Meet Dr Justine Needham, medical director of Hospice Isle of Man

In 2024 Dr. Justine Needham became the Medical Director of Hospice of Man. While many might perceive her role as one steeped in sorrow, Dr. Needham brings a perspective of profound positivity and privilege, reminding us of the strength and resilience found in even the most challenging circumstances.

Every day is different, but it has a similar structure. It starts with a handover from both the community based teams and the in-patient unit. I provide clinical support to all, which includes answering questions regarding care plans and guidance on symptom management. If I’m ward-based, I will manage the patients along with the junior doctor. There’s obviously a lot of paperwork but I’m very keen that my role is not just managerial, I don’t want to lose touch with the clinical side because that’s the bit I really love. I want to be present and approachable for my colleagues and I want to be in direct contact with the patients as much as I can.

Whilst I loved being a GP in the traditional sense of the word, the GP environment has changed a lot in recent years. Thankfully following a placement in my early years of training I decided to pursue specialist palliative care training alongside my GP training. I believe very firmly that having an interest in different areas helps to keep you fresh and focused. This enabled me to have five years or so of concurrent work at Hospice Isle of Man while practicing as a GP. I honestly think if I just stayed in daytime general practice, I would have given up medicine completely five years ago. Working at Hospice rekindled my initial passion for medicine. There’s a special feeling that comes from being able to do all the things that you were trained to do as a doctor, and going home knowing you’ve made a difference, and it’s amplified when you are part of a community that shares your standards and values.

People think that palliative care is all doom and gloom and it’s only about people dying. It is so much more than that - it’s about helping people to live their best lives until the end and that is a real privilege. Yes, we deal with end of life care, but that’s just the tip of the iceberg – we offer so much more for patients to give them a better quality of life before they reach end of life. You’d be surprised by the amount of joy we witness here!

In Liverpool during my GP registrar year, Dr. Heather Walker, a GP and hospice physician was inspirational, and I will never forget her attitude to her work. She would spend so much time with her patients that she would always overrun. She cared, and the patients felt valued. She epitomised why I think we all wanted to become a doctor in the first place. I was also fortunate to learn from Dr Alison Coakley, whose ongoing commitment to improvement and lifelong learning continues to motivate me. She is driving conversations about the importance of patient led care - If the most important thing to a patient is being well enough to walk their daughter down the aisle, then that’s what we as clinicians should prioritise. She inspires people to do better and to not become complacent. I think this is important as every patient should be treated based on their own unique circumstances.

Palliative care is an amazingly rewarding career. I would say to not let other people put you off and to not think that you are taking ‘an easy route’ into medicine. I might not be standing up for eight hours in a theatre, but it is both demanding and rewarding for other reasons. There are days when you want to close your door and have a good cry, but you make such a massive difference to so many at a time when they’re at their most vulnerable and that is priceless.