Doctor Claire’s Story
You might be surprised to learn that hospices have their own team of specialist medical professionals. We talked to Claire Magee, our Medical Director and Consultant in Palliative Medicine, about what the medical team do in an average day….
Hi Claire, can you tell us a bit about how you became a doctor?
I studied medicine at Cambridge and Oxford Universities and became interested in palliative medicine while at medical school. I qualified in 2005 and have worked as a doctor in palliative medicine since 2009. My training involved working in hospices, hospitals and community services across Wessex and the West Midlands. I also undertook an MSc in Palliative Care at King’s College London and spent time in Uganda supporting the development of a new palliative care services and education programmes.
I became a consultant in 2014 and started my consultant career in Coventry where I led an NHS community palliative care team. I grew up in Emsworth and in 2019 I chose to move back to the area with my young family, joining the medical team at St Wilfrid’s Hospice.
Why did you choose to work in palliative medicine?
Palliative medicine is an incredibly rewarding area of medicine. I spent several years as a junior doctor working in busy hospitals which I enjoyed, but I was never able to give as much time to patients and their families as I wanted to. I was inspired by some amazing palliative care doctors and nurses who were excellent communicators and really focused on the patient as an individual.
Palliative care aims to improve the quality of life of those with life limiting illness. It can be highly complex and involves managing a diverse range of conditions across a range of settings, which is part of the appeal. Our patients often present with multiple issues that we aim to support them with. We take a holistic approach managing physical symptoms as well as emotional and practical needs, and we support patients to talk about what is important to them at the end of their lives.
What do you do at St Wilfrid’s?
I lead the medical team at St Wilfrid’s. That means I’m responsible for all of our medical staff, which includes trainee GPs, a clinical fellow, specialty doctors (all of whom worked as GPs before joining the team), and consultants.
I’m responsible for the medical decisions made to support our patients both on the inpatient unit and in the community setting, and I work closely with our nursing and therapy teams (which is what’s known as our multi-disciplinary or MDT team).
As Medical Director for the Hospice, I am part of the Senior Management Team of our charity and so work to ensure we are meeting the needs of our population both now and in the future.
What does an average day at work look like for you?
There isn’t really an average day, which is why I love my job so much! I rarely keep to my planned diary as I need to be responsive to the needs of our patients and the team. Typically, I start the day in a meeting between our inpatient and community teams, and the St Richard’s Hospital palliative care team, discussing potential admissions, new referrals and patients of concern.
I meet patients and their loved ones on my ward round, as outpatients in our Living Well centre, or on visits to their own home or care home. I keep in touch with other healthcare professionals such as GPs, community nurses and hospital colleagues always ensuring there is a joint approach to care. I am part of an on-call rota with several consultants providing advice to other healthcare professionals overnight and at weekends. This direct patient care is combined with teaching, research, team management and other activities aimed at improving the services we offer.
How has the pandemic affected medical work?
The COVID-19 pandemic has been the most disruptive yet transformative health crisis in my career. We have had to work very hard as a team to protect our patients as they are a particularly vulnerable group. There have been many difficult decisions along the way, for example around visiting at the Hospice, but I’m proud that our services have continued throughout.
We’ve kept some of the adaptations we had to make during the height of the pandemic, such as regular virtual conferencing with other healthcare professionals which has helped improve our patient care.
Generally, though, the pandemic has meant missed appointments and late presentations, which sadly means we are seeing more people being diagnosed with a life limiting illness later on when there are fewer options for treatment. At this stage, our role is vital to support patients and their loved ones.
What is it that makes you so passionate about palliative medicine?
There are a lot of myths about palliative and end of life care, and the word ‘hospice.’ Ultimately, we support people to live well and working in palliative medicine can be incredibly uplifting. There is inevitable sadness, but there are also plenty of smiles and laughter. This is one area of medicine where we aren’t ‘fixing’ or ‘curing’ people, but we are making a huge difference to their lives and it’s an honour to share so many special moments. Not all our patients are at the very end of their lives with some supported by the palliative care team for many months, and often alongside ongoing hospital treatments.
Patients often ask me what dying is really like and whether, for example, they will be in pain. We don’t talk openly about death and dying as a society so being able to provide information and reassurance to people at a time they want and need it can be very satisfying. We have one chance to support our patients in having a good death so managing their symptoms well and working to understand and meet their wishes – for example where they would prefer to die – is really important.
What would you say to a colleague thinking of a career in palliative medicine?
I would absolutely recommend working in palliative medicine. I find it a hugely rewarding and varied career. I often speak to junior doctors, GPs and even consultant physicians working in other areas such as respiratory or elderly care who are considering a move into palliative care. It’s so fulfilling to see what a difference you can make.
Here at St Wilfrid’s Hospice, as a charity, we put our patients at the centre of everything we do and work as a strong multi-disciplinary team. We have colleagues who have joined us from the NHS and they really value the close working relationships in the team, and the amount of time they get to spend with patients and their loved ones.
We are also working hard to improve palliative care for the future. We are part of a collaborative with the other hospices in Sussex, sharing knowledge and working together, and we are actively involved in research as part of wider national work.