Scottish Unscheduled Geriatric End of Life Screening Tool (SUGEST): Exploring the Acceptability and Implementation of a Prognostic Tool in Palliative Care
The Scottish Unscheduled Geriatric End of Life Screening Tool project, previously referred to as SUGEST, is a mixed-methods study exploring how a prognostic tool could support earlier identification of people who may benefit from palliative care in unscheduled NHS care settings. The wider project is adapting and validating a tool designed to identify adults at increased risk of near-term mortality when they access emergency or out-of-hours care. The quantitative workstream focuses on using health data science to develop a risk prediction tool that can help identify patients with unidentified/unmet palliative care needs. The qualitative workstream focuses on how such a tool could be implemented in a way that is acceptable, ethical, equitable, and person-centred. The study explores the views of patients, unpaid caregivers, clinicians, and community representatives, with a particular focus on underserved and marginalised populations who may experience barriers to timely palliative and end-of-life care. The project involves interviews with adults in Scotland who have received palliative care or cared for someone receiving palliative care, followed by workshops with clinicians working in unscheduled and/or palliative care. Findings will inform practical guidance for the responsible and inclusive use of prognostic tools in NHS Scotland.
Grant-wide Collaborators
- Dr Sarah E. E. Mills – School of Medicine, University of St Andrews; NHS Fife
- Dr Joanna Bowden – NHS Fife; School of Medicine, University of St Andrews
- Professor Colin McCowan – School of Medicine, University of St Andrews
- Dr Luciana Pedro – School of Medicine, University of St Andrews
- Dr Utkarsh Agarwal – Nuffield Department of Primary Care Health Sciences, University of Oxford
- Dr Andrew Taylor – Yale University; University of St Andrews
- Dr Sarah Bowers – NHS Fife; Univeristy of St Andrews
- Dr Emma Louise Gale – School of Medicine, University of St Andrews
- Dr Lynsey Brown – School of Medicine, University of St Andrews
- Ms Pam Channer – PPI Co-applicant
- Mr Elric Honoree – PPI Co-applicant
Qualitative sub-study team
- Dr Emma Louise Gale –Qualitative Sub-study Lead, School of Medicine, University of St Andrews
- Dr Sarah E. E. Mills – School of Medicine, University of St Andrews; NHS Fife
- Dr Joanna Bowden – NHS Fife; School of Medicine, University of St Andrews
- Dr Sarah Bowers – NHS Fife; Univeristy of St Andrews
- Dr Lynsey Brown – School of Medicine, University of St Andrews
- Dr Kristian Pollock – NHS Fife
PPI Representative
Patient and Public Involvement contributors supported by the Fife Centre for Equalities. The PPI group has helped shape the study design, reviewed ethics and participant-facing materials, and refined the qualitative interview schedules to ensure they are accessible, inclusive, and appropriate for patients, unpaid caregivers, and underserved communities.
Publications
Protocol manuscript in preparation/submission:
Gale, E. L., Brown, L. R., Pedro, L. R., McCowan, C., & Mills, S. E. E. Exploring the Acceptability and Implementation of a Prognostic Tool in Palliative Care: National Unscheduled Care Geriatric End of Life Screening Tool in Scotland.
Future outputs will include open-access academic publications, policy briefings, stakeholder-facing reports, and public engagement materials. Findings will be co-developed with the project team and PPI contributors to ensure outputs are accessible and relevant to healthcare, policy, and community audiences.
Contact Us
Dr Emma Louise Gale
School of Medicine, University of St Andrews
Email: [email protected]