NRS0925 CNS Job Specification - Amended (

Clinical Nurse Specialist (Diabetes-Integrated Care)
HSE Job Specification, Terms and Conditions
Job Title, Grade,
Grade Code
Clinical Nurse Specialist (Diabetes – Integrated Care)
(Grade Code: 2632)
Closing Date
Interview date(s)
Taking up
Week commencing 4th November 2013
Location of Post
Please note that the panel being created from this recruitment campaign will be used to fill
vacancies at all HSE sites as appropriate. Further vacancies may become available
nationally and applicants are encouraged to apply should they be interested in working in
any area.
12 noon, Friday 20th September 2013
To be indicated at job offer stage.
All Health Service Executive (HSE) Areas – DML, DNE, West and South
There are immediate vacancies for Clinical Nurse Specialist (Diabetes – Integrated Care)
Details of Service
Letterkenny General Hospital
Cavan General Hospital.
The development of the National Diabetes Programme model of integrated diabetes care
will enhance effective clinical care of patients and the optimal use of resources. The aim of
the model is to facilitate the structured/managed care of patients with uncomplicated Type
2 Diabetes in the primary care setting only; while patients with complicated Type 2
Diabetes will be managed by primary and secondary care services. To this end, the
diabetes service and multidisciplinary team will include a Clinical Nurse Specialist (CNS) in
Diabetes -Integrated Care.
The appointment of a CNS in Diabetes - Integrated Care, is an essential element in the
provision of a collaborative link to achieve integration between primary care and secondary
care providers. The role is also an essential resource in empowering patients to achieve
optimum diabetes control.
The CNS (Diabetes – Integrated Care) will work as part of a multidisciplinary team,
delivering diabetes care to all patients with Type 2 Diabetes in General Practice, as part of,
and working to the National Diabetes Programme Integrated Care Programme. The post
holder will operate within the agreed model of integrated diabetes care and have agreed
referral protocols and care pathways for providing care to patients with complicated Type 2
Diabetes referred to him/her and will provide support to healthcare professionals involved
in the provision of integrated diabetes care (complicated and uncomplicated) in primary
The CNS (Diabetes - Integrated Care) will work 80% of his/her time in general
practice/primary care. She/He will provide a link for referral to the diabetes services in the
acute hospital/secondary care setting and will spend 20% (1 day per week) of his/her time
in the diabetes services in the secondary care diabetes centre. There will be agreed
referral protocols for patients who need referral to Secondary Care Diabetes Services.
Prescriptive authority for medicinal products will be an advantage to the implementation of
the Integrated Care Programmes, thus successful candidates will be requested to
undertake the requirements to become a Registered Nurse Prescriber (RNP) in Ireland.
The post holder:
Is professionally accountable to the Director of Nursing in the acute hospital/secondary
care setting
Will have line management reporting arrangements to the Asst Director of Nursing
responsible for the Diabetes Nursing Services.
Key Working
The post holder will:
 Have a clinical working relationship with the relevant Consultant Endocrinologist in
secondary care, the Primary Care Clinical Lead responsible for the service and the GP
responsible for the patient.
 Provide support to healthcare professionals involved in the provision of integrated
diabetes care in primary care such as General Practitioners and Practice Nurses and
other primary care nurses partaking in the Integrated Care Programme.
 Provide support to healthcare professionals involved in the provision of integrated
diabetes care in secondary care services.
 Provide support to an integrated care programme management/governance
committee/group/structure developed to ensure the Integrated Care Programme and the
CNS role is embedded in the primary care and secondary care settings across
Purpose of the
The purpose of this post is to support the implementation of the National Diabetes
Programme model of integrated care/structured diabetes care in primary care in order to
enhance the process of care for patients between primary and secondary care. This post
will also involve the core elements of the CNS post to include clinical audit and research.
Principal Duties
Clinical Focus – direct and indirect clinical care
The CNS (Diabetes – Integrated Care) will:
Practice in accordance to relevant legislation, the scope of Nursing & Midwifery
Practice Framework (ABA 2000) and Code of Professional Conduct (ABA 2000).
Assess, using agreed nursing assessments, develop individualised care plans,
initiate and evaluate care and treatment modalities within agreed interdisciplinary
protocols to achieve agreed patient/client centred clinical and nursing outcomes.
Identify health promotion priorities in the area of specialist practice
Use a case management approach to patient with complex needs, to include
prescribing of appropriate medications once a Registered Nurse Prescriber (RNP).
Implement health promotion strategies for patient/client groups in accordance with
the public health agenda.
Support Practice Nurses and General Practitioners involved in the diabetes
integrated, structured care programme.
Develop and evaluate, in consultation with stakeholders, integrated care pathways
for patients with Type 2 Diabetes.
Liaise with hospital staff in order to facilitate the integration of care between
primary and secondary organisations.
Attend identified general practices/primary care centres to support the GP and
Practice Nurse in the provision of structured integrated diabetes care for patients.
Use standardised equipment to monitor and treat diabetes within the community,
which is in line with best practice.
Agree and establish clear referral pathways to enhance communication and cooperation with medical staff, GPs, Practice Nurses and Public Health Nurses and
members of the primary care and secondary care teams.
Support the initiation and continuing care of patients with Type 2 Diabetes who
have been commenced on insulin/injectable therapy.
Facilitate liaison with secondary care services as per agreed protocol and as
necessary for individual patients/clients by spending one day per week in the
secondary care diabetes service where duties will include:
 Preparation of inpatients for discharge as per integrated care programme,
who fall into the remit of the CNS to include new & review patients
Case management liaison with Consultant Endocrinologist / Hospital
based diabetes nurse team for patients who fall beyond the remit of the
CNS as agreed by the integrated care programme.
Patient Advocate
The CNS (Diabetes – Integrated Care) will:
Enable patients/clients families and communities to participate in decisions about
their health needs
Articulate and represent patient/client interests in collaboration with the
multidisciplinary team
Implement changes in healthcare services in response to patient/client need and
service demand
Provide an efficient, effective and high quality service, respecting the needs of
each patient
Actively promote positive approaches enabling patients and families to participate
in the management of their diabetes.
Participate in team discussions regarding treatment for diabetic patients
Have knowledge of existing resources/services, which help patients and their
families/significant others, e.g. social services, support groups, entitlements.
Establish maintain and improve procedures for collaboration and co-operation
between acute services, community services and voluntary organisations.
Education and Training: - Patient, Self and others
The CNS (Diabetes – Integrated Care) will:
Assist with the establishment, delivery and evaluation of structured patient
education programmes
Provide group or individual education sessions for the commencement of
injectable therapies/insulin therapy where appropriate, for patients with Type 2
Provide mentorship, perceptorship, teaching, facilitation and professional
supervisory skills for nurses and midwives and other healthcare workers.
Educate patient/clients, families and communities in relation to their healthcare
needs in the specialist area of practice.
Facilitate structured and impromptu educational opportunities to facilitate staff
development and patient education.
Identify own continuing professional development needs and engage accordingly
Provide advice and support to practice staff involved in the diabetes structured
care in Primary Care
Be responsible for his/her continuing education through formal and informal
educational opportunities, thus ensuring continued credibility amongst nursing,
medical and paramedical colleagues.
Liaise with academic centres including graduate and post graduate education
departments in advisory or teaching capacity
Participate as an active member on practice and community conferences relating
to provision of diabetes care
Promote an awareness of diabetes through health promotion literature and make
health promotion and education literature available to practices.
Undertake the nurse prescribing of medicinal products certificate and achieve
other requirements to become a registered nurse prescriber within an agreed
timeframe i.e. within 2 years of taking up the post.
Audit and Research
The CNS (Diabetes – Integrated Care) will:
Utilise local IT systems to maintain current patient data
Identify, critically analyse, disseminate and integrate nursing/midwifery and other
evidence into the specialist area of practice.
Initiate and participate in evaluations and audits
Use outcomes of audit to improve service provision
Participate in the audit system, which will measure effectiveness of care
Contribute to the delivery and implementation of guidelines and standards in
Diabetes Care across the care settings.
Participate in quality improvements initiatives
Participate and initiate research projects which have the potential to add to the
body of nursing knowledge
Contribute to service planning and budgetary processes through use of audit data
and specialist knowledge
The CNS (Diabetes – Integrated Care) will:
Provide professional leadership in clinical practice and act as a resource and role
model for specialist practice.
Generate and contribute to the development of clinical standards of practice and
Use specialist knowledge to support and enhance general/midwifery practice
Maintain a network of contacts and communication links with other professionals
and organisations in the area of specialist practice including nursing and
multidisciplinary team members within the service and Public Health Nurses,
General Practitioners and all other health professionals in the community and
voluntary groups as appropriate.
Foster relationships with allied health professionals/agencies which enhance
multidisciplinary team working and ensuring role clarity.
Health & Safety
The CNS (Diabetes – Integrated Care) will:
Contribute to the development of policies, procedures guidelines and safe
professional practice and adhere to relevant legalisation, regulations and
Have a working knowledge of HIQA Standards as they apply to the role, for
example, Standards for Healthcare, National Standards for the Prevention and
Control of Healthcare Associated Infections, Hygiene Standards etc. and comply
with associated HSE protocols for implementing and maintaining these standards.
Management / Administration:
The CNS (Diabetes – Integrated Care) will:
Provide an efficient, effective and high quality service, respecting the needs of
each patient/client
Effectively manage time and caseload in order to meet the changing and
developing service
Continually monitor the service to ensure it reflects current needs
Implement and manage identified changes
Ensure confidentiality in relation to patient/client records is maintained
Maintain accurate and up to date statistics of the service provided, including audit
of patient/client contacts
Represent the specialist service at local, national and international meetings as
Maintain accurate and contemporaneous records/data on all matters pertaining to
the planning, management, delivery and evaluation of this service in line with HSE
Compile and maintain resource files of services available to persons with diabetes,
respond to queries from hospitals, GPs and Practice Nurse regarding diabetes
Facilitate the holding and maintenance of a diabetes register in each practice in
the Integrated Care Programme.
Ensure that practices have a call/recall system appropriate to the provision of this
Develop, in conjunction with the participating practices, an up to date
documentation system for use by all personnel involved with the project.
Collect statistical information and data to help develop and improve the service
Produce regular reports on progress in service development
Contribute to service planning process
The above Job Specification is not intended to be a comprehensive list of all duties
involved and consequently, the post holder may be required to perform other duties
as appropriate to the post which may be assigned to him/her from time to time and
to contribute to the development of the post while in office.
Eligibility Criteria
Candidates must, at the latest date for receipt of completed applications for the post:
and/ or
Be registered in the General Division of the Register of Nurses kept Bord Altranais agus
Cnáimhseachais na hÉireann (Nursing Midwifery Board Ireland) or be entitled to be so
Have at least 5 years post registration experience in the general division of the register of
which the applicant is currently practicing
Have a minimum of 2 years experience in the specialist area of diabetes nursing care*
Have the ability to practice safely and effectively fulfilling his/her professional responsibility
within his/her scope of practice
Demonstrate evidence of continuing professional development
Must hold a Level 8 post registration National Qualifications Authority of Ireland (NQAI)
major academic award relevant to the specialist area of Diabetes prior to application.
*Examples of experience would include working in General Medical Nursing where patient
with diabetes are cared for, Emergency Departments, Endocrinology ward/departments
A candidate for and any person holding the office must be fully competent and capable of
undertaking the duties attached to the office and be in a state of health such as would
indicate a reasonable prospect of ability to render regular and efficient service.
Each candidate for and any person holding the office must be of good character
Age restrictions shall only apply to a candidate where he/she is not classified as a new
entrant (within the meaning of the Public Service Superannuation Act, 2004). A candidate
who is not classified as a new entrant must be under 65 years of age.
Post Specific
and/or knowledge
Professional Knowledge
Demonstrate depth and breadth of experience in providing nursing care relevant to
the area of diabetes to include experience of working autonomously in an outpatient
setting and experience of constructing diabetic care packages/treatment programmes
for diabetic clients.
 Once appointed as the CNS the appointee must agree to undertake the Nurse
Prescribing of Medicinal Products Certificate, and achieve the requirements to
become a Registered Nurse Prescriber (RNP) in Ireland within an agreed timeframe
(i.e. 2 years of taking up the post).
an in-depth knowledge of the role of the Clinical Nurse Specialist and clinical nurse
specialist practice
a vision for diabetes integrated care provision crossing primary and secondary
clinical knowledge of all aspects of diabetes care provision
an understanding of the principles of clinical governance and risk management
ability and evidence of teaching in the clinical area
a working knowledge of audit and research processes
evidence of computer skills including use of Microsoft Word, Excel, E-mail and
Online Search facilities.
Communication & Interpersonal Skills
effective communication skills
ability to build and maintain relationships particularly in the context of
multidisciplinary working
ability to present information in a clear and concise manner
ability to manage groups through the learning process
ability to provide constructive feedback to encourage future learning
effective presentation skills
Planning and Organisational skills
evidence of effective planning and organisational skills including awareness of
appropriate resource management.
ability to attain designated targets, manage deadlines and multiple tasks
ability to be self directed, work on own initiative
a willingness to work flexibly in response to changing local/organisational
Leadership and Team Management skills
leadership and team management skills including the ability to work with
multidisciplinary team members.
Customer/Client Focus:
awareness and active appreciation of the service user
commitment to providing a quality service
evidence of motivation by ongoing professional development.
Analysing & Decision Making
specific to the
Specific Selection
Shortlisting /
effective analytical, problem solving and decision making skills
Access to transport as the post will involve frequent travel
Short listing may be carried out on the basis of information supplied in your application
form. The criteria for short listing are based on the requirements of the post as outlined in
the eligibility criteria and skills, competencies and/or knowledge section of this job
specification. Therefore it is very important that you think about your experience in light of
those requirements.
Failure to include information regarding these requirements may result in you not being
called forward to the next stage of the selection process.
Those successful at the shortlisting stage of this process (where applied) will be called
forward to interview.
Code of Practice
The Health Service Executive will run this campaign in compliance with the Code of
Practice prepared by the Commission for Public Service Appointments (CPSA). The Code
of Practice sets out how the core principles of probity, merit, equity and fairness might be
applied on a principle basis. The Codes also specifies the responsibilities placed on
candidates, feedback facilities for candidates on matters relating to their application, when
requested, and outlines procedures in relation to requests for a review of the recruitment
and selection process, and review in relation to allegations of a breach of the Code of
Practice. Additional information on the HSE’s review process is available in the document
posted with each vacancy entitled “Code Of Practice, Information For Candidates”.
Codes of Practice are published by the CPSA and are available on in the
document posted with each vacancy entitled “Code of Practice, Information For
Candidates” or on
The reform programme outlined for the Health Services may impact on this role and as structures change the job
description may be reviewed.
This job description is a guide to the general range of duties assigned to the post holder. It is intended to be
neither definitive nor restrictive and is subject to periodic review with the employee concerned.
Clinical Nurse Specialist (Diabetes)
Terms and Conditions of Employment
The initial vacancies for this post are permanent whole time. This post is pensionable. A
panel will be formed from this recruitment campaign and future permanent or specified
purpose vacancies of whole-time or part-time duration will be filled from this panel. The
tenure of these posts will be indicated at “expression of interest” stage
Appointment as an employee of the Health Service Executive is governed by the Health Act
2004 and the Public Service Management (Recruitment and Appointment) Act 2004.
The Salary Scale (as at 01/07/13) for the post is:
Euro 47,089 – 47,886 – 48,559 – 49,659 – 50,874 – 52,067 – 53,260 – 54,604 – 55,852
(pro rata)
Working Week
The standard working week applying to the post is: 39 hours (pro rata)
HSE Circular 003-2009 “Matching Working Patterns to Service Needs (Extended
Working Day / Week Arrangements); Framework for Implementation of Clause 30.4 of
Towards 2016” applies. Under the terms of this circular, all new entrants and staff
appointed to promotional posts from Dec 16th 2008 will be required to work agreed roster
/ on call arrangements as advised by their line manager. Contracted hours of work are
liable to change between the hours of 8am-8pm over seven days to meet the
requirements for extended day services in accordance with the terms of the Framework
Agreement (Implementation of Clause 30.4 of Towards 2016).
Annual Leave
The annual leave associated with the post is to be confirmed at job offer stage.
Membership of the HSE Employee Superannuation Scheme applies to this appointment.
Existing Members who transferred to the HSE on 1st January 2005 pursuant to Section
60 of the Health Act 2004 are entitled to superannuation benefit terms under the HSE
Scheme which are no less favourable to those to which they were entitled at 31 st
December 2004.
Appointees to posts in the Mental Health Services which formerly attracted fast accrual
of service should note that the terms of Section 65 of the Mental Treatment Act 1945 do
not apply to New Entrant Public Servants as defined by Section 12 of the Public Service
Superannuation (Miscellaneous Provisions) Act 2004.
Every appointment of a person who is not already a permanent officer of the Health
Service Executive or of a Local Authority shall be subject to a probationary period of 12
months as stipulated in the Department of Health Circular No.10/71.
As this post is one of those designated under the Protection of Persons Reporting Child
Abuse Act 1998, appointment to this post appoints one as a designated officer in
accordance with Section 2 of the Act. You will remain a designated officer for the duration
of your appointment to your current post or for the duration of your appointment to such
other post as is included in the categories specified in the Ministerial Direction. You will
Protection of
Reporting Child
Abuse Act 19981
Infection Control
receive full information on your responsibilities under the Act on appointment.
Have a working knowledge of HIQA Standards as they apply to the role for example,
Standards for Healthcare, National Standards for the Prevention and Control of
Healthcare Associated Infections, Hygiene Standards etc.
Appendix 1 – Categories of Designated Officers
Categories of Designated Officers as set out in DoHC letter, date 2003 directing change to list
of Designated Officers under PPRCA Act, 1998
Social Workers
Child Care Workers
Public Health Nurses
Hospital Consultants
Non-Consultant Hospital Doctors
All other Health Board Medical and Dental
Community Welfare Officers
Speech and Language Therapists
All Health Board Nursing Personnel
Occupational Therapists
Health Education/Health Promotion Personnel
Substance Abuse Counsellors
Care Assistants
Child Care Managers
Family Support Co-ordinators
Family Support Workers
Environmental Health Officers
Pre-school Services Inspectors
Childminder Co-ordinators
Managers of Disability Services
Residential Care Managers/Residential Child
Care Workers
HIV and AIDS Services
Counsellors in Services for AVPA
Children First Information & Advice Persons
Children First Implementation Officers
Quality Assurance Officers
Advocacy Officers
Access Workers
Project Workers
Training and Development Officers