  2. To work closely with the physiotherapy service and collaboratively as part of a wider highly specialist multi-disciplinary team to provide holistic patient centred care to patients with complex palliative care needs, with an emphasis on symptom control, rehabilitation, and discharge planning.
  3. Using a broad range of skills identify through thorough assessment the individual needs of each patient and devise a treatment plan to support patients and carers to achieve the best possible quality of life.
  4. Participate in the training of students and other health professionals to promote their professional development and clinical practice.
  5. Participate in the educational programmes of undergraduate and postgraduate students .
  6. To work within the Clinical Governance Framework of St Columba’s Hospice, which underpins the delivery of safe, effective, person centred care across all Hospice services.

Range of clinical area
St. Columba’s Hospice has 30 beds in the in-patient unit and a day hospice which has the facility to accommodate 15 patients daily. A fluctuating number of out-patients and patients who require OT advice as well as those known to the Community Palliative Care Service are catered for throughout the year.
Staff Responsibility
  • Supervise/ manage workload of OTTI
  • To be responsible for the performance management, appraisal and CPD of the OTTI.
  • Budget management of the day to day requirements of the department (Annual budget - £6045)
  • Responsible for the ordering and management of supplies and equipment including storage, monitoring and cleaning of same.
  • Responsibility for the safe use of equipment and care of equipment, including cleaning, upkeep of equipment supplied by the department, including safety checks and referral to stewards for repair as necessary.
  • Authorised signatory for payment of goods ordered, including checking of deliveries.



The Occupational Therapy service is part of the MDT providing a specialist programme to any person under the care of St Columba’s Hospice providing a flexible service to meet the demands of all clinical areas.
  • .To provide a high quality, effective and equitable occupational therapy service to the patient group encompassed by the hospice – inpatients, day care, community and outpatients.
  • To work together with other clinical specialists and generalist colleagues in the community to provide the most effective care to patients with a diverse range of conditions that require palliative care.
  • To play an integral role in the discharge planning of patients from the inpatient unit and their carers
  • To establish and maintain high professional standards and conform to the College of Occupational Therapists’ Code of Professional Conduct and to its Ethics, Standards, Policies and Proceedings.



  1. Assess and analyse all patients referred to the Occupational Therapy service to determine and prioritise their need for Occupational Therapy intervention within a specialised area.
  2. To plan, implement and monitor patient centred treatment and rehabilitation programmes. Being prepared to adapt or withdraw treatment programmes in response to a patient’s condition.
  3. Plan, implement, evaluate, treat and progress patient care, with full professional responsibility, to maximise functional independence and rehabilitation potential, as appropriate, within a specialist area whilst ensuring that psychological, emotional, social and spiritual needs are met, and in order to maintain and improve quality of life.
  4. Working as part of a therapy team play an integral part in the discharge planning process, identifying patients with complex needs making detailed recommendations regarding discharge needs.
  5. Work closely with the multidisciplinary team, both internally and externally. Arrange and carry out home visits to/with patients (as appropriate) to assess their safety, their home environment and identify any risks that would affect discharge from the Hospice.
  6. Anticipate problems delivering equipment depending on patient’s home or social circumstances or locality, which could affect timely discharge.
  7. Attend and report to relevant clinical reviews and case conferences ensuring effective communication and co-ordination of patient care.
  8. Evaluate outcomes by standard setting, audit and communication with other health care professionals in the MDT to facilitate expeditious and safe discharge in a cost-effective manner.
  9. Develop and implement appropriate clinical guidelines where necessary ensuring clinical effectiveness to optimise patient care.
  10. Assess Health and Safety issues related to the use of equipment, by patients and relatives, in the Hospice and in their own homes.
  11. Supervise Technical Instructor on duties pertinent to her role and abilities, and delegate activities as appropriate.
  12. Teach Technical Instructor techniques and procedures pertinent to her role and abilities.
  1. To be actively involved in the development of the occupational therapy service and implement initiatives as appropriate.
  2. Develop and manage specific areas of symptom control such as, rehabilitation, dyspnoea, fatigue and anxiety management.
  3. To prioritise, delegate and supervise work undertaken by junior staff and students as required.
  4. To participate in the management of junior staff and undertake supervision and annual Personal Performance Reviews.
  5. To participate in clinical supervision programme.
  6. Actively participate in the Hospice Clinical Governance framework leading groups/initiatives as delegated.
  7. To participate in the Hospice’s Personal Performance Review Development with own Line Manager, identifying objectives in line with the strategic plan.
  8. To assist in the collection and management of service data, ensuring all patient activity is demonstrated using paper and electronic systems in place.
  9. To actively promote the occupational therapy profession in palliative care.
  10. To maintain registration with the HPC/BAOT.
  1. To keep up to date with all new developments in clinical practice.
  2. To attend training programmes/education courses as agreed with line manager.
  3. To participate in the teaching and training of all staff and students as required.
  4. To investigate and provide learning opportunities for Junior staff within the working area.
  5. To maintain own continuous professional development identifying own training needs.
  6. To participate in local link groups in Palliative Care for allied Health Professionals.
  7. Participate in undergraduate and post graduate education training/ placements.
Research and Development
  1. To initiate and be involved in research as required.
  2. To initiate clinical audit, developing and modifying practice where required.
  3. Disseminate results of research and audit to line manager and Hospice Clinical Governance risk group as appropriate.
This job description does not contain an exhaustive list of duties, and the postholder may be required to undertake other duties that are within the postholder’s skills and abilities whenever reasonably instructed. The job description will be reviewed from time to time in order to adapt and develop the role according to service needs and Hospice policies.


Use a wide range of equipment during assessment and/or therapeutic interventions. A sample of which is noted below.
Activities of Daily Living Equipment
  • Dressing e.g. stocking aids, helping hands, button hooks, long-handled shoe horns, leg lifters
  • Feeding e.g. adapted cutlery, specialised plates and feeding cups and straws
  • Toileting e.g. raised toilet seats, rails, frames, commodes
  • Kitchen e.g. trolley, jar openers, can openers
  • Mobility e.g. walking sticks, wheelchairs
  • Seating e.g. pressure cushions, chairs, electrically operated recliners, footstools
  • Transfers e.g. sliding board, hoists, sliding sheets
  • Leisure e.g. grips for pencils, pens, brushes, magnifiers, card holders, smoker’s robot (smoking aid).
  • Nurse call system adaptations – variety of switching systems
  • Chat box and communication aids (Speech and Language Therapy equipment)
  • Boardmaker computer programme for non-verbal and foreign language communication charts
  • Loop system for those with hearing difficulties, with or without a hearing aid
  • Variables …, folding tables, lighting equipment
Creative e.g. craft knives, guillotine
  • Computers for presentations, e.g. Power Point
  • Flipcharts
Miscellaneous e.g. Computers, printers, programmes and digital camera for patient’s personal work, digital voice recorder.
Creation of register to record new patients and patient numbers in day hospice and in – patient unit, referral forms, initial assessment forms, activities of daily living assessment sheets, patients’ activities records
  • Chronological recording of interventions and outcomes in multidisciplinary medical notes.
  • Recording in Care Plans.
  • Ensuring records, patients’ work, equipment, materials, etc are stored securely, as required.
  • Use of Microsoft Office packages e.g. Powerpoint, Publisher, Excel, etc. to produce documentation, leaflets, patients’ work.
  • Electronic recording of data – monthly statistics, activity sheets, discharge documentation.
  • Using online equipment ordering service.
  • Using online ordering of: Taxicard, Blue Badge, CAS alarm, Keysafe.
  • Completing Carenap electronically
  • Using Fax machine


  • Clinical caseload is unpredictable and will be generated by the specific needs of each clinical area.
  • Non – clinical tasks may be on-going in response to the requirements of the clinical, administrative, managerial and educational aspects of the role, and may be at the request of the Governing body of the Hospice, or the Management.
  • Some clinical and non-clinical tasks are self – directed in response to a perceived need or anticipation of a problem. Patients who have not been referred may be noted to have needs which could be addressed by OT intervention. In this case, the named nurse or doctor will be approached and a request made for referral to the OT service. New legislation, guidelines, or changes in other areas which will directly affect the OT service are observed and acted upon in order to maintain a smooth – running service. E.g. Changes in the use of the rooms normally used by the OT service.
  • Work independently on a day to day basis.
  • Attend meetings, mentoring and appraisal sessions with Line Manager, as appropriate.
  • Audits and reports related to OT activity executed as required.
  • Take an active role in all aspects of personal professional development.

  • Postholder works autonomously, using their own initiative, to plan and manage the OT service.
  • Postholder is responsible for all of the patients on the caseload, managing the administrative requirements of the service and responding to requests to participate in education, meetings etc.
  • Postholder is responsible for interpreting national professional policies for specialist area.
Referrals – analysis and decision making including:
  • Appropriate referral
  • Is the reason for the referral an issue of concern to the patient, or is there another issue they would like dealt with?
  • What is the priority of this referral?
  • Is referral to other agencies, internal or external, appropriate?
Clinical care
  • Continuous analysis of patient needs and their condition by assessment of patient and using highly specialist clinical reasoning skills to plan appropriate interventions.
Manage service area
  • Ensure adequate and appropriate staffing levels for the smooth running of the service.
  • Ensure that OTTI cover during periods of post holder’s absence is as smooth running as possible.
  • Ensure continuity of service during periods of annual leave/holidays/sickness
  • Decide what can be delegated to the Occupational Therapy Technical Instructor.
  • Deal with staff performance issues
  • Deal with staff absences
  • Forecast future needs / development of the service, and budgeting for the same.
  • Cover for Social Worker during periods of absence as outlined in local Discharge
  • Planning procedures policy.


  • Knowing that all of the patients will deteriorate and die.
  • Patients present with multiple pathologies, and concerns related to matters other than their terminal disease (e.g. cancer, COPD, cardiac, MND) need to be dealt with. An extensive clinical knowledge is required to do this and so information must be sourced, and a variety of agencies identified and contacted.
  • Having to move between patients with such a diverse range of needs, with little or no time to reflect on a situation.
  • Frequently communicating with people who are distressed – patients, relatives and carers.
  • Working as a stand alone OT means there is no-one in the same place of work with whom to discuss professional matters.
  • Always being flexible and adapting to the variable and unpredictable demands of both clinical and managerial workload; in addition to developing and supporting the needs of a small team.
  • Undertaking a mentally, physically and emotionally demanding job, whilst at the same time taking care to safeguard personal health and safety as well as that of colleagues, including students, and patients.

  • Provide and receive highly complex, sensitive and contentious information regarding assessment, diagnosis and treatment.
  • Use highly developed interpersonal and communication skills to impart contentious information to patients.
  • Use highly developed communication skills (verbal and non-verbal), including negotiation and persuasion skills, to motivate and encourage patient compliance.
  • Patients will have a range of physical and mental health problems and require the OT to utilise highly developed motivation and persuasion skills to facilitate rehabilitation both in an individual and group setting, and to adapt approaches creatively to enable patients to continue to participate in activities as they deteriorate.
  • Negotiate with patients and carers care needs, including the provision of information leaflets, written instructions and CDs.
  • Provide communication charts for patients who are unable to vocalise their needs; cannot read or write due to their physical or mental condition or due to cognitive impairment; or who cannot communicate in English.
  • Work with relatives / carers to develop a personal notebook of that patient’s likes and dislikes, needs, and who they are as a person, to assist staff and others in the provision of meaningful dialogue with the cognitively/sensory impaired patient, and to avoid frustrations and respond to behaviour management issues, e.g. agitation, disorientation.
  • Diffusing difficult situations.
  • Provide a variety of diaries for therapeutic purposes, such as assisting patients with poor memory, to record activity and to assist with lifestyle planning and management
  • Provide orientation aids
  • Assessment and provision of alternative equipment for patients unable to use the call systems installed.
  • Advice and equipment for patients with sensory deficits, e.g. hearing, (LOOP system), visual impairment.
  • Use highly developed interpersonal and communication skills to impart contentious information to carers.
  • Provide and receive information regarding complex and sensitive issues
  • Educate and negotiate with carers in relation to patient care needs
  • Teach a range of patient management strategies
  • Provide information leaflets to back up advice given re: lifestyle management, breathlessness management, relaxation, meals services, mobility services, sensory impairment services, etc.
  • Provision of regular clinical and professional supervision to delegated staff
  • Carry out annual appraisal and Performance Development Plan and review with delegated staff
  • Educate therapist in new aspects of the work appropriate to her role and abilities
  • Contribute to, network and collaborate with a variety of external bodies.
  • Negotiate and liaise with the multidisciplinary team regarding service needs
  • Teach OT patient management strategies to optimise patient care
  • Liaise with, and advise nursing staff to ensure patient management is maximised
  • Advise on appropriate assistive equipment for patient use, e.g. ADL equipment, LOOP system, communication charts, multisensory equipment (Snoezelen), and remedial activities, e.g. breathing techniques, relaxation, mindfulness.
  • Teach staff a variety of treatment techniques to enhance patient care and support activities taught to the patient by the OT
  • Liaise with, and advise medical staff in order to increase their knowledge relating to individual patients and the specialist area; ensuring patient management is maximised.
  • Liaise with Line Manager changes to the service, ongoing activities within the service and provide written and verbal reports re the ongoing service
  • Liaise with various internal staff groups, e.g. Day Hospice, Community Palliative Care Team, kitchen staff, admin staff, fundraising department, domestic staff.
  • Negotiate and liaise with other agencies to optimise patient care and ensure efficient and up to date service delivery – physiotherapists, community speech and language therapists, RNID, RNIB, Dementia Services Centre, specialist palliative care organisations, Lothian/East Lothian joint stores, reablement teams, etc.
  • Liaise with OT colleges and universities regarding student education and hospice placements.