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The clinical lead: ‘I’ve never been able to say no to anything’

Dr Euan Paterson, clinical lead at Greater Glasgow and Clyde Palliative Care Managed Care Network,

How did you end up in your position?

The position was advertised and no one applied, so senior figures in the health board asked me to do it! I had been a GP for about 20 years, worked with a hospice for 10 years and been a Macmillan GP facilitator for eight years. I've never been able to say no to anything. I also felt as a generalist I might be able to bring breadth to something that otherwise risked focusing on specialist services and just cancer.

What does it involve?

I have to prepare for and chair quarterly, two-hour, managed-care network meetings. There's also an interface role with the local health board and national bodies including the Scottish Government. My biggest job is trying to help coordinate all the different professional services involved in palliative care, across about 25% of Scotland's population – eight major hospitals, six hospices and around 260 general practices!

I meet a huge number of really interesting, caring and committed colleagues and ensure the non-specialist voice is heard (loudly). I have genuinely been able to ensure there is significant breadth to the focus of the managed care network. But the job is very time-consuming and stressful (though I make it more stressful than it really is), and I have been the recipient of some pretty hostile communication – my professional conduct was recently called in to question! I do worry that I don't know enough about palliative care because I am a not a specialist, and also if all the effort can possibly make any difference given the current economic climate.

What is pay and responsibility?

The sessional rate is very similar to standard general practice. The post is assigned only a single session, but I estimate it probably uses about three times that. The responsibility is hard to quantify. I feel a huge responsibility for the smooth running of the network and the strategic direction of palliative care services. I suspect the actual responsibility is less (I tend to take things too seriously).

Can the position effectively lead change?

I think so. The real challenge for palliative care will be to genuinely embrace the needs of patients who do not have cancer and I do think having a generalist clinical lead has helped in this.