In the current political environment I think that it is more important than ever to build bridges and work with international colleagues for the benefit of palliative care patients across Europe. I am standing for board membership of the EAPC because I want to contribute to the global development of palliative care and to strengthen the scientific basis for our specialty.
I first became interested in palliative care as a medical student, impressed by the caring and high-class medical care provided by the hospital palliative care service at St Bartholomew’s Hospital in London where I was training. I was drawn to the way in which the relatively new speciality of palliative care seemed to combine the best of both the science and the art of medicine. Shortly after obtaining membership of the Royal College of Physicians I took up my first palliative care post as a junior doctor at the Marie Curie Hospice in Hampstead. Adrian Tookman, the medical director, inspired me by the way in which he used innovative medical approaches, including the use of bedside interventional pain techniques, medical ultrasound and the re-purposing of drugs to manage difficult to control symptoms. However, it was apparent that, although these strategies appeared to be successful, there was very little hard evidence to support their use outside of the hospice setting. As a direct result of this experience, I decided to undertake post-graduate research in palliative care so that I could contribute to the evidence base of this evolving specialty.
I undertook my MD studies on the topic of cancer-related fatigue at the Royal Marsden Hospital in Surrey gaining further clinical experience at various hospices, community teams and hospital palliative care services. In 2001, I was appointed senior lecturer and honorary consultant at St George’s Hospital medical school in London where I worked for 13 years as head of the clinical service and latterly as a professor of palliative medicine. Since 2014, I have been head of the Marie Curie Palliative Care Research Department at University College London and an honorary consultant at University College London Hospitals NHS Trust. My research interests are centred on ways to improve prognostication in palliative care (using both algorithms and clinical intuition); the management of difficult to control symptoms including cancer-related fatigue; palliative care in seldom-heard groups (e.g. those with liver cirrhosis and homeless people); and the management of the terminal phase (including the proportionate use of sedatives at the end of life).
During my career I have served on the Science Committee of the Association of Palliative Medicine, the National Cancer Research Institute Palliative Care Clinical Studies Group, and the Palliative Care Research Society. I have previously worked with the EAPC by contributing to the development of guidelines for the use of opioids in cancer pain and as a member of the Association’s fatigue working group. I was a member of the European Palliative Care Research Collaborative and I have contributed to the academic work of the Association as a member of Scientific Advisory Boards for several EAPC clinical and research congresses over the past ten years.
I support the EAPC’s aim of advocating internationally for the delivery of high-quality palliative care through research, policy, education and evidence-based practice. I will aspire to represent the views of UK palliative care practitioners at a European level and to promote the activities of the EAPC at home. If elected to the board, I will strive to achieve the Association’s strategic aim of supporting and disseminating research and development in all aspects of palliative care. I believe that the EAPC should be an advocate for palliative care development throughout Europe and internationally, particularly in resource-poor countries.
Outside of palliative care, I am a father of three adult children, a school governor, a keen squash player, a poor chess player and an enthusiastic but somewhat ungainly skier.