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Dr Marlise Poolman

Uwch Ddarlithydd Clinigol

m.poolman@bangor.ac.uk

0000-0002-2837-363X

Dr Marlise Poolman

Gwelwch proffil Dr Marlise Poolman ar Bortal Ymchwil Bangor

Rhagolwg

I was appointed as Clinical Senior Lecturer in Palliative Medicine in 2009, and am based at the North Wales Centre for Primary Care Research in Wrexham. I am a senior hospice and palliative medicine specialist with an interest in quality improvement, an accomplished educator with experience of working at national level, and a researcher with a track record of securing UK National Institute for Health and Care Research (NIHR) funding. My particular areas of interest are care in the last days of life for home-based people (including in rural areas), and how best to prepare relatives/carers for the dying process. I am a strong advocate for the benefits of roles integrating clinical work, education and research.

Cymwysterau

  • Arall: Postgraduate Certificate in Professional Development in Higher Education
    Glyndwr University, 2011
  • Profesiynol: Membership
    Royal College of Physicians, London, 2004
  • Profesiynol: MB CHB with distinction
    University of Stellenbosch, 2000

Addysgu ac Arolygiaeth

I hold a post-graduate qualification in education (PGCPD in HE, obtained in 2011). In addition to delivering many teaching sessions over the years on palliative care topics to a range of (postgraduate) healthcare professionals in a range of education settings, I have had much involvement in education coordination and design in the region.

I am an appraiser for fellow consultants (specialists) in the region and a Designated Supervising Medical Practitioner (for ANP/non-medical prescribing training). Until recently, I was educational supervisor for the palliative medicine specialty trainees in North Wales, as well as for a range of other junior doctor clinical and academic training grade posts. I have experience of mentoring trainees, and dealing with those in difficulty.

I held the national position of Chair of the Wales Deanery Specialty Training Committee for Palliative Medicine for 4 years until my term expired in October 2017, and on a UK-wide basis I was a question writer for the Specialty Clinical Examination in Palliative Medicine (the knowledge-based exit examination for those sub-specialising in Palliative Medicine in the UK, and a pre-requisite for completion of specialty training) until 2021.

I am a Fellow of the UK Higher Education Academy.

Diddordebau Ymchwil

I was co-Chief Investigator on an NIHR-funded study of the feasibility of (unpaid relative/)carer-administered as-needed medication for symptoms in the last days of life in home-based patients. As co-author on the rapidly developed All-Wales policy in the pandemic context, I have led on clinical implementation since April 2020. I obtained my PhD qualification on the topic in April 2022. Through our work, we have influenced implementation of the intervention across the UK, and I am founding co-chair of the national Community of Practice.

Supported by infrastructure funding from PRIME Centre Wales, our unit's research programme focussing on community palliative care in the last days of life is gaining pace. I am co-lead for the PRIME work package on Supportive and End of Life Care. We have also built strong research links with Australian partners, where strategies to deliver rural palliative care are of utmost importance.

Between 2013 and 2019 I was a panel member of the NIHR HTA Panel A.

Cyhoeddiadau

2023

  • CyhoeddwydCARiAD: Training healthcare professionals to train lay carers
    Poolman, M., 25 Medi 2023
    Allbwn ymchwil: Cyfraniad arall › Cyfraniad Arall

2022

  • Heb ei GyhoeddiImplementation framework for carer-administration (utilising QIF)
    Poolman, M., 2022, (Heb ei Gyhoeddi)
    Allbwn ymchwil: Cyfraniad arall › Cyfraniad Arall
  • CyhoeddwydThe intricacy of interactions: qualitative exploration of prefernces and perceptions of advance care planning among healthcare professionals, patients and those close to them
    Hendry, A., Hiscock, J. & Poolman, M., Rhag 2022, Yn: Palliative Care and Social Practice . 16, 9 t.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid
  • CyhoeddwydThe juxtaposition of the natural and the medical perspectives in noisy breathing at the end of life
    Hendry, A., Hiscock, J., Evans, E., Pottie, J., Wilkinson, C. & Poolman, M., 2 Chwef 2022, Yn: International Journal of Palliative Nursing. 28, 2, t. 72-79 8 t.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

2020

  • CyhoeddwydCarer administration of as-needed sub-cutaneous medication for breakthrough symptoms in people dying at home: the CARiAD feasibility RCT
    Poolman, M., Roberts, J., Wright, S., Hendry, A., Goulden, N., Holmes, E., Byrne, A., Perkins, P., Hoare, Z., Nelson, A., Hiscock, J., Hughes, D., O'Connor, J., Foster, B., Reymond, L., Healy, S., Lewis, P., Wee, B., Johnstone, R. P. & Roberts, R. & 3 eraill, Parkinson, A., Roberts, S. & Wilkinson, C., 2 Meh 2020, Yn: Health Technology Assessment. 24, 25, 150 t.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid
  • CyhoeddwydCARer-Administration of as-needed subcutaneous medication for common breakthrough symptoms in home-based dying people in Wales (The CARiAD Package): Policy and procedure
    Poolman, M. & Shuler, A., 20 Maw 2020, 45 t. NHS Wales Health Collaborative.
    Allbwn ymchwil: Cyfraniad arall › Cyfraniad Arall › adolygiad gan gymheiriaid
  • CyhoeddwydDying at home of cancer: whose needs are being met? The experience of family carers and healthcare professionals (a multiperspective qualitative study)
    Pottle, J., Hiscock, J., Neal, R. D. & Poolman, M., Maw 2020, Yn: BMJ Supportive and Palliative Care. 10, 1, e6.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid
  • CyhoeddwydPercutaneous cervical cordotomy for cancer-related pain: national data
    INPIC Group, Rhag 2020, Yn: BMJ Supportive and Palliative Care. 10, 4, t. 429-434 6 t.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

2019

  • CyhoeddwydCARer-ADministration of as-needed subcutaneous medication for breakthrough symptoms in homebased dying patients (CARiAD): study protocol for a UK-based open randomised pilot trial
    Poolman, M., Roberts, J., Byrne, A., Perkins, P., Hoare, Z., Nelson, A., Hiscock, J., Hughes, D., Foster, B., O'Connor, J., Reymond, L., Healy, S., Roberts, R., Wee, B., Lewis, P., Johnstone, R., Roberts, S., Holmes, E., Wright, S. & Hendry, A. & 1 eraill, Wilkinson, C., 7 Chwef 2019, Yn: Trials. 20, 1, 16 t., 105.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid
  • CyhoeddwydDo published patient decision aids for end-of-life care address patients' decision-making needs? A systematic review and critical appraisal.
    Philips, G., Lifford, K., Edwards, A., Poolman, M. & Joseph-Williams, N., 1 Medi 2019, Yn: Palliative Medicine. 33, 8, t. 985-1002
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid
  • CyhoeddwydPercutaneous venting gastrostomy/gastrojejunostomy for malignant bowel obstruction: a qualitative study
    Singh Curry, R., Evans, E., Raftery, A.-M., Hiscock, J. & Poolman, M., 3 Rhag 2019, Yn: BMJ Supportive and Palliative Care. 9, 4, t. 381-388
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

2017

  • CyhoeddwydAssessing Advance Care Plan Discussions in Hospice Day Care
    Johnstone, R. P., Poolman, M., Ryan, K., Schofield, P. & Watt, B., 27 Medi 2017, Yn: Palliative Medicine and Hospice Care. 3, 2, t. 32-38 7 t.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid
  • CyhoeddwydCare Decisions for the Last Days of Life: A Welsh Perspective: Poster No. PO1-042
    Johnstone, R., Mitchell, H. & Poolman, M., Mai 2017.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Murlen › adolygiad gan gymheiriaid
  • CyhoeddwydCarer-administration of as-needed sub-cutaneous medication for breakthrough symptoms in homebased dying patients: a UK study (CARIAD)
    Wilkinson, C., Poolman, M., Roberts, J., Wee, B., Hiscock, J., Hughes, D., Nelson, A., Perkins, P., Johnstone, R. P., Reymond, E., Foster, B., O'Connor, J., Jones, S., Hoare, Z., Roberts, R., Byrne, A., Healy, S. & Lewis, P., 1 Medi 2017.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Murlen › adolygiad gan gymheiriaid
  • CyhoeddwydCompassionate communities in North Wales: A service evaluation
    Watt, B., Hiscock, J., Poolman, M. & Livingstone, T., 1 Medi 2017.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Murlen › adolygiad gan gymheiriaid
  • CyhoeddwydEvolving A Sustainable Model of Guidance to Support Individual Care of Dying Patients: A National Perspective
    Johnstone, R. P., Poolman, M. & Mitchell, H. E., 28 Awst 2017, Yn: Palliative Medicine and Hospice Care. 3, 2, 7 t.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid
  • CyhoeddwydPercutaneous Venting Gastrostomy in the Management of Malignant Bowel Obstruction: A Qualitative Study Exploring Patients’ Experiences: Oral Presentation No. FC05
    Singh Curry, R., Evans, E., Poolman, M. & Hiscock, J., Mai 2017.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Arall › adolygiad gan gymheiriaid

2016

  • CyhoeddwydAdvance Care Planning (ACP) in Specialist Palliative Care (SPC) Teams across North Wales: Knowledge, Competency and Education: Poster No. 164
    Johnstone, R. P., Ryan, K., Poolman, M., Richards, T. & Usborne, C., 1 Ebr 2016.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Murlen › adolygiad gan gymheiriaid
  • CyhoeddwydCare in the Last Days of Life: Patient Involvement: Poster No. 171
    Mitchell, H. E., Poolman, M., Johnstone, R. P. & Rawlinson, F., 1 Ebr 2016.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Murlen › adolygiad gan gymheiriaid

2015

  • CyhoeddwydDeveloping Palliative Care Knowledge and Skills in a Heart Failure Team: Does it Improve Quality of Care Delivery?: Poster No. P1-122
    Welstand, J., Poolman, M. & George, J., Mai 2015.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Murlen › adolygiad gan gymheiriaid
  • CyhoeddwydPercutaneous Cervical Cordotomy for Mesothelioma (and other Cancer)-Related Pain: Is it Effective and Safe, and is Continued Commissioning Warranted? (Results of the UK National Registry): Poster No. P1-121
    Poolman, M., Mayland, C., Byers, J., Campkin, N., Antrobus, H. & Sharma, M., Mai 2015.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Murlen › adolygiad gan gymheiriaid
  • CyhoeddwydSupporting Care in the Last Days of Life: An All-Wales Approach to Shifting Gear: Poster No. P2-145
    Johnstone, R., Mitchell, H. & Poolman, M., Mai 2015.
    Allbwn ymchwil: Cyfraniad at gynhadledd › Murlen › adolygiad gan gymheiriaid

2014

  • CyhoeddwydCordotomy in mesothelioma-related pain: a systematic review
    France, B. D., Lewis, R. A., Sharma, M. L. & Poolman, M., 1 Maw 2014, Yn: BMJ Supportive and Palliative Care. 4, 1, t. 19-29
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

2009

  • CyhoeddwydOpioid use in the last days of life: what is good practice?
    Philp, R., Poolman, M., Martin, N. & Makin, M., 2009, Yn: European Journal of Palliative Care. 16, 3, t. 110 115 t.
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

2006

  • CyhoeddwydDiabetes mellitus in adult palliative care: A literature review and management proposal for hospice inpatients
    Poolman, M. & Makin, M., 1 Ebr 2006, Yn: Palliative Medicine. 20, 3
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Crynodeb Cyfarfod › adolygiad gan gymheiriaid
  • CyhoeddwydRapid escalation of diamorphine dose in the last days of life-fact or fallacy?
    Makin, M., Poolman, M., Philp, R. & Martin, N., 1 Ebr 2006, Yn: Palliative Medicine. 20, 3, t. 307
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Crynodeb Cyfarfod › adolygiad gan gymheiriaid

2003

  • CyhoeddwydDiabetic diarrhoea: a neglected complication
    Poolman, M. & Hough, S., 2003, Yn: Journal of Endocrinology, Metabolism and Diabetes of South Africa. 8, 2, t. 52-59
    Allbwn ymchwil: Cyfraniad at gyfnodolyn › Erthygl › adolygiad gan gymheiriaid

Gweithgareddau

2024

  • Primary Care Clinical Reference Group (North Central London): GP Provider Alliance meeting

    Attending SPC/hospice colleagues in support of the Palliate package (derived from CARiAD) to be rolled out to the whole region. Agreement in principle sought, and obtained, from the group.

    18 Ebr 2024

    Gweithgaredd: Arall (Cynghorydd)
  • CARiAD research and implementation

    10 Ebr 2024

    Gweithgaredd: Sgwrs wadd (Siaradwr)
  • Every failure is a piece of important knowledge". Experiences and insights from re-applying for research funding.

    10 Ebr 2024

    Gweithgaredd: Sgwrs wadd (Siaradwr)

2023

  • PRIME Centre Wales Annual Meeting

    Workshop: Value-added palliative and end of life care in Wales.

    1 Tach 2023

    Cysylltau:

    • https://healthandcareresearchwales.org/about/events/prime-centre-wales-annual-meeting-2023
    Gweithgaredd: Cymryd rhan mewn gweithdy, seminar, cwrs Academaidd (Cadeirydd)
  • Macmillan Professionals Conference

    CARiAD presentation as part of ‘We’re here, this is what we do. Developing creative opportunities in rural communities’ workshop.

    Tach 2023 →

    Gweithgaredd: Cymryd rhan mewn gweithdy, seminar, cwrs Academaidd (Siaradwr)
  • CARer-ADministration of as-needed subcutaneous medication for breakthrough symptoms in people dying at home: accelerating the impact of new practice (CARiAD).

    Highest-scoring abstract, invited to present the annual Andy Fowell Memorial Lecture

    Hyd 2023 →

    Gweithgaredd: Cyflwyniad llafar (Siaradwr)
  • CARer-ADministration of As-needed Subcutaneous Medication for Breakthrough Symptoms in People Dying at Home (CARiAD): Rapid Implementation, Quality Improvement and Accelerating Impact of New Practice.

    Oral presentation, international conference

    16 Meh 2023

    Cysylltau:

    • https://journals-sagepub-com.bangor.idm.oclc.org/doi/10.1177/02692163231172891
    • https://eapccongress.eu/2023/
    Gweithgaredd: Cyflwyniad llafar (Siaradwr)

2022

  • BU-IIA Funded Project: CARiAD Intervention

    The aim of the activities outlined in this proposal is to accelerate the impact of the intervention as studied in the NIHR- funded CARIAD feasibility trial and subsequently implemented in clinical practice. The acceleration of the impact of carer-administration supported by this funding will be strengthened by the established external partnerships with BCUHB, Helix Centre (Imperial College London) and the national (UK) Community of Practice (CoP) (co-facilitated by MP). It will support the building of new collaborations and partnerships, including with patients and carers, policy makers, health care organisations and academic institutions. Activities will focus on IT support for the already established CoP (national network of HCPs), creating a social media presence for the intervention and working towards a national database/registry of important outcomes.

    Funding awarded through the Bangor University Innovation and Impact Award (Research Wales Innovation Funding). Value = £50,000

    1 Ebr 2022 – 31 Maw 2023

    Gweithgaredd: Arall (Cyfrannwr)
  • Lay Carer Medication Administration

    Presentation of North Wales CARiAD implementation and clinical outcomes. Introduction by Alison MacRobbie.

    9 Maw 2022

    Gweithgaredd: Sgwrs wadd (Siaradwr gwadd)

2021

  • CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in home-based dying patients (CARiAD)

    7 Gorff 2021

    Gweithgaredd: Cyflwyniad llafar (Siaradwr gwadd)
  • National Community of Practice for Lay Carer Administratrion

    I am founding co-facilitator of the national community of practice for the intervention studied as part of the CARiAD feasibility RCT.

    2021 →

    Gweithgaredd: Mathau o waith ymgysylltu academaidd allanol - Cyfraniad at waith pwyllgorau a gweithgorau cenedlaethol neu ryngwladol (Cadeirydd)

2020

  • CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in homebased dying patients: a UK study (CARiAD)

    Oral presentation of CARiAD feasibility RCT results

    2020

    Gweithgaredd: Cyflwyniad llafar (Siaradwr)

2019

  • Lived experiences of lay carers trained to give subcutaneous medications at the end of life: a qualitative study

    Oral presentation by Annie Hendry on behalf of CARiAD team.

    In this paper we discuss accounts of lay carers who have cared for a dying person at home during the last days of life. Many people nearing the end of life express a wish to die at home; the fulfilment of this wish often depends on the ability of a lay carer to support them at home during this difficult and emotional time. Relationships between carers and those they care for may experience change as the needs of an individual evolve, boundaries between the medical and the non-medical world shift, and end of life becomes increasingly closer.

    Healthcare professionals support those having a home death by visiting to administer medications. This can mean long waiting times which may contribute to distress and discomfort for patient and carer.

    In this study, lay carers were trained to give under the skin medications when needed. In depth interviews were conducted with carers and analysed using Interpretive Phenomenological Analysis.

    The rich and detailed accounts of carers in this study reveal the complexity of caring relationships during the last days of life and are intrinsically bound with the desire to fulfil wishes, alleviate pain and suffering and to contribute actively towards care. However, these factors are further intertwined with concerns regarding lay/ professional boundaries, carer burden and the potential for hastening death. This paper will shed light on the lived experiences of those caring for a dying person and the ways in which they navigate their way through this challenging time.

    5 Rhag 2019

    Gweithgaredd: Cyflwyniad llafar (Siaradwr)
  • CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in homebased dying patients: a UK study protocol (CARiAD)

    Oral presentation by Jess Richards on behalf of the CARiAD team

    27 Tach 2019

    Gweithgaredd: Cyflwyniad llafar (Siaradwr)
  • CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in homebased dying patients: a UK study (CARiAD)

    Oral presentation of CARiAD feasibility RCT results

    21 Tach 2019

    Gweithgaredd: Cyflwyniad llafar (Siaradwr)
  • CARer-ADministration of as-needed subcutaneous medication for breakthrough symptoms in homebased dying patients: a UK study (CARiAD)​

    Oral presentation of CARiAD results, poster presentation of protocol. Poster presentation was highly commended.

    24 Hyd 2019

    Gweithgaredd: Cyflwyniad llafar (Siaradwr)
  • CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in homebased dying patients: a carer's perspective

    Joint oral presentation by CARiAD team and public contributor. CARIAD results poster also presented; won first prize.

    18 Hyd 2019

    Gweithgaredd: Cyflwyniad llafar (Siaradwr)
  • ‘We were able to keep her at home and we weren’t scared of uncontrollable pain’

    Oral presentation of qualitative findings from the CARiAD project by Annie Hendry on behalf of the CARiAD team.

    11 Medi 2019

    Gweithgaredd: Cyflwyniad llafar (Siaradwr)

2017

  • Should family members be given more power to help relatives dying at home?

    Conversation article authored by Professor Clare Wilkinson.

    15 Maw 2017

    Cysylltau:

    • https://theconversation.com/should-family-members-be-given-more-power-to-help-relatives-dying-at-home-74407
    Gweithgaredd: Mathau o waith ymgysylltu â'r cyhoedd a gwaith maes - Erthygl neu gyfranogiad yn y cyfryngau (Cyfrannwr)

Projectau

  • What can we learn from firsthand accounts of death and dying? An exploration of raw and honest narratives from those at the end of life, their loved ones and their healthcare professionals in North Wales.

    01/01/2025 – 30/04/2025 (Wedi gorffen)

  • Noisy Breathing at life's end: preparatory work

    01/10/2016 – 15/08/2018 (Wedi gorffen)

    Disgrifiad

    Preparatory work towards NIHR HTA commissioning brief 16/102

    Qualitative study (interviews with, and self-recorded brief accounts of primary and palliative care clinicians)

Grantiau a Projectau Eraill

2022: Co-Chief Investigator. BCUHB Specialist Palliative Care (Welsh Government funding allocated via the End of Life Board). Understanding the cost-effectiveness of the CARiAD intervention in North Wales. 1/4/2022 for 4 months.
 
2019: Co-applicant. Welsh Government: Health and Care Research Wales. Wales Centre for Primary and Emergency (including unscheduled) Care Research (PRIME Centre Wales). 1/4/2020 for 5 years, £4.8M. Work Package (WP) (Supportive & Palliative Care) co-lead with Professor Annmarie Nelson.
 
2019: Co-applicant. BCUHB Specialist Palliative Care grant and Macmillan. Understanding Advance Care Planning in North Wales: Exploring patients and carer views. 1/4/2019 for 15 months.
 
2018: Co-applicant. BCUHB Specialist Palliative Care (Welsh Government funding allocated via the End of Life Board). Understanding Advance Care Planning in North Wales: A focus group study of health care professionals. 1/8/2018 for 8 months.
 
2018: Co-Chief Investigator: Betsi Cadwaladr University Health Board Specialist Palliative Care grant (Welsh Government funding allocated via the End of Life Board) for ‘Six Steps Evaluation’, 19/3/2018 for 3 months.
 
2018: Health and Care Research Wales Clinical Research Time Award (CRTA-17-03) (awarded 19 January 2018), 2 sessions per week for 3 years commencing 1/4/2018.
 
2016: Co-Chief Investigator: Betsi Cadwaladr University Health Board Pathway to Portfolio (C003027 F006926) Grant (awarded October 2016) for ‘Noisy breathing at life’s end: preparatory work’, 1/10/2016 for 9 months.
 
2016: Co-Chief Investigator: NIHR HTA Project (15/10/37) Grant (awarded August 2016) for ‘CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in home-based dying patients: a UK study (CARiAD)’, 1/11/16 for 30 months.
 
2011: Principal Investigator: NCRI Lung Cancer Supportive and Palliative Care Research Grant subcontract (awarded January 2011) for ‘Cordotomy in mesothelioma-related pain: a systematic review of the literature’.
 
2008: Co-investigator: NCRI Lung Cancer Supportive and Palliative Care Research Grant (awarded June 2008) for ‘The role of cordotomy in the management of mesothelioma-related pain in the United Kingdom (The INPIC pilot study) (Invasive Procedures in Cancer Pain)’, Principal Investigator: Dr Matthew Makin.

Gwybodaeth Arall

In January 2022 I took up the post of co-Clinical Director of Palliative Care for Betsi Cadwaladr University Health Board (BCUHB).

Since February 2009, as part of my clinical sessions, I have had joint hospice and community care appointments across several localities in the large geography of North Wales, giving me a clear understanding of the functioning of both National Health Service (NHS) and independent (charity) sectors. Hospice care includes leading ward rounds of hospice inpatients, providing senior managerial input to the medical/Advance Nurse Practitioner team and supporting the Clinical Effectiveness programme. Community specialist palliative care support is provided by integrated medical and nursing teams, and we work in concert with primary care teams (general practitioners and district nurses) to support people with palliative care needs at home. Both clinical roles come with the associated supporting professional activities including support for colleagues involved in quality improvement projects. In terms of non-malignant palliative care, my interest lies in heart failure palliative care, and I have had much involvement in regional service development for this patient group. I provide cross-cover for clinical colleagues in the hospital specialist palliative care team, as well as out-of-hours telephone advice to clinicians across North Wales as part of a regional on call rota.

On a national (all-Wales) level I am academic lead for the Care Decisions for the Last Days of Life project, a well-established project providing dedicated guidance to support last days of life care irrespective of setting, with a national feedback system providing outcomes on care.

I am a Fellow of the Royal College of Physicians, London and have been trained in Quality Improvement (IQT Silver, NHS Wales).

Personol

Originally from Namibia, I studied Medicine at the University of Stellenbosch (Cape Town, South Africa), obtaining my primary degree cum laude in December 2000. In 2001, I moved to the United Kingdom. I concluded junior doctor training in November 2004 after achieving membership of the Royal College of Physicians, London by completing general internal medicine specialty examinations. I sub-specialised in Palliative Medicine (Completion of Specialty Training, October 2008) and was offered a full-time permanent senior clinical academic appointment (50% clinical, 50% academic, North Wales campus of Cardiff University, then Bangor University) which commenced February 2009.

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