How the Gold Line is bringing health care home An interview with Dr Linda Wilson

Dr Linda Wilson is a Consultant in Palliative Medicine at Airedale NHS Foundation Trust. Linda is the Clinical Lead for ‘Bringing Healthcare Home’, a programme of work which is improving the safety and quality of care for people in their last year of life. We spoke to Linda about her role in improving patients’ experience of end-of-life care through setting up the Gold Line service.

How the Gold Line came about

Before the Gold Line was set up, Linda and her colleagues working in end-of-life care in Airedale and Bradford were already looking at local quality of care and patient experience for people in their last year of life, identifying where there were gaps and where things were working well.

Separately, Airedale Hospital was developing a project to use video consultations between patients and health professionals (known as telemedicine) to support care outside hospital and particularly in care homes.

The Gold Line brought together these two areas of work. The business development team at Airedale Hospital saw an opportunity to apply for funding to add an end-of-life service to its telemedicine hub and Linda was brought in as clinical lead.

Building on strong foundations

One of the key things that made the Gold Line successful was that it was built on strong foundations. A lot of work on end-of-life care had already been going on in the hospital and in the community, for example work had been done to raise awareness of the importance of identifying people in the last year of life.

Linda says that having a clinical lead and a project manager working together was a strong combination and made things happen – and having support from the top was crucial.

‘It was that combination of strong clinical leadership, with committed project support and support from the executive team, ’she says.

An electronic system to co-ordinate end-of-life care had been developed, and all the local GPs and the hospital used the same computer system. Capturing and sharing key information about end-of-life care was made easy by creating a new template on the system for people to fill in.

Linda says, ‘The Gold Line became a focal point, but it wouldn’t have succeeded if all that background work hadn’t been going on for quite a few years. It is only really as good as the community services that are out there to respond, because if someone rings up and needs a district nurse, you need someone to send in a timely way.’

Telling a powerful story

The original funding bid for the Gold Line included a fictional ‘before and after’ story, about a young woman nearing the end of her life.

In the ‘before’ story, her care is uncoordinated and fraught, and she spends her last days in hospital, anxious and away from her young children. In the ‘after’ story, she is well-supported and able to spend her last days of life at home, in part because of a telemedicine service. The team believe this story was important in the success of their funding bid because it presented the idea from the point of view of a patient and told a powerful story.

Linda became aware of Stephen Lock’s story (featured in our film, Gold Line: bringing health care home) when he wrote to a national newspaper in response to an article about end-of-life care, explaining that the care he and his wife had received had been fantastic. In fact, Stephen and Bea’s story is strikingly similar to the ‘after’ story in the original funding bid.

‘We’d worked so hard on the Gold Line. To read Stephen’s letter and to think the care had been so good, and that Gold Line had been central to that, it was a remarkable moment. What he was saying was what we had aspired to achieve.’