Dietitian, Clinical Specialist (Cardio Metabolic Chronic Disease (CMCD))
HSE West and North West Community Services
Job Specification & Terms and Conditions
Job Title, Grade Code
Dietitian, Clinical Specialist (Cardio Metabolic Chronic Disease)
(Grade Code: 3715)
Remuneration
The salary scale for the post as at 01/03/2025 is:
€69,998; €71,349; €72,737; €74,117; €75,496; €76,949; €78,478; €80,004; €81,288
New appointees to any grade start at the minimum point of the scale. Incremental credit will be applied for recognised relevant service in Ireland and abroad (Department of Health Circular 2/2011). Incremental credit is normally granted on appointment, in respect of previous experience in the Civil Service, Local Authorities, Health Service and other Public Service Bodies and Statutory Agencies.
Campaign Reference
CHW45CSD25
Closing Date
13th June 2025 at 12 Noon
Proposed Interview Date (s)
Interviews will be held as soon as possible after closing date.
Candidates will normally be given at least two weeks' notice of interview. The timescale may be reduced in exceptional circumstances.
Taking up Appointment
A start date will be indicated at job offer stage.
Location of Post
There is currently one permanent whole time vacancy available in:
Mayo Integrated Hub, County Clinic Castlebar Co Mayo F23 XK72
A supplementary panel may be formed as a result of this campaign for Dietitian, Clinical Specialist (Cardio Metabolic Chronic Disease) HSE West and North West Community Services (Galway/Mayo/Roscommon) from which current and future, permanent and specified purpose vacancies of full or part-time duration for the post of Dietitian, Clinical Specialist (Cardio Metabolic Chronic Disease) may be filled.
Informal Enquiries
Heather Miller, Dietitian Manager in Charge
Mobile: 087 4531996
Email: heather.miller@hse.ie
Caroline Groarke, Operational Lead for the Integrated Chronic Disease Hub, Mayo.
Mobile: 0872563069
Email: caroline.groarke1@hse.ie
Details of Service
In line with Sláintecare (2017) and the Department of Health’s Capacity review (2018), a shift in healthcare service provision is now required to place the focus on integrated, person-centred care, based as close to home as possible. In order to enable this, the Integrated Care Programme for the Prevention and Management of Chronic Disease (ICPCD) is supporting the national implementation of a model of integrated care for the prevention and management of chronic disease as part of the Enhanced Community Care Programme (ECC). The Model of Care for the Integrated Prevention and Management of Chronic Disease has a particular focus on preventive healthcare, early intervention and the provision of supports to live well with chronic disease.
The investment in the ECC programme will be delivered on a phased basis with a view to national coverage being achieved within a two- to three- year period. Three priority areas have been identified as follows:
1. Structural reform of healthcare delivery within the community with Community Health Networks (CHNs) becoming the basic building blocks for the organisation, management and delivery of community services across the country;
2. Creating Specialist IntegratedCare Hubs within the community to support primary care management of chronic disease and older people with complex needs; and,
3. Scaling Integrated Care for Older People and Chronic Disease through the recruitment of specialist integrated care teams including Frailty at the Front Door Teams.
Integrated care hubs provide access to specialist services within the community with each hub affiliated with a local hospital and serve a population of approximately 150,000 and will focus primarily on the prevention and management of chronic disease (cardiovascular disease, diabetes and chronic respiratory disease). There are 3 Integrated Care Hubs in HSE West and North West Community Services (Galway/Mayo/Roscommon)and all 3 are operational
· Galway City Hub (linked with University Hospital Galway)
· East Galway/Roscommon Hub (linked with Portiuncula University Hospital and Roscommon University Hospital)
· Mayo Hub (linked with Mayo University Hospital)
Each integrated care hub has the following staffing
· Consultant Cardiologist, Integrated Care
· 3 Hub CVD CNS’s
· 1 WTE CR Coordinator,
· 1 WTE CR Staff Nurse,
· 1 WTE Senior Cardiac Physiotherapist,
· 0.2 WTE Senior Clinical Psychologist.
· 1 WTE cardiac physiologist.
The Integrated Cardiology Service provides
· A holistic, multidisciplinary approach to the care of individuals with heart failure, atrial fibrillation and atherosclerotic CVD
· Comprehensive holistic cardiac rehabilitation as per the newly published HSE Model of Care for CR. It is also anticipated that the hub CR services will run in an integrated fashion with existing hospital-based CR including joint MDTs with the integrated care consultant cardiologist
· Early intervention pathways/rapid access clinics for heart failure and atrial fibrillation
· Direct access diagnostics for primary care including Echocardiography
Role of the Clinical Specialist Dietitian CMCD.
Multimorbidity refers to the presence of two or more concomitant chronic diseases and is one of the most challenging issues in healthcare today being associated with increased disability and functional impairment, lower quality of life, increased health services utilization, fragmentation of care and increased mortality. CMCD disease is one of the most prevalent chronic disease combinations with multiple clinical manifestations including heart failure, atrial fibrillation, hypertension, chronic kidney disease, atherosclerotic CVD, type 2 Diabetes Mellitus and Obesity. CMCD also increases the risk of developing COPD and conversely COPD is independently associated with ischemic heart disease (IHD), heart failure (HF), atrial fibrillation, and peripheral vascular disease likely due to systemic inflammation and shared lifestyle risk factors. For these reasons CMCD is particularly relevant to the integrated care hubs. But the cardiology integrated care service currently has no dietetic support despite diet/anthropometrics being one of the most potent modifiers of CVD and in particular CMCD.
The role of the Dietitian, Clinical Specialist CMCD
The successful candidate will:
- Develop and deliver integrated dietetic care across hospital and community CR services in conjunction with the cardiac rehab team
- Provide clinical leadership for the development of dietetic services for patients with CRM in the integrated care hub
- Provide clinical Dietetic assessment and intervention to people presenting with multi-morbidity including 2 or more of the following; Type 2 Diabetes Mellitus, Obesity, Heart Failure, atrial fibrillation, hypertension, chronic kidney disease or CVD.
- Foster close working relationships with existing dietetic services across hospital and community including (but not limited to) renal, hepatology, diabetes, bariatric and cardiology to avoid duplication of services and streamline care for the hub patients with CMCD as much as possible.
It is recognised however the exact role will differ according to the needs and configuration of existing services at the local level.
The post holder will work as part of the hub cardiology multidisciplinary team as well as provide supervision and education to other hub staff (e.g. staff grade/senior Dietitian working in cardiac rehab across acute and Community).
The post will be based in the Integrated Care Hub cardiology service with close links and cross working into the associated hospital.
Reporting Relationship
· Operationally Accountable to the Operational Lead Integrated Care ICPCD Specialist Community Team on operational and administrative matters
· Professionally and Clinically Accountable to the Dietetic Manager
Key Working Relationships
· Clinical working relationship with the Consultant Cardiologist,
· Consultant teams working across the continuum of integrated care for chronic disease e.g. Cardiology, Diabetes and Obesity services in CHO 2.
· Chronic disease multi-disciplinary HSCP teams across CHO 2
· Healthcare professionals and stakeholders involved in the provision of Chronic Disease care (Cardiology, Diabetes, Obesity & Respiratory) as part of Integrated Care in primary care such as General Practitioners (GP) and Practice Nurses (PN) and the broader multidisciplinary team when required;
· Healthcare professionals and stakeholders involved in the provision of integrated Chronic Disease care (Cardiology, Diabetes, Obesity & Respiratory) in the acute hospital setting.
· Dietitian Managers in acute, community and chronic disease hub services etc
· National Chronic Disease Self-management Education and Support Office
· National Clinical Programmes for Cardiology, Diabetes and Obesity
Purpose of the Post
The Dietitian Clinical Specialist CMCD will:
· Provide a specialist dietetic service for the eligible patient population with CMCD in the integrated care hubs
· Provide a specialist dietetic service across both hospital and hub CR services.
· Participate in the development of the strategic direction of the Nutrition & Dietetic service in conjunction with the Dietitian Manager, the operational lead and clinical lead within the integrated care hub and other relevant agencies and stakeholders.
· Act as a resource and provide expert opinion, advice and guidance to dietetic colleagues and other healthcare professionals
· Contribute to inter-professional patient assessment as a core member of the multi-disciplinary team highlighting nutritional risks and priorities and translating the evidence and best practice guidelines into a nutrition care plan that is part of a collaborative care decision making process.
· Develop a service model in collaboration with key stakeholders and the Operational lead for integrating dietetics services across inpatient and hub settings, with a focus on supporting early discharge home and admission avoidance
· Collaborate with dietitian colleagues nationally in the design, development and implementation of a standardised CR dietetic curriculum for CR services across hospitals and integrated care hubs.
· Participate in the development of the strategic direction of the Nutrition & Dietetic service in conjunction with the Dietitian Manager and the op lead and relevant agencies and stakeholders.
In conjunction with the Dietitian Manager, develop local policies and care pathways within the specialist area.
Principal Duties and Responsibilities
The Dietitian Clinical Specialist CMCD will:
Professional
· Provide leadership on development of innovative dietetic service design and delivery solutions to support implementation of services within the integrated care hubs for patients living with cardiometabolic multimorbidity
· Identify and prioritise the requirements of the service within a constantly changing environment.
· Ensure professional standards are maintained in accordance with the requirements as set out by CORU https://coru.ie/files-recognition/standards-of-proficiency-for-dietitians.pdf
· Ensure a high standard of dietetic assessment and management and ensure that professional standards of practice are adhered to. Set and monitor performance standards.
· Keep abreast of research and practice developments in the specialist area. Develop innovative models of dietetic care and service delivery.
· Develop, manage and evaluate the service provided in the designated specialist area.
· Undertake research and develop and maintain high standards of clinical practice within the designated specialist area.
· Provide expert opinion, advice and guidance to dietetic colleagues, medical team members and other health professionals.
· Undertake audit to establish service needs and monitor current service.
· Seek ways to benchmark and assure quality of the dietetic service.
· Be aware of national policy, guidelines and consultations and in conjunction with the Dietitian Manager, develop local policies and care pathways within the specialist area.
· Actively engage with relevant special interest groups and research-associated bodies, as appropriate.
· Serve on local or national committees to promote nutrition and dietetic practice.
· Ensure the privacy and dignity of the service user is respected at all times.
Education and Development
· Contribute to a structured process for the education of colleagues and other disciplines in the specialist area.
· Engage with professional disciplines & academic institutions in developing and evaluating educational programmes in dietetics. Contribute, where appropriate, to the implementation and delivery of these programmes. Contribute to the critical assessment of participants undertaking such modules, as deemed appropriate by the institution / discipline.
· Actively participate in a structured continuous professional development (CPD) process and promote the professional and personal development of staff.
· Engage in the HSE performance achievement process in conjunction with your Line Manager and staff as appropriate.
· Ensure a clinical supervision programme is available to staff.
· Disseminate advanced clinical practice guidelines. Produce current, clear, evidence-based resources for patients and carers and / or health professionals, suitable for use locally and / or nationally.
· Contribute to a structured process for the education of colleagues, undergraduates and other disciplines in the specialist area.
·
· Quality and Risk, Health and Safety Management
· Liaise with line manager and with other departments to ensure safe and effective service delivery consistent with health service management strategies.
· Promote a safe working environment in accordance with Health and Safety legislation.
· Implement agreed policies, procedures and safe professional practice by adhering to relevant legislation, regulations and standards.
· Be aware of risk management issues. Adequately identifies, assesses, manages and monitors risk within their area of responsibility.
· Document appropriately and report any adverse incidents, near misses, hazards and accidents in accordance with organisational guidelines.
Management
· Collaborate with relevant stakeholders in relation to the strategic direction of the service.
· Negotiate strategic plans for service delivery in conjunction with line manager.
· Take responsibility for achieving service delivery targets by monitoring, recording and reporting activity levels.
· Manage day-to-day operations of the service with regard to scheduling and assignment of staff, ensuring seamless delivery of care and equity of workloads between team members
· Facilitate change where necessary in order to maintain services at an optimal level.
· Be involved in the collection, processing and analysis of data, for research purposes and for use as a national resource.
· Ensure compliance with a high standard of documentation, including service user files in accordance with local guidelines, Freedom of Information (FOI) and General Data Protection Regulation (GDPR).
· Have a working knowledge of the Health Information and Quality Authority (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 as appropriate to the role.
· Support, promote and actively participate in sustainable energy, water and waste initiatives to create a more sustainable, low carbon and efficient health service.
·
· 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 them from time to time and to contribute to the development of the post while in office.
Eligibility Criteria
Qualifications and/ or experience
Candidates must have at the latest date of application:
1. Statutory Registration, Professional Qualifications, Experience, etc
(a) Candidates for appointment must:
i. Be registered, or be eligible for registration, on the Dietitians Register maintained by the Dietitians Registration Board at CORU.
And
ii. Have 5 years full time (or an aggregate of 5 years) years post registration qualification experience. Of which 4 years full time (or an aggregate of 4 years) post registration qualification clinical experience must be in the required area of Specialism.
And
iii. Demonstrate a proven record of clinical excellence in the specialism
And
iv. Candidates must demonstrate evidence of continuing professional development relevant to the required area of specialism, in the form of post-graduate qualification or relevant courses.
And
v. Candidates must demonstrate achievement in the areas of clinical audit, quality improvement initiatives, practice development, teaching and research.
And
vi. Provide proof of Statutory Registration on the Dietitians Register maintained by the Dietitians Registration Board at CORU before a contract of employment can be issued.
2. Annual registration
1. On appointment practitioners must maintain annual registration on Dietitians Register maintained by the Dietitians Registration Board at CORU.
And
1. Practitioners must confirm annual registration with CORU to the HSE by way of the annual Patient Safety Assurance Certificate (PSAC).
3. Health
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.
4. Character
Each candidate for and any person holding the office must be of good character.
Post Specific Requirements
Demonstrate depth and breadth of experience in management of cardio-metabolic conditions as relevant to the role.
Other requirements specific to the post
Access to appropriate transport to fulfil the requirements of the role.
Skills, competencies and/or knowledge
Professional Knowledge and Experience
· Demonstrates an advanced level of clinical knowledge, clinical reasoning skills and evidence based practice appropriate to carrying out the duties and responsibilities of the role in line with relevant legislation and standards.
· Demonstrates an ability to apply specialist knowledge to best practice.
· Demonstrates evidence of having applied / used appropriate assessments and treatments and a knowledge of the implications of outcomes for service users, particularly those with complex needs in the specialist area.
· Participates in research and continuously generate new knowledge and skills
· Demonstrates evidence of computer skills including use of Microsoft Word, Excel, email and PowerPoint systems, as relevant to the role.
· Maximises the use of ICT with a willingness to develop IT skills relevant to the role.
Planning and Managing Resources
· Balances clinical work with other research and educational responsibilities.
· Provides flexible interventions to meet the varied needs of individual service users.
· Demonstrates the ability to plan and manage the delivery of an optimum service in an effective and resourceful manner, within a model of person-centred care.
· Demonstrates a high level of initiative, flexibility and adaptability in response to workforce demands.
· Promotes the delivery of a holistic, user-focused approach, which encompasses a multi-professional and inter-professional perspective.
Managing and Developing (Self & Others)
· Demonstrates advanced leadership and team skills including the ability to lead by example.
· Demonstrates a commitment to managing and developing self and others in a busy working environment.
· Deals positively and constructively with obstacles and conflict within teams.
· Demonstrates commitment to continuing professional development (CPD) and facilitates staff development by providing support such as; supervising, mentoring, coaching and formal development planning. Develops and/or implements systems to support a CPD culture within the service.
Commitment to Providing a Quality Service
· Demonstrates commitment to providing quality results.
· Leads on the design, delivery and implementation of a high-quality, person-centred service.
· Demonstrates and promotes collaborate working relationships as well as having the ability to work independently and exercise a high degree of professional autonomy.
· Displays awareness and appreciation of service users and the ability to empathise with and treat others with dignity and respect.
Evaluating Information and Judging Situations
· Exercises a high degree of professional autonomy in the analysis of highly complex facts or situations that contribute to the implementation of a treatment or management strategy for the service user.
· Uses a broad range of resources to identify key issues that may impact on dietetic practice.
· Critically evaluates and draws sound conclusions from evidence available pertaining to clients and the potential impact of new or altered therapies.
· Evaluates effectiveness and outcome of any new or altered therapies implemented and revises practice based on results.
Communication and Interpersonal Skills
· Displays effective communication skills (written & verbal) e.g. presents written information in a clear, concise and well-structured manner / communicates complex information by tailoring the communication method and the message to match the needs of the audience.
· Demonstrates sound interpersonal skills including the ability to collaborate effectively with a wide range of people, colleagues, families, carers etc.
· Demonstrates sensitivity, diplomacy and tact when dealing with others and is patient and tolerant when dealing with conflict or negative attitudes from others.
· Demonstrates strong negotiation skills, remains firm but flexible when putting forward a point of view.
Campaign Specific Selection Process
Ranking/Shortlisting / Interview
A ranking and or shortlisting exercise may be carried out on the basis of information supplied in your application form. The criteria for ranking and or shortlisting 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 ranking stage of this process (where applied) will be placed on an order of merit and will be called to interview in ‘bands’ depending on the service needs of the organisation.
Diversity, Equality and Inclusion
The HSE is an equal opportunities employer.
Employees of the HSE bring a range of skills, talents, diverse thinking and experience to the organisation. The HSE believes passionately that employing a diverse workforce is central to its success – we aim to develop the workforce of the HSE so that it reflects the diversity of HSE service users and to strengthen it through accommodating and valuing different perspectives. Ultimately this will result in improved service user and employee experience.
The HSE is committed to creating a positive working environment whereby all employees inclusive of age, civil status, disability, ethnicity and race, family status, gender, membership of the Traveller community, religion and sexual orientation are respected, valued and can reach their full potential. The HSE aims to achieve this through development of an organisational culture where injustice, bias and discrimination are not tolerated.
The HSE welcomes people with diverse backgrounds and offers a range of supports and resources to staff, such as those who require a reasonable accommodation at work because of a disability or long term health condition.
Read more about the HSE’s commitment to Diversity, Equality and Inclusion
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 CPSA is responsible for establishing the principles to be followed when making an appointment. These are set out in the CPSA Code of Practice. The Code outlines the standards to be adhered to at each stage of the selection process and sets out the review and appeal mechanisms open to candidates should they be unhappy with a selection process.
Read the CPSA Code of Practice.
The reform programme outlined for the Health Services may impact on this role and as structures change the Job Specification may be reviewed.
This Job Specification 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.
Dietitian, Clinical Specialist (Cardio Metabolic Chronic Disease (CMCD))
HSE West and North West Community Services
Terms and Conditions of Employment
Tenure
The current vacancy available is permanent and whole time.
The post is pensionable. A supplementary panel may be formed as a result of this campaign for Dietitian, Clinical Specialist (Cardio Metabolic Chronic Disease) HSE West and North West Community Services (Galway/Mayo/Roscommon) from which current and future, permanent and specified purpose vacancies of full or part-time duration for the post of Dietitian, Clinical Specialist (Cardio Metabolic Chronic Disease) may be filled. 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 Appointments) Act 2004 and Public Service Management (Recruitment and Appointments) Amendment Act 2013.
Working Week
The standard weekly working hours of attendance for your grade are 35 hours per week. Your normal weekly working hours are 35 hours. Contracted hours that are less than the standard weekly working hours for your grade will be paid pro rata to the full time equivalent.
You are required to work agreed roster/on-call arrangements advised by your Reporting Manager. Your contracted hours are liable to change between the hours of 8.00am and 8.00pm over seven days to meet the requirements for extended day services in accordance with the terms of collective agreements and HSE Circulars
Annual Leave
The annual leave associated with the post will be confirmed at Contracting stage.
Superannuation
This is a pensionable position with the HSE. The successful candidate will upon appointment become a member of the appropriate pension scheme. Pension scheme membership will be notified within the contract of employment. Members of pre-existing pension schemes who transferred to the HSE on the 01st 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 which they were entitled to at 31st December 2004
Age
The Public Service Superannuation (Age of Retirement) Act, 2018* set 70 years as the compulsory retirement age for public servants.
* Public Servants not affected by this legislation:
Public servants joining the public service or re-joining the public service with a 26 week break in service, between 1 April 2004 and 31 December 2012 (new entrants) have no compulsory retirement age.
Public servants, joining the public service or re-joining the public service after a 26 week break, after 1 January 2013 are members of the Single Pension Scheme and have a compulsory retirement age of 70.
Probation
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.
Protection of Children Guidance and Legislation
The welfare and protection of children is the responsibility of all HSE staff. You must be aware of and understand your specific responsibilities under the Children First Act 2015, the Protections for Persons Reporting Child Abuse Act 1998 in accordance with Section 2, Children First National Guidance and other relevant child safeguarding legislation and policies.
Some staff have additional responsibilities such as Line Managers, Designated Officers and Mandated Persons. You should check if you are a Designated Officer and / or a Mandated Person and be familiar with the related roles and legal responsibilities.
Visit HSE Children First for further information, guidance and resources.
Infection Control
Have a working knowledge of Health Information and Quality Authority (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 as appropriate to the role.
Health & Safety
It is the responsibility of line managers to ensure that the management of safety, health and welfare is successfully integrated into all activities undertaken within their area of responsibility, so far as is reasonably practicable. Line managers are named and roles and responsibilities detailed in the relevant Site Specific Safety Statement (SSSS).
Key responsibilities include:
• Developing a SSSS for the department/service[1], as applicable, based on the identification of hazards and the assessment of risks, and reviewing/updating same on a regular basis (at least annually) and in the event of any significant change in the work activity or place of work.
• Ensuring that Occupational Safety and Health (OSH) is integrated into day-to-day business, providing Systems Of Work (SOW) that are planned, organised, performed, maintained, and revised as appropriate, and ensuring that all safety related records are maintained and available for inspection.
• Consulting and communicating with staff and safety representatives on OSH matters.
• Ensuring a training needs assessment (TNA) is undertaken for employees, facilitating their attendance at statutory OSH training, and ensuring records are maintained for each employee.
• Ensuring that all incidents occurring within the relevant department/service are appropriately managed and investigated in accordance with HSE procedures[2].
• Seeking advice from health and safety professionals through the National Health and Safety Function Helpdesk as appropriate.
• Reviewing the health and safety performance of the ward/department/service and staff through, respectively, local audit and performance achievement meetings for example.
Note: Detailed roles and responsibilities of Line Managers are outlined in local SSSS.
[1] A template SSSS and guidelines are available on the National Health and Safety Function, here: https://www.hse.ie/eng/staff/safetywellbeing/about%20us/
2 See link on health and safety web-pages to latest Incident Management Policy
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