Christina Lilley, Macmillan Quality and Governance Lead for End of Life Care

Spring 2012

In post Since October 2011
Location Western General Hospital, Edinburgh
Contact Email Christina|

What does your role involve?

One of the main features of my role is to develop achievable key outcome measures for end-of-life care in NHS Lothian. We want these to reflect the quality and standards of care valued by patients, their families and carers, and by clinical teams. This is something that hasn’t been addressed in any great depth before in Scotland, and as such, this is quite an innovative role. I would be keen to hear from other professionals carrying out similar work.

Why was the post created?

Embedding key outcome measures within NHS Lothian’s quality and governance processes is vital to ensuring the long-term sustainability of improvements to care. This post was created to identify how this can be achieved within existing systems and resource, and to support the implementation of the resulting strategic plan.

What policies are behind the work?

Living and Dying Well is the national action plan for palliative and end-of-life care in Scotland, and Living and Dying Well in Lothian is the local strategy that aims to improve systems of identification, planning and communication in palliative and end-of-life care.

What are your key relationships in this role?

My role links with NHS Lothian’s Clinical Governance team, which provides specialist support around integration into organisational governance processes. It also links with the Liverpool Care Pathway (LCP) teams based in the acute and community settings. These teams are currently rolling out implementation of the LCP, an integrated plan for provision of care during the dying phase. They have a good knowledge of the LCP and an understanding of the challenges that have been faced during its implementation in different settings.

 

I will also work in partnership with specialist palliative care teams and the local managed clinical network for palliative care, which includes local hospices. This will ensure a consistent and coordinated approach to end-of-life care in Lothian.

What is your vision for patients?

Our vision is for optimal end-of-life care for all patients, in all care settings; where patients feel comfortable and secure. This includes having their individual care needs met, as well as those of their relatives and carers.

What challenges do you anticipate?

One of the challenges of this role will be to identify ways in which data can be captured and reported within existing systems and levels of resource.

Staff throughout NHS Lothian have many competing priorities, so we’ll need to make sure that the methods of data capture are kept simple, realistic, and are well-communicated. The LCP teams have already built good relationships with a number of other teams across care settings. This will help to support our communications plan.

What type of evaluation measures will you be using?

Feedback will be gathered from staff through questionnaires, focus groups and interviews. We also want feedback from relatives and carers. I’m aware of other groups and similar programmes of work both locally and in the UK already doing this, and I hope to get advice and learn from their experiences when developing our approach.

How would you like the role and service to develop?

After the initial scoping period to identify meaningful data, the focus will shift to implementing data capture and reporting in practice. I will need to respond to the challenges that arise from this. I hope that along the way there will be opportunities to become involved in relevant, collaborative research projects.

What type of work were you doing prior to this role?

I was a project manager for the Scottish Government’s Cancer team, where I worked on national projects associated with radiotherapy and chemotherapy provision across the nation. Prior to this I worked on cancer audits and in research. This post pulls together elements of work I’ve done in the past.

Why did you choose to go into this area of care?

I was always interested in working in healthcare. I wanted to make a difference. As work to develop outcome measures for end-of-life care is in its early stages, I saw this as an excellent opportunity to do just that, and to get involved in something that will benefit patients and their families long after the post has ended.

Who inspires you?

I admire the hard work and commitment to patient care shown by healthcare staff. I hope the achievements of this post will help support them in caring for patients and their families at the end-of-life.