University Senior Lecturer in General Practice and Palliative Care, General Practitioner and Honorary Consultant Physician in Palliative Care
M.A., B.M., B.Ch., M.Sc., F.R.C.G.P., F.H.E.A., M.D.
Email: sigb2@medschl.cam.ac.uk
Tel: 01223 763082
Background
Stephen’s pre-clinical medical training was in Cambridge and his clinical training in Oxford. After GP training in Bristol he started work in a market town practice in the Cambridgeshire Fens and then in 1990 moved to a GP practice in Cambridge. He continues to work clinically in General Practice. He has worked clinically in the Arthur Rank Hospice in Cambridge since 1995, where he has been Honorary Consultant Physician in Palliative Care since 1996.
Funded by a NHS R&D Health Services Research Training Fellowship 1998 – 2001, he undertook the City University MSc course in Advanced Social Science Research Methods and Statistics. His 2005 MD thesis from the University of Cambridge “General Practitioner provision of Palliative Care in the United Kingdom” was awarded the Clinical School’s Ralph Noble prize.
In 2006 he was awarded a Department of Health / Macmillan Post-Doctoral Research Fellowship, leading a programme of research “Towards an intervention to optimise Primary Palliative Care: identifying patients and understanding their preferences.”
In 2011 he was appointed HEFCE Clinical Senior Lecturer in General Practice and Palliative Care in the Primary Care Unit. He was promoted to University Senior Lecturer and awarded a university Pilkington Prize for teaching excellence in 2015. He leads the Unit’s Palliative and End of Life Care research group and the teaching of Palliative Care in the Medical School.
He is Clinical Lead in End of Life Care for the Cambridge and Peterborough CCG and is the Clinical Lead for the CCG End of Life Care Data Sharing project. He was GP member of the 2012 NICE Topic Expert Group that developed Quality Standards for End of Life Care in the NHS. He is Chair of the NIHR Research for Patient Benefit East of England Regional Advisory Panel and leads the national Marie Curie Design to Care Collaborative.
Research Interests
Stephen has worked in Palliative and End of Life Care research for over 20 years. His research focuses on Palliative and End of Life Care in Primary Care, with a particular interest in General Practitioner and District Nurse provision of care, end of life care conversations in cancer and non-cancer illness, decision-making concerning treatment cessation in advanced disease and medical student education in Palliative Care. He led the End of Life Care theme of the NIHR CLAHRC for Cambridgeshire and Peterborough 2008 – 2013 and currently leads the End of Life Care sub-theme in the NIHR CLAHRC East of England 2014 – 2018.
Teaching
In 2002 he was appointed by the Cambridge School of Clinical Medicine as Specialty Director for Palliative Care: since then he has led a considerable expansion of the curricular time allocated to Palliative Care, which now forms a major component of the clinical course in Cambridge and is regularly examined in the medical students’ Finals examinations. He co-leads the Undergraduate Education Forum of the Association for Palliative Medicine and led to 2014 revision of the national curriculum for medical student teaching in Palliative Care.
Selected recent publications include :
Thomas T, Clarke G, Barclay S (2018). “The difficulties of discharging hospice patients to care homes at the end of life. A focus group study”. Palliative Medicine: e-pub May 2018 DOI: 10.1177/0269216318772735
Diver R, Thiemann P, Quince T, Barclay S (2018). “Palliative care in medical practice: medical students’ expectations”. BMJ Supportive and Palliative Care: e-pub April 2018 doi:10.1136/bmjspcare-2017-001486
Stow D, Matthews F, Barclay S, Iliffe S, Clegg A, De Biase S, Robinson L, Hanratty B (2018). “Frailty scores to predict mortality in older adults using data from population based electronic health records: case control study”. Age and Ageing: epub 15.03.2018 doi: 10.1093/ageing/afy022
Petrova M, Barclay S (2018). “Something’s awry (again) in the debate on patient data sharing”. British Journal of General Practice: 68 (688); 133. DOI:10.3399/bjgp18X695081
Buck J, Webb W, Moth L, Morgan L, Barclay S (2018). “Persistent inequalities in Hospice at Home provision: findings from a service evaluation”. BMJ Supportive and Palliative Care: published on line Feb 2018 doi.10.1136/bmjspcare-2017-001367
Green E, Knight S, Gott M, Barclay S, White P (2018). “Patients’ and carers’ perspectives of palliative care in general practice: a systematic review and narrative synthesis of the literature”. Palliative Medicine: 32 (4); 838 – 850 doi/10.1177/0269216317748862
Sharp T, Malyon A, Barclay S (2017). “GPs’ perceptions of advance care planning with frail and older people.” British Journal of General Practice: 68; 44 – 53. DOI/10.3399/bjgp17X694145
Gamlin C, Womersley K, Taylor H, Fay I, Brassett C, Barclay S (2017). “Can you be a doctor, even if you faint?” the tacit lessons of cadaveric dissection. Psychiatria Danubina, 2017; Vol. 29, Suppl. 3, pp 247-253
Fleming J, Calloway R, Perrels A, Farquhar M, Barclay S, Brayne C and CC75C Cambridge City over-75s Cohort study collaboration (2017). “Dying comfortably in very old age with or without dementia in different care settings: a representative “older old” population study”. BMC Geriatrics 2017 17/222 DOI 10.1186/s12877-017-0605-2
Hiscock A, Barclay S (2017). “It’s a hard conversation to have”. Healthcare professionals’ views concerning advance care discussions with young people affected by life-limiting neuromuscular diseases: an interview study. BMJ Supportive and Palliative Care; doi.org/10.1136/bmjspcare-2017-001369
Spathis A, Hatcher H, Booth S, Gibson F, Stone P, … Barclay S (2017). “Cancer-related fatigue in adolescents and young adults after cancer treatment: persistent and poorly managed.” Journal of Adolescent and Young Adult Oncology; 6(3); 1 – 5. Pub online July 2017 doi.org/10.1089/jayao.2017.0037
Petrova M, Barclay M, Barclay SS, Barclay S (2017). “Between “the best way to deliver patient care” and “chaos and low clinical value”: General Practitioners’ and Practice Managers’ views on data sharing”. International Journal of Medical Informatics: 104: 74 – 83 doi.org/10.1016/j.ijmedinf.2017.05.009
Walker S, Gibbins J, Paes P, Barclay S, Adams A, Chandratilake M, Gishen F, Lodge P, Wee B (2017). “What do palliative care course organisers think of their course and institution, are they adequately preparing future doctors and what are the barriers to delivery? A survey of all UK medical schools.” BMJ Supportive and Palliative Care: 0:1–8. doi:10.1136/bmjspcare-2017-001319
Barry C, Spathis A, Carding S, Treadell S, Barclay S (2017). “Palliative Care clinicians’ knowledge of the law regarding the use of the Deprivation of Liberty Safeguards”. BMJ Supportive and Palliative Care: 0:1–7. doi:10.1136/bmjspcare-2016-001186
Clarke G, Fistein E, Holland A, Barclay M, Thiemann P, Barclay S (2017). “Preferences for care towards the end of life when decision-making capacity may be impaired: a large scale cross-sectional survey of public attitudes in Great Britain and the United States”. PLoS ONE 12(4): e0172104. DOI:10.1371/journal.pone.0172104
Borgstrom E, Barclay S (2017). “Experience Based Design, Co-Design and Experience-based Co-Design in Palliative and End of Life Care”. BMJ Supportive and Palliative Care: doi: 10.1136/bmjspcare-2016-00111795)
Ryan R, Clow A, Spathis A, Smyth N, Barclay S, Fallon M, Booth S (2017). “Salivary diurnal cortisol profiles in patients suffering from chronic breathlessness receiving supportive and palliative care services: a cross-sectional study”. Psycho-Neuro Endocrinology: 79: 134 – 145 DOI:10.1016/j.psyneuen.2017.01.025
Hiscock A, Kuhn I, Barclay S. (2016) “Advance care discussions with young people affected by life-limiting neuromuscular diseases: a systematic literature review and narrative synthesis”. Neuromuscular Disorders: 27: 115 – 119. DOI:10.1016/j.nmd.2016.11.011
Walker S, Gibbins J, Paes P, Adams A, Chandratilake M, Gishen F, Lodge P, Wee B, Barclay S. (2016). “Palliative care education for medical students: differences in course development, organisation, evaluation and funding. A survey of all UK medical schools”. Palliative Medicine: 31(6); 575 – 581 DOI: 10.1177/0269216316671279
Walker S, Gibbins J, Barclay S, Adams A, Paes P, Chandratilake M, Gishen F, Lodge P, Wee B (2016). “Progress and divergence in palliative care education for medical students: a comparative survey of UK course structure, content, delivery, contact with patients and assessment of learning”. Palliative Medicine: 30(9): 834-842. DOI: 10.1177/0269216315627125
Petrova M, Riley J, Abel J, Barclay S. (2016) “A crash course in EPaCCS (Electronic Palliative Care Coordination Systems): eight years of successes and failures in patient data sharing to learn from”. BMJ Supportive and Palliative Care: published online Sept 2016 doi:10.1136/bmjspcare-2015-001059
Fleming J, Farquhar M, Cambridge City over-75s Cohort (CC75C) study collaboration, Brayne C, Barclay S. (2016) “Death and the oldest old: attitudes and preferences for End-of-Life Care. Qualitative research within a population-based cohort study”. PLOS ONE: 11(4): e0150686. doi:10.1371/journal.pone.0150686
Hoare S, Slote-Morris Z, Kelly M, Kuhn I, Barclay S. (2015) “Do patients want to die at home? A systematic review of the UK literature, focused on missing preferences for place of death”. PLOS ONE: 10(11): e0142723. doi:10.1371/journal.pone.0142723
Clarke G, Johnson S, Corrie P, Kuhn I, Barclay S. (2015) “Withdrawal of anticancer therapy in advanced disease: a systematic literature review”. BMC Cancer: 15: 892. DOI: 10.1186/s12885-015-1862-0
Dzeng E, Colaianni A, Levene D, Roland M, Kelly M, Barclay S, Smith T. (2015) “Moral distress amongst house staff regarding futile treatments at the end of life”. Journal of General Internal Medicine; 30(9): 1 – 9. DOI: 10.1007/s11606-015-3505-1
Thiemann P, Quince T, Benson J, Wood D, Barclay S. (2015) “Medical students’ death anxiety: severity and association with psychological health and attitudes toward palliative care”. Journal of Pain and Symptom Management; 50 (3): 335 – 342. DOI: 10.1016/j.jpainsymman.2015.03.014
Wilmott M, Kingdon A, Barclay S. (2015) “Comparing India and the UK: a study of doctors’ and nurses’ attitudes towards Palliative Care”. BMJ Supportive Palliative Care: 5(5): 468 – 470. doi:10.1136/bmjspcare-2014-000762
Clarke G, Holland A, Woodward J, Galbraith S, Barclay S. (2015) “Eating and drinking interventions for people at risk of lacking decision-making capacity: Who decides and how?” BMC Medical Ethics; 16:41. doi.org/10.1186/s12910-015-0034-8
Spathis A, Booth S, Grove S, Hatcher H, Kuhn I, Barclay S. (2015). “Teenage and young adult cancer-related fatigue is prevalent, distressing and neglected: it is time to intervene.” A systematic literature review and narrative synthesis. Journal Adolescent and Young Adult Oncology: 4(1): 3 – 17.
Dzeng E, Colaianni A, Chander G, Smith T, Roland M, Kelly M, Barclay S, Levine D (2015). “Institutional policies’ influence on Do Not Resuscitate decision-making at the end of life”. JAMA Internal Medicine; 175(5): 812-819 DOI 10.1001/jamainternmed.2015.0295
Barclay S, Whyte R, Thiemann P, Benson J, Wood D, Parker R, Quince T (2014). “An important but stressful part of my future work”. Medical students’ attitudes to End of Life Care throughout their course. Journal of Pain and Symptom Management: 49 (2): 231 – 242.
Barclay S, Froggatt K, Crang C, Mathie E, Handley M, Iliffe S, Manthorpe J, Gage H, Goodman C. (2014) “Living in uncertain times: trajectories to death in residential care homes”. British Journal of General Practice: 64 (626); 576 – 583
Perrels A, Fleming J, Zhao J, Barclay S, et al (2013). “Place of death and end-of-life transitions experienced by very old people of different cognitive status. Retrospective analysis of a population-based cohort aged 85 and older”. Palliative Medicine: 28 (3); 220 – 233.
Sharp T, Moran E, Kuhn I, Barclay S. (2013) “Do the elderly have a voice? End of life care discussions with frail & elderly individuals: a systematic literature review & narrative synthesis”. British Journal of General Practice: 63; 657 – 668.
Badrakalimuthu R, Barclay S. (2013) “Do people with dementia die at their preferred location of death? A systematic literature review and narrative synthesis”. Age and Ageing: 43 (1); 13 – 19.
Knights D, Wood D, Barclay S. (2013) “The Liverpool Care Pathway for the Dying: what went wrong?” British Journal of General Practice: 63; 509 – 510.
Corrie P, Moody M, Armstrong G, Nolasco S, Lao-Sirieix S, Bavister L, Prevost T, Parker T, Sabes-Figuera R, McCrone P, Balsdon H, McKinnon K, Hounsell A, O’Sullivan B, Barclay S. (2013) “Is community treatment best? A randomised trial comparing delivery of cancer treatment in the hospital, home and GP surgery”. British Journal of Cancer: (109); 1549-1555
Mason B, Epiphaniou E, Nanton V, Donaldson A, Shipman C, Daveson B, Harding R, Higginson I, Munday D, Barclay S, et al (2013) “Coordination of care for people with advanced progressive conditions: a multi-site prospective study”. British Journal of General Practice: 63; 421 – 422.
Clarke G, Holland A, Barclay S. (2013) “How are treatment decisions made about artificial nutrition for individuals at risk of lacking capacity? A systematic review and qualitative synthesis”. PLOS ONE: 8(4): e61475.
Whyte R, Quince T, Benson J, Wood D, Barclay S. (2013) “Medical students’ experience of personal loss: incidence and implications”. BMC Medical Education: 13; 36.
Momen N, Hadfield P, Harrison K, Barclay S. (2012) “Managing pain in advanced cancer: a survey of United Kingdom General Practitioners and Community Nurses”. Journal of Pain and Symptom Management: 46 (3); 345 – 354.
Gwilliam B, Keeley V, Todd C, Roberts C, Gittens M, Kelly L, Barclay S, Stone P. (2012). “Prognosticating in patients with advanced cancer – observational study comparing the accuracy of clinicians’ and patients’ estimates of survival”. Annals of Oncology: 24 (2); 482 – 488.
Gwilliam B, Keeley V, Todd C, Gittins M, Roberts M, Kelly L, Barclay S, Stone P (2011). “Improving prognostication in advanced cancer: development of the Prognosis in Palliative care Study (PIPS) predictor models”. British Medical Journal: 343; 459
Quince T, Barclay S, Spear M, Parker R, Wood D (2011). “Student Attitudes towards cadaveric dissection at a UK medical school”. Anatomical Sciences Education: 4(4); 200 – 207.
Mathie E, Goodman C, Crang C, Froggatt K, Iliffe S, Manthorpe G, Barclay S. (2012) “An uncertain future: the changing views of care home residents about living and dying”. Palliative Medicine: 26 (5); 734 – 743
Momen N, Hadfield P, Kuhn I, Smith E, Barclay S. (2012) “Discussing an uncertain future: End of Life Care conversations in COPD. A systematic literature review and narrative synthesis”. Thorax: 67; 777 – 780.
Borgstrom E, Barclay S, Cohn S (2012) “Constructing denial as a disease object: accounts by medical students meeting dying patients”. Sociology of Health and Illness: 35 (3); 391 – 404.
Barclay S, Momen N, Case-Upton S, Kuhn I, Smith E. (2011). “The conversation that rarely happens”. End of life care conversations with heart failure patients: a systematic literature review and narrative synthesis. British Journal of General Practice: 61; 59 – 60.