Overview
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.
Qualifications
- Other: Postgraduate Certificate in Professional Development in Higher Education
Glyndwr University, 2011 - Professional: Membership
Royal College of Physicians, London, 2004 - Professional: MB CHB with distinction
University of Stellenbosch, 2000
Teaching and Supervision
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.
Research Interests
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.
Publications
2023
- PublishedCARiAD: Training healthcare professionals to train lay carers
Poolman, M., 25 Sept 2023
Research output: Other contribution
2022
- UnpublishedImplementation framework for carer-administration (utilising QIF)
Poolman, M., 2022, (Unpublished)
Research output: Other contribution - PublishedThe 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., Dec 2022, In: Palliative Care and Social Practice . 16, 9 p.
Research output: Contribution to journal › Article › peer-review - PublishedThe 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 Feb 2022, In: International Journal of Palliative Nursing. 28, 2, p. 72-79 8 p.
Research output: Contribution to journal › Article › peer-review
2020
- PublishedCARer-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 Mar 2020, 45 p. NHS Wales Health Collaborative.
Research output: Other contribution › peer-review - PublishedCarer 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., Parkinson, A., Roberts, S. & Wilkinson, C., 2 Jun 2020, In: Health Technology Assessment. 24, 25, 150 p.
Research output: Contribution to journal › Article › peer-review - PublishedDying 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., Mar 2020, In: BMJ Supportive and Palliative Care. 10, 1, e6.
Research output: Contribution to journal › Article › peer-review - PublishedPercutaneous cervical cordotomy for cancer-related pain: national data
INPIC Group, Dec 2020, In: BMJ Supportive and Palliative Care. 10, 4, p. 429-434 6 p.
Research output: Contribution to journal › Article › peer-review
2019
- PublishedCARer-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. & Wilkinson, C., 7 Feb 2019, In: Trials. 20, 1, 16 p., 105.
Research output: Contribution to journal › Article › peer-review - PublishedDo 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 Sept 2019, In: Palliative Medicine. 33, 8, p. 985-1002
Research output: Contribution to journal › Article › peer-review - PublishedPercutaneous venting gastrostomy/gastrojejunostomy for malignant bowel obstruction: a qualitative study
Singh Curry, R., Evans, E., Raftery, A.-M., Hiscock, J. & Poolman, M., 3 Dec 2019, In: BMJ Supportive and Palliative Care. 9, 4, p. 381-388
Research output: Contribution to journal › Article › peer-review
2017
- PublishedAssessing Advance Care Plan Discussions in Hospice Day Care
Johnstone, R. P., Poolman, M., Ryan, K., Schofield, P. & Watt, B., 27 Sept 2017, In: Palliative Medicine and Hospice Care. 3, 2, p. 32-38 7 p.
Research output: Contribution to journal › Article › peer-review - PublishedCare Decisions for the Last Days of Life: A Welsh Perspective: Poster No. PO1-042
Johnstone, R., Mitchell, H. & Poolman, M., May 2017.
Research output: Contribution to conference › Poster › peer-review - PublishedCarer-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 Sept 2017.
Research output: Contribution to conference › Poster › peer-review - PublishedCompassionate communities in North Wales: A service evaluation
Watt, B., Hiscock, J., Poolman, M. & Livingstone, T., 1 Sept 2017.
Research output: Contribution to conference › Poster › peer-review - PublishedEvolving A Sustainable Model of Guidance to Support Individual Care of Dying Patients: A National Perspective
Johnstone, R. P., Poolman, M. & Mitchell, H. E., 28 Aug 2017, In: Palliative Medicine and Hospice Care. 3, 2, 7 p.
Research output: Contribution to journal › Article › peer-review - PublishedPercutaneous 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., May 2017.
Research output: Contribution to conference › Other › peer-review
2016
- PublishedAdvance 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 Apr 2016.
Research output: Contribution to conference › Poster › peer-review - PublishedCare in the Last Days of Life: Patient Involvement: Poster No. 171
Mitchell, H. E., Poolman, M., Johnstone, R. P. & Rawlinson, F., 1 Apr 2016.
Research output: Contribution to conference › Poster › peer-review
2015
- PublishedDeveloping 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., May 2015.
Research output: Contribution to conference › Poster › peer-review - PublishedPercutaneous 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., May 2015.
Research output: Contribution to conference › Poster › peer-review - PublishedSupporting Care in the Last Days of Life: An All-Wales Approach to Shifting Gear: Poster No. P2-145
Johnstone, R., Mitchell, H. & Poolman, M., May 2015.
Research output: Contribution to conference › Poster › peer-review
2014
- PublishedCordotomy in mesothelioma-related pain: a systematic review
France, B. D., Lewis, R. A., Sharma, M. L. & Poolman, M., 1 Mar 2014, In: BMJ Supportive and Palliative Care. 4, 1, p. 19-29
Research output: Contribution to journal › Article › peer-review
2009
- PublishedOpioid use in the last days of life: what is good practice?
Philp, R., Poolman, M., Martin, N. & Makin, M., 2009, In: European Journal of Palliative Care. 16, 3, p. 110 115 p.
Research output: Contribution to journal › Article › peer-review
2006
- PublishedDiabetes mellitus in adult palliative care: A literature review and management proposal for hospice inpatients
Poolman, M. & Makin, M., 1 Apr 2006, In: Palliative Medicine. 20, 3
Research output: Contribution to journal › Meeting Abstract › peer-review - PublishedRapid escalation of diamorphine dose in the last days of life-fact or fallacy?
Makin, M., Poolman, M., Philp, R. & Martin, N., 1 Apr 2006, In: Palliative Medicine. 20, 3, p. 307
Research output: Contribution to journal › Meeting Abstract › peer-review
2003
- PublishedDiabetic diarrhoea: a neglected complication
Poolman, M. & Hough, S., 2003, In: Journal of Endocrinology, Metabolism and Diabetes of South Africa. 8, 2, p. 52-59
Research output: Contribution to journal › Article › peer-review
Activities
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 Apr 2024
Activity: Other (Advisor) - CARiAD research and implementation
10 Apr 2024
Activity: Invited talk (Speaker) - Every failure is a piece of important knowledge". Experiences and insights from re-applying for research funding.
10 Apr 2024
Activity: Invited talk (Speaker)
2023
- Macmillan Professionals Conference
CARiAD presentation as part of ‘We’re here, this is what we do. Developing creative opportunities in rural communities’ workshop.
Nov 2023 →
Activity: Participation in Academic workshop, seminar, course (Speaker) - 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
Oct 2023 →
Activity: Oral presentation (Speaker) - 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 Jun 2023
Links:
- https://journals-sagepub-com.bangor.idm.oclc.org/doi/10.1177/02692163231172891
- https://eapccongress.eu/2023/
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 Apr 2022 – 31 Mar 2023
Activity: Other (Contributor) - Lay Carer Medication Administration
Presentation of North Wales CARiAD implementation and clinical outcomes. Introduction by Alison MacRobbie.
9 Mar 2022
Activity: Invited talk (Invited speaker)
2021
- CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in home-based dying patients (CARiAD)
7 Jul 2021
Activity: Oral presentation (Invited speaker) - 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 →
Activity: Types of External academic engagement - Contribution to the work of national or international committees and working groups (Chair)
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
Activity: Oral presentation (Speaker)
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 Dec 2019
Activity: Oral presentation (Speaker) - 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 Nov 2019
Activity: Oral presentation (Speaker) - 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 Nov 2019
Activity: Oral presentation (Speaker) - 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 Oct 2019
Activity: Oral presentation (Speaker) - 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 Oct 2019
Activity: Oral presentation (Speaker) - ‘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 Sep 2019
Activity: Oral presentation (Speaker)
2017
- Should family members be given more power to help relatives dying at home?
Conversation article authored by Professor Clare Wilkinson.
15 Mar 2017
Links:
Activity: Types of Public engagement and outreach - Media article or participation (Contributor)
Projects
-
Noisy Breathing at life's end: preparatory work
01/10/2016 – 15/08/2018 (Finished)
Description
Preparatory work towards NIHR HTA commissioning brief 16/102
Qualitative study (interviews with, and self-recorded brief accounts of primary and palliative care clinicians)
Other Grants and Projects
Other Information
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).
Personal
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.