BGS Rising Star Award for Clinical Quality 2019: Anna Steel

This year’s BGS Rising Star Award for Clinical Quality has been awarded to Dr Anna Steel. Anna is an SpR in geriatric medicine at North Middlesex University Hospital NHS Trust and has made a significant contribution to the care of frail older people in North London. Whilst a registrar in Barnet Hospital she developed a multi-layered QI programme with a focus on advance care planning. Here she discusses her work and winning the award. 

It is a great honour to receive the Rising Star Award for Clinical Quality in recognition of my work on advance care planning. I am currently a less than full time Registrar in Geriatrics and General Medicine in North London. I qualified from University College London in 2008 and have gained the last 10 years of medical training in and around London. One of my core interests is medical ethics and end of life care with my publications focusing mainly around this topic. I was part of the London End of Life Care Clinical Leadership Group, supporting the London End of Life Care Clinical Network and developing guidelines within NHS England (2014 –2015).

As a Geriatrics Registrar, I found that most of the patients I was caring for were in need of advance care planning. During my time in Barnet Hospital, I have initiated and driven a quality improvement project to increase advance care planning on the wards. Following the pilot’s success, the interventions were implemented across six Geriatrics wards. Through recruitment of team members on different sites and collaboration with primary and secondary care colleagues, the project has grown significantly to include the three hospitals in the clinical practice group. As part of a new initiative to promote a collaborative approach to care home medicine, I was able to work with colleagues to improve advance care planning in the community as well. I am also currently working on introducing advance care planning into specialty outpatient clinics.

The project has been presented and won awards locally and nationally and I have been invited to present at the upcoming International Association of Gerontology and Geriatrics European Region Congress 2019. The British Geriatrics Society has been very supportive in helping me attend the event.

I believe that for a sustained change in practice and for advance care planning to be truly effective, education and communication are the two key elements. For this reason, my colleagues and I have created an interdisciplinary advance care planning simulation course. We were awarded £7000 by Health Education England and University College London Partners to further deliver the course across the region. I have organised training days on cultural diversity at the end of life and continue to teach both in the community and secondary care. Within the new hospital computer system, we have developed a designated advance care planning section to aid documentation. Through organising hospital-based training for ‘Coordinate My Care’, the sharing of information has further improved.

Moving forwards, we aim to continue to develop educational programmes and services for advance care planning in London and build more bridges with primary care and our allied healthcare professional colleagues. We will continue to present at conferences and help raise the national profile. The overall aim is to equip healthcare professionals across all disciplines with the skills and incentive to facilitate excellent advance care planning so that our patients are given the opportunity to have their end of life preferences achieved and receive excellent care.

The Rising Star Award was inaugurated in 2014 to recognise young doctors, nurses and AHPs who have made exceptional contributions to the field of older people's health care, early in their career. Two awards are available each year; one for research contributions that have translated into, or are in the process of being translated into, improvements to the care of older people, and the other for a clinical quality project which improves the care of older people with frailty in the award holder's locality.