POSITION DESCRIPTION
______________________________________________________________________
Title:
Family History Assessor Level 2
Organisation: New Zealand Familial Gastrointestinal Cancer Registry
Reports to:
The Regional Coordinator, New Zealand Familial Gastrointestinal Cancer Registry.
Purpose of the Position: To assess the family medical history of patients referred to the service
for familial risk of hereditary syndromes associated with gastrointestinal cancer and
to provide on going surveillance and advice to registered families.
______________________________________________________________________
Key Accountabilities:
Service Quality:
Specifically the Family History Assessor will practice on a semi independent basis under the guidance
of a Family History Assessor Level 3 and/or a Regional Co-ordinator to:

Provide a high quality service to patients, referrers and colleagues

Obtain and document a detailed relevant 4 generational pedigree and family history
in a clinically appropriate way, using appropriate symbols to explain complex
relationships

Critique a family history and draw appropriate conclusions

Conduct patient interviews in a clinic setting or via the phone including patients
where:

o
diagnosis is known, eg HNPCC/FAP
o
history suggests one of the familial Gastrointestinal Cancer Syndromes
o
families have low to medium risk
Have a comprehensive understanding of:
o
gastrointestinal anatomy and physiology
o
gastrointestinal disease – presentation, diagnostic techniques,
medical
management and surgical interventions
o
oncological disease - presentation, diagnostic techniques, medical and
surgical management, chemotherapy and radiotherapy processes
o
chromosomes, genes, disease carrying mutation
o
principles of genetic inheritance
o
genetic inheritance as it applies to gastrointestinal cancer
o
inherited cancer syndromes
o
genetic testing processes and laboratory techniques
o
pathology testing
o
elements of complexity or rarer genetic syndromes
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o
risk categories identified in the ‘guidelines’ and can explain reasons for
categorisation to patients and apply them with appropriate judgement

Explain the above knowledge in a way that is easily understood by the families
assigned to their care

Fully inform referred families about registry processes to ensure that:
o
they understand the need to share information with other family members
o
they understand the consent process and are able to make an informed
decision

o
they understand their right to withdraw from the process
o
the explanatory process and the patient’s response and fully documented
Keep referrals for procedures up to date and obtain and review histology/procedure
reports as required including understanding and recognising histological features of
common syndromes on pathology reports

Recognise and refer for review, pathology reports of concern

Competently and confidently advise General Practitioners

Act as an advocate for patients

Appropriately document:
o
all interactions with patients
o
letters to patients
o
consultation with advisors and senior colleagues
o
the strategy for managing the patient in a way which ensures it is clearly
discernable from planning notes.

Demonstrate the ability to provide empathic counselling to clients and their families
in a way which:
o
does not impinge on their autonomy
o
demonstrates an understanding of the ethical issues involved in both the
genetic and medical management aspects of practice
o
displays the sensitivity needed in approaching patients
o
understands the psycho-social impact of being diagnosed with a genetic
disorder, with having cancer or being at risk of having cancer
o
respects professional boundaries in interactions with patients, while
providing a supportive environment.
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Service Effectiveness:
Specifically the Family History Assessor will:

Provide an efficient and effective service by:
o
adhering to Registry policy, procedural guidelines and clinical protocols,
ensuring the completion of Registry processes within specified timeframes
o
drawing a detailed family history which incorporates all of the relevant
information
o
following up on medical procedure results, on pathology and genetic testing
outcomes, and tracking the progress of actions requiring follow-up in a
timely manner
o
providing interim and final surveillance and medical management advice or
recommendations in accordance with the guidelines or in consultation with
the Registry’s senior staff
o
ensuring that the patient’s referrer and their general practitioner are
provided with management advice specific to the case, and kept informed of
any revision of that information
o
exercising good judgement throughout the process in understanding when
to seek advice, the need to consult, the need for more experienced or
knowledgeable input
o
actively demonstrating a collaborative approach to practice as evidenced by
proactive communication and sharing of information, supporting other team
members and showing a willingness to take direction and guidance from
supervisors and colleagues
o
accepting responsibility for the registered families assigned for oversight
ensuring that:

their
surveillance
programme
is
actioned
within
prescribed
timeframes

family recommendations and information is reviewed in association
with the Medical Advisors or the Clinical Manager

you are proactive in researching new generations and then ensuring
that they are appropriately managed.
Administration
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Specifically the Family History Assessor will:

Ensure that administrative functions are actioned to maintain and uphold standards
by:
o
diligently and accurately entering all clinical information into the patient data
base, recording all actions information and decision-making pertinent to the
assessment of the family
o
revising the documentation in the family file to reflect current knowledge,
updating the pedigree chart with new family information and recording
progress as tasks and processes are completed
o
working cooperatively with the regional administrator to ensure that patients
are booked to be seen in clinic in accordance with the importance and
priority assigned.
Self Development and Personal responsibility
Specifically the Family History Assessor will:

Ensure that on-going self-development and personal conduct reflects the Registry’s
objectives at all times, by:
o
collaborating with all members of the registry team, demonstrating an ability
and willingness to share information and skills
o
seeking constructive feedback, changing performance and practice as
necessary
o
taking action when issues or concerns are identified with practise,
contributing to ideas for improvement, identifying obstacles to achievement
o
regularly recording and reporting progress on the assigned case load
o
taking responsibility for personal professional development, setting and
meeting goals
o
demonstrating attitudes and behaviours that facilitate the provision of quality
customer service.
Continuous Improvement and Contribution to Registry Processes
Specifically the Family History Assessor will:
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
Understand the service goals of the Registry, demonstrate an awareness of where
the role fits and contribute to the attainment of organisational performance
objectives and quality initiatives by:
o
contributing to the formulation or review of standards, policies, guidelines
and protocols
o
assisting in the creation or review of patient information through various
media
o
identifying areas for improvement, offering feedback and ideas at team
meetings
o
supporting the management team both regionally and nationally to improve
processes and develop services.
Staff Training and Education
Specifically the Family History Assessor will:

Contribute to the training programme by:
o
supervising, coaching and developing Level 1 Family History Assessors
o
contributing to development and improvement of the educational content of
the programme
o
where appropriate, providing oversight for and formally supervising assigned
staff
o
providing both informal and structured feedback on the performance of staff
for whom they have oversight
o
actively and sensitively mentoring and coaching less experienced colleagues.
Promoting the Registry
Specifically the Family History Assessor will:

under the direction of the Regional Co-ordinator or above, and within their level of
knowledge, promote the services of the Registry to the public and to referrers by:
o
facilitating public meetings and educational support group meetings about
familial gastrointestinal cancer services
o
assisting with patient support groups.
Special Requirements
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Specifically the Family History Assessor will be required to travel outside of their region to undertake
clinics. From time to time this may require an overnight stay. There may also be a requirement to
conduct some evening clinics for patients.
Working Relationships:
External

General Public
Internal
Regional Centres’ staff
National Office staff

Auckland District Health
Board staff
 Canterbury District Health
Board staff



General
Practitioners
 Consultants
 Laboratory staff

Committees/Groups/Organisations



National Familial Gastrointestinal Registry
Auckland Multi-disciplinary Advisory Group
Bowel Screening Taskforce
National Multi-Disciplinary Advisory Group
Northern Region Genetic Service
 Central & Southern Genetic Service
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Person Specification
Education
Family History Assessor Level ONE
Essential: Health or science degree or relevant equivalent, in a health related
discipline. This may be a qualification gained overseas, which is not registerable in
New Zealand. As example but not limited to clinical genetics, nursing and/or
research nursing.
Desirable: Undertaking or have completed study towards a postgraduate
qualification in a related subject or in approved subject related, non certificated
courses. Experience and a Family History Assessor.
Experience
Essential: One of the following: Has successfully completed a period of training
within a Familial Gastrointestinal Cancer Registry or has experience working within
a genetic service or can demonstrate relevant experience, knowledge and
understanding.
Desirable: Previous general medical, oncology or gastrointestinal service
experience. Working knowledge of the services provided by Familial Cancer
Registries.
Computer skills – Experience in working with patient information using a database.
A basic understanding of entering, sorting and reporting data.
Competent
keyboard skills.
Competency
Proficiency: Is capable of managing an assigned case load with supervision. Shows
a developing understanding of the genetic drivers behind hereditary cancer,
diagnostic techniques, the medical implications of the disease syndrome and
appropriate surveillance guidelines.
Communication: Listens well to draw out information and learn, asks questions to
clarify. Expresses information effectively, demonstrating effective written and
verbal communication skills.
Collaboration: Collaborates with fellow team members and other work groups to
achieve objectives for the good of the whole. A good team player.
Time management: Capable of working independently and can establish methods
to manage workload / workflow. Takes account of changing priorities.
Technology Skills: Demonstrates ability to learn and use the computer packages
used in the department.
Attention to Detail: Demonstrates attention to detail and initiates self-checking
procedures. Ensures high levels of accuracy and consistent quality.
Professionalism: Recognises and acts within the scope of the role.
Staff relationships: Ability to develop a positive working relationship with Registry
staff. Identifies and seeks to meet their needs.
Patient relationships: Has the ability to relate to those patients referred to the
Registry and to provide a high quality and considerate service. Treats them as a
first priority.
Treaty of Waitangi: Is knowledgeable of the implications of the Treaty of Waitangi
and a commitment to its application in the health service.
Self
Development
Demonstrates commitment to personal and professional development
Acknowledges and learns from mistakes and seeks to improve outcomes. Knows
when to ask for help.
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