Back to the Future – Part IX – Investing in a strong multi-disciplinary team approach

Categories: Leadership and People & Places.

There are repeated stories of the value of the multi- disciplinary approach that has been a hallmark of care at St Christopher’s throughout its lifetime.

Many individuals who have gone on to have influential roles in end of life care in the course of their career describe early, seminal learning via the multi-disciplinary team (MDT) meetings that took place at the hospice.

They recall a respectful acknowledgement of all in the room, the value afforded to every professional and the unerring focus of the chair on the care of the patient and their family.

These characteristics have been perpetuated through education and the work of professionals who lead MDT meetings on a regular basis as they model best practice.

An MDT approach has value for those who seek help, and also for the clinicians and others who respond.

Clinicians reflecting on the changes over the years recognise a shift in the type of person most likely to receive care via the hospice, in which increasing priority is given to those with the most complex of needs.

These are individuals most likely to benefit from seamless and finely-honed multi-professional input. More recent changes provoked by the pandemic call for additional skills related to remote consultations alongside face-to-face care. Again, these must be multi-disciplinary in approach.

The membership of the MDT involved in planning and delivering the care for groups of patients and those close to them has changed over time.

The history of St Christopher’s describes an incremental approach on the part of the scope of the team and its work to recognise, then respond to, the needs of those who were dying or bereaved.

People and services were encouraged to develop, then refine their emerging offer, negotiating and testing new ways of working across the multi professional team as well as with those in their care.

Stories suggest that the shape of the MDT and the care on offer by the hospice has been heavily influenced, not unsurprisingly, by the professional backgrounds of those in charge.

Strong social work leadership, for example, established St Christopher’s for a while as a social hospice, with a focus on care for the person as a social being.

The different professional groups working at St Christopher’s are proud of what they bring to the mix of care – aware of their unique offer alongside an aggregate contribution.

Social workers confirm their role in addressing psychological and social needs; doctors talk about advising on medications and treatments to reduce symptom burden, physiotherapists the role and contribution of the gym and the opportunity to give back control, to improve function regardless of disease progression amongst other offers.

Realising that nursing could develop and be something that was really respected as a speciality was valuable. Seeing how senior nurses operated, their autonomy, that their professional offer wasn’t subservient; that every member of the team had respect for other’s profession. That’s ALWAYS ATTRACTED ME – that everybody has a contribution to make to someone’s care

Anne Nash Consultant Nurse, St Christopher’s Hospice



This is the ninth in our serialisation of “Back to the Future – Reflections on an Oral History of St Christopher’s Hospice”

Part I – Introduction

Part II – Being Prepared to be Radical

Part III – Responding to the Experience of Suffering

Part IV – Supporting Innovation

Part V – Hospice as a Way of Life

Part VI – Building and Nurturing Relationships

Part VII – Being True to the Founding Values

Part VIII – Creating a Committed and Talented Workforce

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