Without question, we can all make a difference

One of the things I love about my younger grandchildren is the questions they ask. It often feels like they have an insatiable appetite to make sense of the world around them by asking endless questions. Whilst some folk might find this irritating, I have to say I love it. Answers can easily become stories, and all children love hearing stories. Of course, whilst it is always important to be truthful, answers to children’s questions don’t always need to be evidence-based. Answers just need to satisfy the child’s curiosity in the moment, but also whet their appetite to learn more. Here’s an example:

Chickens and Dinosaurs. For some reason most of my grandchildren have gone through a dinosaur phase. Dinosaurs seem to appear on the school curriculum very early on in school life, and fuel a relatively short-lived, but intense fascination for these long-gone creatures. It makes buying birthday and Christmas presents very easy while they move through this phase. Now some of my grandchildren love our chickens. Whenever they visit, they like to ‘round them up’, or ‘collect the eggs’ and in the Spring, pick the baby chicks up to give them a ‘cuddle’; usually the Mother Hens are less than impressed with their chicks being cuddled. So, when you tell the children that chickens are actually related to dinosaurs, it adds a little magic and wonder to the conversation. And chickens and dinosaurs are related, well more or less – see here.

However, last week I met with a group of folk where ‘more or less’ answers to questions are not good enough. This was at our regular informal meeting with our Council of Governors’ colleagues. As well as being Chair of the Board, I’m also Chair of the Council of Governors, and I love meeting with them. Their main role is to hold the Non-Executive Directors individually and collectively to account for the overall performance of the Board. The ‘holding to account’ is about seeking assurance. They are an integral part of our overall governance approach. They are a tough, informed group, who do their homework. Their contribution is vital to ensuring that local people get the best service possible from health care providers such as the Trust that I chair.

When I first started as a Chair at the Trust, it was difficult to get any interaction at all. The meetings felt a lot like me talking to people not talking ‘with’ people. But over time this has changed, and all the meetings are now lively, purposeful and very interactive! We provided training to the governors in how to raise challenges and questions. These days, and almost inevitably, they will start their questioning with ‘can you tell us how you get assurance about….’ whatever the concern might be. As I say, there is no room for ‘more or less’ answers when you want assurance, and not simply reassurance.

Mind you, last Wednesday I met with some absolutely brilliant colleagues who could provide reassurance and assurance in a context that most of us would find very challenging. Last Wednesday was National Cancer Clinical Nurse Specialists’ Day. It was a day of celebration and awareness raising in terms of what these nurses do. Most Cancer Clinical Nurse Specialists (CNS) are Macmillan nurses. 

There are 6,700 Macmillan nurses in the UK. Macmillan usually fund these nurses for the first 3 years and then the NHS (or other health care organisations) will continue the funding. It was a group of these nurses that I met with last week. They had put on a wonderful exhibition of their work and I was able to talk with many of the CNSs, each providing an insight into the care they provide across the many different fields of cancer.

It was an eye-opening experience, and one I was glad to be part of, albeit very briefly. Not only did I learn a lot about the types of cancer most prevalent in Greater Manchester, but also about the pivotal role in the cancer pathways CNS have. Right from the start of a person’s cancer journey they are there. They provide advice, information and support to all individuals who find themselves on a cancer pathway. And this is where the assurance and reassurance come into play.

I don’t have personal experience, but I’ve had family members who have been on a cancer pathway. All of them have had so many questions and all experienced difficulty in the early days of diagnostic testing in finding someone who would be a trusted voice; someone who was experienced and knowledgeable to talk to. Last week, what I heard is that during that first period of uncertainty where there isn’t a confirmed diagnosis, people don’t always know what questions to ask. On being given a diagnosis of cancer those unknown questions multiply exponentially.

Anxiety, bewilderment, anger and possibly the full range of Kubler Ross’s five stages of grief will often be experienced. This is where the cancer CNS role is so important. All through these times of questions and a need for answers, Macmillan nurses are there to offer emotional support, and help folk work through all those questions in a totally person-centred way. I was impressed with what I saw and heard. I’m always proud of what all our nurses do. Last week, it felt like a real privilege to see and hear what these specialist nurses do in making a difference to the lives of others.