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Ep 33. Barbara-Anne Walker, CEO Ashgate Hospice: Changing the conversation about death and dying
47 Plays2 years ago
“Part of Ashgate’s ambition is to change the conversation about death and dying… to enable conversations to happen in daylight, in general conversation, about death and dying. We’re all going to die, its not something that any of us can avoid… ”
Barbara-Anne Walker is the Chief Executive of Ashgate Hospice.
Ashgate Hospice is a specialist hospice, providing palliative and end of life care for the community of North Derbyshire.
Their vision is for people with a life-limiting illness to be able to live well, and have a good death. And for their families to be supported and comforted through the process.
Less than 30% of hospice funding comes from the NHS and yet the hospices provide a vital service within the UK healthcare system. Barbara-Anne and her team at Ashgate Hospice have been prolific in engaging the community, campaigning and raising awareness for hospice funding, both locally as well as on the national stage.
Barbara-Anne is emphatic about the need to change the conversation about death and dying.
We talk about the organisation’s iconic Sparkle Walk event. We also talk about Ashgate Hospice’s own podcast, The Life and Death Podcast, which explores frank and honest conversations about death and what ‘dying well’ really means.
Barbara-Anne shares her thoughts on the importance of visible leadership and her role, as a leader, in creating a learning culture. She also shares some practical learnings gained from working through the pandemic.
Recorded May 2022.
Guest Biography
Barbara-Anne Walker is the CEO of Ashgate Hospice. Barbara-Anne has worked in the voluntary sector for over 30 years and has had an interest in palliative and end of life care since early in her career when she worked with people affected by HIV.
Barbara-Anne led the national social care programme for Macmillan Cancer Support and previously worked as Operations Director with the British Red Cross. She was a Non-Executive Director of Derbyshire Community Health Services NHS Foundation Trust for eight years. In 2021 she was shortlisted for the Charity Times ‘Leader Of The Year’ award.
Barbara-Anne is Scottish and Derbyshire has been her home for over 20 years.
Links
https://ashgatehospice.org.uk/
Barbara-Anne Walker is the Chief Executive of Ashgate Hospice.
Ashgate Hospice is a specialist hospice, providing palliative and end of life care for the community of North Derbyshire.
Their vision is for people with a life-limiting illness to be able to live well, and have a good death. And for their families to be supported and comforted through the process.
Less than 30% of hospice funding comes from the NHS and yet the hospices provide a vital service within the UK healthcare system. Barbara-Anne and her team at Ashgate Hospice have been prolific in engaging the community, campaigning and raising awareness for hospice funding, both locally as well as on the national stage.
Barbara-Anne is emphatic about the need to change the conversation about death and dying.
We talk about the organisation’s iconic Sparkle Walk event. We also talk about Ashgate Hospice’s own podcast, The Life and Death Podcast, which explores frank and honest conversations about death and what ‘dying well’ really means.
Barbara-Anne shares her thoughts on the importance of visible leadership and her role, as a leader, in creating a learning culture. She also shares some practical learnings gained from working through the pandemic.
Recorded May 2022.
Guest Biography
Barbara-Anne Walker is the CEO of Ashgate Hospice. Barbara-Anne has worked in the voluntary sector for over 30 years and has had an interest in palliative and end of life care since early in her career when she worked with people affected by HIV.
Barbara-Anne led the national social care programme for Macmillan Cancer Support and previously worked as Operations Director with the British Red Cross. She was a Non-Executive Director of Derbyshire Community Health Services NHS Foundation Trust for eight years. In 2021 she was shortlisted for the Charity Times ‘Leader Of The Year’ award.
Barbara-Anne is Scottish and Derbyshire has been her home for over 20 years.
Links
https://ashgatehospice.org.uk/
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Transcript
Changing the Conversation on Death
00:00:00
Speaker
Part of Ashgate's ambition is to change the conversation about death and dying and to enable conversations to happen in daylight, in general conversation about death and dying. We're all going to die. It's not something that any of us kind of all read. And actually for us, I think, and for me, this is the power of seeing 2000 people all dressed in pink and sparkly and lights on and all sorts of things walking through
00:00:28
Speaker
North Dutch Chesterfield and parts of North Derbyshire. Just that light, literally the symbolism of that light in the dark is immensely powerful.
The Charity CEO Podcast's Recognition
00:00:46
Speaker
Welcome to Season 4 of the Charity CEO Podcast, the podcast for charity leaders by charity leaders, bringing you inspirational and meaningful conversations with leaders who are driving change in the non-profit space. I am truly delighted and humbled that the show has been named in the Charity Times Top 10 Charity Podcast for 2022. Thank you all for that incredible endorsement. I'm Divya O'Connor, and here's the show.
Ashgate Hospice's Mission and Vision
00:01:14
Speaker
Barbara Ann Walker is the Chief Executive of Ashgate Hospice. Ashgate Hospice is a specialist hospice, providing palliative and end-of-life care for the community of North Derbyshire. Their vision is for people with a life-limiting illness to be able to live well and have a good death. Less than 30% of hospice funding comes from the NHS, and yet the hospices provide a vital service within the UK healthcare system.
00:01:39
Speaker
Barbara Ann and her team at Ashgate Hospice have been prolific in engaging the community, campaigning, and raising awareness for hospice funding, both locally as well as on the national stage. Barbara Ann is emphatic about the need to change the conversation about death and dying. We talk about Ashgate Hospice's own podcast, the Life and Death podcast, which explores frank and honest conversations about death and what dying well really means.
00:02:06
Speaker
Babran shares her thoughts on the importance of visible leadership and her role as a leader in creating a learning culture. She also shares some practical learnings gained from working through the pandemic. Here's the conversation.
Barbara Ann's Leadership Philosophy
00:02:21
Speaker
Hi, Babran. Welcome and thank you for joining us on season four of the Charity CEO podcast. It's very lovely to be here. I'm a huge fan of the podcast. It's really wonderful to be invited. Thank you.
00:02:33
Speaker
Thank you for saying so. Lovely to have you on. Being a fan of the podcast then, Babran, you will be familiar with the Icebreaker format. I have five questions, so if you're ready, we can kick off. For sure. Question one. What are three words that your team would use to describe you at your best? Oh, at my best.
00:02:56
Speaker
Now, I'm a Calvinist, Davia, so I have a real problem with describing anything about me at my best. I think probably curious, passionate. And I'm going to say impatient. And I mean that in both, I mean, it is both good and bad. Inasmuch as it's that sense of we have to keep moving. We don't, you know, we have things we have to do. Let's get on with it. So yes, I would, I think that's probably, they might give you something completely different.
00:03:26
Speaker
I love it. And question two, then, is what would you say is your professional superpower? Oh, I'm going to go back to the first thing I think my team would say about me, which is curious. But I might embroider that a little and say intentional curiosity because it isn't enough just to do the why are you doing that or could we do it differently? There has to be some there's no point in that really. There has to be some action behind it.
00:03:54
Speaker
So curiosity has, I think, in it things like courage and interest and creativity. When you become intentional about it, then it has to be about, okay, what happens if we try that? So let's try it and see what happens. Why do we do it that way? What would happen if we did it a different way? Because that's how you start to move down and move through the journey of kind of changing and improving that constant.
00:04:22
Speaker
not quite good enough. Could we do it better? For me, it's very much in curiosity. I do sometimes drive. I know my team nuts and people at Ashgate nuts because I do quite often do the, can we just go back up step? Why would we? Can we just understand? Could somebody go and look at that and come back? But I actually think the more
00:04:45
Speaker
Complacent you are, Michael West talks about the idea of being, are you a comfort seeker or a problem sensor? And I am by nature a problem sensor. And I think it's, yeah, that's how you improve. That's how organizations get better. And it's how the voluntary sector came into being because people said, what would happen if we did this in response to a problem? So yeah, I'm kind of constantly curious.
00:05:12
Speaker
I love that, being intentionally curious and being a problem sensor. Two fantastic superpowers
Personal Insights and Guilty Pleasures
00:05:18
Speaker
there. So the next question, what is your guilty pleasure? Oh, curling up on the sofa with a book and a box of chocolates. And no, I actually, my guilty pleasure is sometimes not leaving the house for an entire weekend. I can very easily intentionally
00:05:40
Speaker
you know, finish work on a Friday night and just never leave the house and not have to be on kind of phone calls with friends, not have to engage with people, not have to see people. Um, yeah. And I kind of, it's not, I don't have guilty as the right word, but I'm conscious that it's something that only some people would relate to. Luckily I have a husband who's happy to go out and do the show. Question four, if you could wave a magic wand and change one thing in the world right now, what would that be?
00:06:09
Speaker
It would have to be high quality end of life care provided by organisations with sustainable funding. Absolutely have to be. Including Ashgate, of course. And our final icebreaker question. If you had the opportunity to interview anyone in the world, dead or alive, who would it be and what one question would you like to ask them? I'm not just saying this because I'm a Scott. It would have to be Nicholas Sturgeon.
00:06:39
Speaker
And my question would be how she found the energy and the resilience to turn up every day for two years pretty much at those press conferences every day. Do you know what I mean? With full face on, the dress, the whole thing.
00:07:03
Speaker
And kind of the leadership, whatever your stripe of politics, I think the leadership that she showed through that. And I'd want to understand what she drew from in order to do that. Because there have been many days for me through the last couple of years where I have been really thankful that I've been working from home and I haven't had to put on shoes and, you know, kind of properly get dressed and go out and engage with people.
00:07:29
Speaker
So, yeah, I would love to understand more about what whale she drew on in order to be able to do that, because I thought it was an astounding achievement. So, Babran, you are the CEO of Ashgate Hospice.
Challenges and Community Support during the Pandemic
00:07:44
Speaker
Let's start off by talking about your organisation and its vision and mission. So, Ashgate is a specialist hospice. We provide palliative and end-of-life care for the community of North Derbyshire.
00:07:56
Speaker
Our vision is for people with a life-limiting illness to be able to live well. It's not just about dying, it's about living more than it is about dying. So for them to be able to live well and to have a good death, and for their loved ones to be well supported and comforted too. So we're not just about our patients, we're also about their families, their friends, their loved ones.
00:08:21
Speaker
We have a 21 bed inpatient unit and we also have in effect a full suite of community services. So we have clinical nurse specialists and support workers, physios, occupational therapists, day services, lymphedema team, we have a full medical team and we also have a supportive care service. So we work, we have social workers, therapists, we provide
00:08:49
Speaker
Over the last couple of years through the pandemic, we've been providing specialists in effect post trauma support for our local acute hospital and their staff in light of everything that they were having to deal with. So we have about 340 staff and best part of 700 volunteers. So it's a big operation for a kind of local charity. We've been around since 1988 was when the doors first opened.
00:09:16
Speaker
And actually we were started by a group of volunteers at that time in order to get end of life specialists, end of life care people in North Derbyshire had to go to Sheffield and they had the vision of wanting to have somewhere local for local people to go so that people didn't have to travel very far. And they raised at that time over a million pounds just to open the doors of the hospice. And some of them are still involved. We've got one of our founding patron is still around.
00:09:45
Speaker
and also a couple of volunteers who were on that original fundraising group who are still volunteering for us.
00:09:51
Speaker
Wow, that's such amazing advocacy and support when you have some of the original founding volunteers still supporting. But tell us a bit more about the funding model then for the hospice. I know that what a lot of people don't actually realize is that less than 30% of your funding is via the NHS or indeed from the government. But what are some of the challenges of having one foot in the NHS whilst also then being a charity and needing to fundraise to provide your essential services?
00:10:21
Speaker
Yes, we're effectively in the healthcare system, but not of the healthcare system. And it's classic model. You know, most charitable hospices across the country have less than 30% of their funding provided by the NHS, even though we are in effect providing services, healthcare services that should be provided and are required to be provided by the NHS. So yes, we are, so our budget last year, our expenditure budget last year was 11 something, 11.8 million, something like that.
00:10:51
Speaker
Less than 3 million of that was funded by the NHS. So we cared for 1,900 people last year in our clinical services and almost 300 people in our supportive care services. So over 2,000 people. And as I say, yes, less than 3 million pounds from the NHS. The rest of that money comes from our fundraising work and our retail. So we have 15 shops and three coffee shops. I hope I got that right.
00:11:18
Speaker
across North Derbyshire, who generates about £3 million a year. The shops are wonderful. They really are our ambassadors in the community. We know that people come into our shops because they either perhaps have a connection to the hospice or they want more information about the hospice. They also go in just because the shops are very good.
00:11:40
Speaker
And actually, they don't look like traditional charity shops. They don't smell of dampness, for a start. And they're colorful and they're bright. There is a real, I think, public perception of what a charity shop looks like, and it actually mostly isn't the reality anymore. It certainly isn't the reality for ours. The rest of our income is generated by fundraising, and it's kind of classic
00:12:04
Speaker
voluntary sector stuff. So it's a mixture of trusts and grants. We have some really big events. We have an event once a year called Sparkle Walk. And we're doing it again this year in person where we had run it virtually for a couple of years. And that's a really wonderful event. It's a huge fundraising event for us. It brings in about a quarter of a million pounds. And in previous years prior to the pandemic, and I think I hope again this year, it's 2,000 people who come together all dressed in pink and all sparkly.
00:12:35
Speaker
to celebrate generally somebody who they have lost. So people will have on the backs of their t-shirts, photographs of their dad or their husband or their brother or their daughter or their friend. And it's a sponsored walk in effect, but they walk through Chesterfield in the dark. And there's something for me about not just the income that raises, but the symbolism of that because it's a pilgrimage for so many of those people.
00:13:03
Speaker
And part of Ashgate's ambition is to change the conversation about death and dying and to enable conversations to happen in daylight, in general conversation about death and dying. We're all going to die. It's not something that any of us can avoid. And actually for us, I think, and for me, this, the power of seeing 2000 people all dressed in pink and sparkly and lights on and all sorts of things walking through
00:13:32
Speaker
North Dutch Chesterfield and parts of North Derbyshire. Just that light, literally the symbolism of that light in the dark is immensely powerful. So we have those kinds of events. We have a whole range of different events that raise funding, that raise money for us. And actually I have to say after 30 years in the charity sector, I have never worked for a charity that is so well loved and so well supported by its community.
00:13:59
Speaker
And that really showed up at the end of 2020. We weren't that long into what became a rather extended pandemic and lockdown situation. And we'd been saying to the NHS for years that they don't give us enough funding. We are beginning to run out of money. The demand is too much. We cannot continue to do this anymore.
00:14:20
Speaker
And they were sort of, I think they spent a lot of time going, yeah, yeah, yeah, but you're a charity. You won't stop because they didn't really understand the concept of the liabilities and responsibilities of charities. We got to a point in the late summer of 2020 where we actually had to say to them, it is enough now. We are going to have to stop doing some of what we're doing. We're going to have to stop providing some of the services that we provide because we just do not have the money to do it. And we had to take.
00:14:50
Speaker
The NHS commissioners on a long journey of learning what it meant to be a charity, because of course all they can think of is NHS. They work in the NHS and do a lot of education with them in effect about what it meant to be a charity and what it means for us to be a charity and the value that we bring as well. You know, like most hospices, we kind of pay for two thirds of the services that we provide. They get that for free in effect.
00:15:16
Speaker
But in order to back that up with the support of our wonderful marketing and communications team at the hospice, we launched a communications campaign, particularly locally, but also nationally, that was about raising awareness of the insecurity of our funding situation, the implications of all of that, raising awareness of the fact that we're not 100% funded by the NHS. And we had a phenomenal response.
00:15:45
Speaker
There was something in there for me about rather than just going out to our staff and our volunteers and to our community and saying things are bad, we have a problem and here you need to understand that we may have to take certain actions. But also going behind that with an electrical to action to see and hear something you can do to change that situation. Here's something you can do to help. And our community and our staff and our volunteers responded with phenomenal support.
00:16:15
Speaker
I'm not sure our MPs have had quite ever so many letters about a particular situation. They suddenly became very interested in what we do and it really helped. It has given us a level of security for the last couple of years that we did not have in 2020. And for me, it was very much, it was a, an immensely stressful experience. I mean, really like, you know, talk about losing sleep. Um, but actually it turned out to be a really,
00:16:44
Speaker
positive and heartwarming experience just to get that support from the community and to really understand what the care that we provide means to people. There are very few people in North Abershire who haven't been touched by Ashgate in some way or another.
00:17:00
Speaker
I'm really struck hearing you talk by how well-loved Ashgate Hospice is by its community and how you really exist for the community as well, and also how you, being a locally focused organization, have still been able to get on the national stage and really raise the profile
00:17:22
Speaker
of your worker and of the sector more broadly as well. And I particularly love how you talk about the sparkle event and how it's so connected to the mission about celebrating somebody who has died. And so it's all about living well and then celebrating the death for the families as well, who of course left behind. But if we go back to COVID times, I know that Ashgate was one of the few hospices that accepted
00:17:50
Speaker
end-of-life COVID patients in your patient unit and you talked there a little bit about how it was such a difficult time. How are things right now do you think and how well equipped do you feel your organization is to perhaps face into the next crisis which is currently the cost of living crisis that we are all facing into? Yeah and it has been a really interesting experience and I think I
00:18:17
Speaker
I don't usually try and speak for everybody, but I would, I think, speak for everybody. I should say, at least from my perspective, I think we all surprised ourselves with everything we could do. And we did things that we asked. We were in common with the NHS and other kind of social care and health care providers. We were asking our staff and our volunteers to put themselves at risk, to care for people who were COVID positive, whether in the community or in an inpatient unit. And we were one of the few hospices that proactively took
00:18:47
Speaker
dying people from our local acute trust into the hospice, people with COVID who were dying, which enabled them to have people with them. So we had visitors all the way through the pandemic. We still do, partly because of things like practical stuff like the design of the building, but also because our staff and our volunteers were hugely committed to making that possible. And it was hard for them. It was heartbreaking because so much of what we do and so much of
00:19:14
Speaker
palliative and end of life here is about the small things. It's about the touch on the arm or even the hug if somebody is really struggling. It's about going into somebody's bedroom and giving them a big smile, which is almost impossible to do when you're wearing a mask. It's been really hard. One of the things that we did last year was we did something called a learning history. This is huge learning for me in itself.
00:19:44
Speaker
But it's an actual model that is prescribed, and I think it was devised by MIT, that's about understanding and working and talking to people to enable them to identify how has it been for you and what have you learned and how are you going to take that into the future. So you're able to do that at an individual level. And we interviewed something like 70 people, staff and volunteers across the organization over the course of a number of months last year.
00:20:11
Speaker
And so it was about learning them learning and having a chance to just think having what my husband would call a good listening to about kind of how has it been for you? What have you learned? And that was, was everybody. So people who had suddenly in March, 2020 being sent home with the laptops and told not to come into the hospice, as well as the people who continue to work in the hospice building itself and our retail staff, our fundraising staff, all of them, and
00:20:39
Speaker
It tells a story. I mean, it's like a 90 page document, but it's really rich information. It tells a story about all of the different perspectives from the people who were interviewed about how it was. And I think there's real learning in there about understanding that going forward, we're just beginning to have conversations with staff now about kind of hybrid working. So what does
00:21:05
Speaker
You know, some people work really well at home and some people can be at home all the time. Some people are not able to be at home. If you work in a shop, you work in the inpatient unity states, catering, that kind of thing, you can't be at home. You have to be weird at your place of work. That's not an option that's generally available to you. Everybody else, people like me are sort of somewhere in the middle, but actually rather than prescribing everybody come back to work or everybody stay where you are,
00:21:32
Speaker
There's a Myron's maxim that I love, which is that the process you use to get the future is the future you create. And actually for me, beginning to go out and have individual conversations with teams and sometimes with individuals about what do you need in your future? What does your future need to look like? We create that future together. And that includes going and talking to people like nurses on the inpatient unit and medical staff and healthcare assistants and housekeepers.
00:22:01
Speaker
who don't have the option of working from home. But it's equally important that we hear that conversation. So I think we are as ready as anybody else is for whatever might
Strategizing for Future Challenges
00:22:13
Speaker
come to us. But actually, I think the way that we work now, which is very different, I think it's fair to say, from the way that we worked a few years ago, which is very much about the conversation, the invitation to engage.
00:22:29
Speaker
The new strategy that we've got, for example, which includes some of this thinking, came from some hot groups that we did. It picked up lots of different intelligences. But one of the things that we did was we invited, there was an open invitation. And again, we had about 60 or 70 people who came and joined some hot groups to look at different ways in which we could do the future differently. And lots and lots of ideas from that that have been fed into the strategy. I think what makes us as ready as we can be is not
00:22:58
Speaker
So much of what we do is the how we do it. So engaging with people, having those conversations with people, listening to people we've had, you know, through the kind of two years of the pandemic to date, we've had a business continuity structure. So we've had daily meetings where it was necessary, reducing down to twice weekly or weekly, which were about, can we respond? How do we respond really fast to practical questions on the ground?
00:23:23
Speaker
So the shops were struggling about new regulations that were coming in about social distancing. OK, what do we need to do? Who's doing it? Let's go and get it done. So there was a real operational emphasis. And we can lift that up again. We can do that again. We've stepped it down. So we're ready to do all of that. But also, there's something for me about just continuing to ask that question. It's a curiosity thing. What did we learn? Why would we do it differently next time? And I have a phenomenal bunch of staff and volunteers who
00:23:53
Speaker
just do astonishing things, sometimes without even being asked. So, you know, I think we are absolutely ready for whatever the future brings, which doesn't mean it's not sometimes scary. And doesn't mean that we don't acknowledge and recognize sometimes that it's scary. I remember going to our inpatient unit in December when Omicron was really beginning to make itself felt. And we had again said,
00:24:21
Speaker
that we were going to take COVID positive patients from Chesterfield Royal, which is our local acute hospital, and going to talk to staff about our thinking about that to get their perspective on it. And there were people who were really struggling with it because they just felt that they had got back to, even with masks and that kind of thing, a level of normality. And all of a sudden it felt like we were going, actually, you need to ramp it back up again.
00:24:49
Speaker
And there were some tears, there were some nurses in that meeting who were crying. But I went back in again the next morning and did a shift on the unit, and I was really struck by how they had just got their head round it, because this is what they do. And I think the challenge for all of our staff, and particularly our clinical staff, has been our best, even right now in May 2022, our best still looks very different to what it was two and a half years ago.
00:25:19
Speaker
And, and for them, a lot of what I've been trying to do is kind of change that thinking round to actually, this is the best you can do under the circumstances. This is your best. It's just your best looks different right now by necessity to what it did two and a half years ago, but they are still doing astonishing things for the community that nobody else in, you know, is doing.
00:25:45
Speaker
I love the maxim you quoted there, Babran, which is the process you use to create the future is the future that you get. So the focus is really on how you do things rather than necessarily the what. And I want to just delve into something else that you mentioned in the context of really creating this hybrid working environment and looking at the best today looks different to how it might have done pre-pandemic.
00:26:12
Speaker
How do you really cultivate a joined up culture and this one team ethos of everybody pulling together? I mean, do you have any tips or advice for other leaders? Because I do think a lot of organizations are grappling with that right now. Yeah, and I grapple with it too. It has been hard, I think, particularly over the last couple of years. We have something that we call for shorthand, I guess, but also for Visibility One Ashgate. And I think that's one of the really important things is to name it. I'll go back to being intentional.
00:26:42
Speaker
If that's what you want to do, then you have to name it. If people don't know where they're going, then they can't possibly come on the same journey as you. It's hard when the organization is so disparate and continues to be disparate, and we're moving into a future that we don't yet know what it looks like, really. I think there's something really important for me about, well, there's a number of different things. One is visible leadership. And pre-pandemic, that was very much physically visible. It's now much more about
00:27:13
Speaker
emails and being online on screen and that kind of thing. There's something for me about if you as chief executive Ashgate, I know the kind of culture that I want to create and therefore I need to also live that culture and be seen to live that culture. And sometimes we're necessary to face up when I don't get it right. Um, because that's part of the culture as well. If we want to learn in culture, then I have to model that too.
00:27:41
Speaker
There's something for me as well about seeding leadership everywhere. That kind of idea, that recognition, that reality, I think that whoever you are, whether you're a volunteer who works one afternoon in a shop or whether you're a full-time chief exec, you can be and you are a potential leader in the organization and you're all driving towards that same place, that same vision, that same destination. So we've done things like we've got a program that we call Leading Together.
00:28:10
Speaker
we bring together a group of people from across the organization. We've done it twice. The first cohort were by invitation because we just wanted to start it. The second cohort, we invited applications and we had a real mix in the group as we did in the previous group that ranged from housekeepers, nurses, healthcare assistants, people who work in retail, people who work in HR, people who work in fundraising, from all across the organization,
Leadership Development Programs
00:28:39
Speaker
managers but below that level in terms of the hierarchy. It's not a come and sit in a classroom and we'll do some PowerPoints of what leadership models look like. It's a real chance to understand that concept that leadership is nothing to do with you and all about you at the same time. It's that notion of having some space to think about what does your leadership look like? What's the influence that you have in the organization?
00:29:06
Speaker
But also, it's not just about the organization. I really absolutely believe, because I've seen it, if you give people the chance to develop, they will surprise themselves. And actually, whatever they do in that space will bring something powerful to the organization. Now, some of them will eventually move on precisely because you enabled them to understand and to see what their potential might be. But actually, that's OK, because they go and do that somewhere else. And that's wonderful in itself.
00:29:34
Speaker
So I think you have to, you know, that idea of kind of if leadership and culture is about doing something, you know, starting somewhere and following it everywhere. I think if you're going to do something like one Ashgate, you have to do it in lots of different ways. And it can't be about the kind of communicating of it is the least of it in lots of ways. It has to be about going out and having conversations and modeling it and talking about it.
00:30:03
Speaker
And the reason that I know it has had some traction at the hospice is because we sometimes will get emails or somebody, a member of staff or a volunteer will raise something and they will say, it's not very one-ash-gate. And actually, although that's usually a problem that needs to be fixed, actually, I think that's really positive that they're saying that and pointing that out because it tells me they have a commitment to it. They see something that's out of line with our culture.
00:30:33
Speaker
So actually, although it's usually something that needs fix, I think that's really positive.
00:30:38
Speaker
So many pearls of wisdom there, Barran. I'm just going to briefly summarize the key points. I love the idea of naming the destination. And so One Ashgate does that so powerfully, as you've just described, having visible leadership, but also really driving home the importance of it's not just about communication. It's actually about modeling and living that, which was your next point about being seen to live the culture.
00:31:05
Speaker
and of course, seeding leadership everywhere and developing future leaders. But just coming back to something that you talked about a little earlier on in terms of the organization or hospices in more broadly being in the healthcare system, but not of the healthcare system. I'm curious to know your thoughts around what else you would like to see from government right now.
00:31:32
Speaker
Well, I mean at its most fundamental, more funding for hospices and end of life care generally. I think that the Health and Care Act 2022, the most recent one that's just kind of set up the new NHS structure and the ICSs has for the first time ever in it
00:31:53
Speaker
a requirement on the NHS to provide end-of-life and palliative care. It's worded in such a way that they have to provide palliative and end-of-life care where people need it. Now, I think that's an odd sentence because everybody needs it everywhere, but that notwithstanding. That's the first time the NHS has ever formally been required to provide end-of-life care. Cradle to the grave, yeah.
00:32:18
Speaker
And don't misunderstand me, there, I don't think there's anywhere in the country that the NHS does not provide palliative end of life care. I think there's a difference between, often tangibly between what the NHS is able to do, given the culture of the NHS, given the top down kind of nature of that leadership and the funding challenges. There's a tangible difference between that and what generally hospices provide.
00:32:45
Speaker
partly because of the independence of being a charity of the ability to fundraise of the just the kind of charity experience that the NHS brings and the hospices bring rather and the the fact that we're grounded in the charity ethos of changing the world of doing something that is about social change of seeing a need and doing something about it whether it's
00:33:13
Speaker
the volunteers that set up Ashgate in the first place or whatever we have. There are millions of examples of it across the country over the years. It's the joy of the charity sector. I think the NHS and the government are still on a journey and they probably don't want to do it, but they do have to go on that journey, I think, to understand what charities bring and why the hospice charity model is one of value.
00:33:44
Speaker
to avoid the instinct to say, well, we'll just take it all into the NHS. But actually, the NHS is full of intelligent, smart people. Government is full of intelligent, smart people. It doesn't take a lot. You just have to go on the journey and do the learning. It doesn't take a lot to understand and work with a multiplicity of providers, including charities.
Role of Charities in Healthcare
00:34:07
Speaker
If I can understand, if Ashgate can work with the NHS and understand the NHS, which has to be,
00:34:12
Speaker
one of the most complicated structures and complicated political organizations in the world. Actually, it's not beyond the ability of the NHS to understand and value and work with charities as providers, but there is a need to be blunt just to provide more funding to do what we do because we are doing a lot of what the NHS cannot or does not and probably would not be able to do.
00:34:39
Speaker
I'd like to switch lanes slightly now, Barbara, and talk about one of my favorite topics, which is podcasting. And as everyone probably knows, I love the medium of podcasting. And I think it's a great channel with which to deeply engage with supporters. And I think there is real merit actually in charities having their own podcasts to talk to audiences to really propagate the charity ethos that you mentioned, which is all about changing lives and changing the world.
00:35:06
Speaker
So I was thrilled to find out that Ashgate has its own podcast. Tell us about the Life and Death podcast. Indeed, we do. We're into Series 3 now. It's wonderful, I would say that. I am biased. But I do think it is genuinely interesting. It was an idea, again, of our marketing and communications team. They've done a huge amount of work over the last couple of years. And we wanted, it goes back to this thing a bit, we wanted to change the conversation.
00:35:31
Speaker
We wanted to, there was a sense of why wouldn't we take a step onto the national stage? Why would we not? We have a story to tell. We have experience that is valuable in the same way as anybody else does. And it's hosted by Steven Rumford, who's our senior physiotherapist and who is an absolute passionate advocate for palliative and end of life care. First season was, I was a guest on it. That was my only previous podcast experience.
00:36:00
Speaker
And we've had a range of different guests. The current series I think is really exciting because we've gone wider. So the first interview was with a lady called Kimberly, whose husband that we cared for, just talking about her husband died about 15 months ago and just talking about her experience of the last 15 months of being now a single mother in effect with children.
00:36:25
Speaker
But we're also interviewing authors and people who are on the national stage to talk about their experiences, their insights, that kind of thing. So the most recent episode, Stephen interviewed Seamus Mahoney, who's a gastroenterologist, who's recently retired, who wrote a wonderful about death and dying that I actually read before I started at Ashgate. But just some really interesting guests
00:36:54
Speaker
It's really about, a bit like this podcast, it's about raising awareness of things that happen, of conversations that are going on of people, what they're doing, how they are living their lives, what their insights are, their reflections are on living and dying, which is why it's called the Life and Death podcast. And it's a really, it's about having frank and honest conversations about exactly that. What does it mean to live well?
00:37:23
Speaker
and to die well. How do we do that? How is our society doing that? How well are we doing that? What else do we need to do? I think it's a really brave thing to do. And for some of the guests who come on, some of them have been immensely powerful conversations. And we had, for example, in the last season, we had Catherine Mannix, who is an end-of-life palliative care consultant.
00:37:49
Speaker
Yeah, we've had some really interesting guests. And yeah, third season, so third time lucky, we'll see. We're not quite as your fourth season, so we're a bit behind you, but we'll catch up. Well, I'm sure you will get there. And so listeners, if you work in the hospice sector or more broadly have been touched by loss and want to find out more insights, I would strongly encourage you to listen to the Life and Death podcast.
00:38:14
Speaker
But Babran, tell us now a bit more of your personal story in terms of your career path.
Barbara Ann's Career Journey
00:38:20
Speaker
What has led you to where you are today? Sure. So I'm, as you can tell from the accent, I'm Scottish. I was born in Glasgow and lived in Glasgow until I was in my early thirties. I was the first member of my family, my wider family to go to university. So I was brought up in a fairly working class family with one brother.
00:38:43
Speaker
My mum and dad had always volunteered, although in those days, that would have been the early sixties and seventies, it wasn't really called that. There wasn't the same infrastructure behind it and the kind of awareness of it, I think that there is now, but they'd always volunteered for local groups and for their local church. And my mum in particular was very involved in kind of peace and justice work when I was a child. So it was kind of.
00:39:05
Speaker
That notion that that's what you do, that volunteering is something normal, if you like, something that is good to do, that people do, was very much kind of just in me, I guess. And I, as I say, I was the first person to go to university. I had to have a degree in psychology from Glasgow University. And that's only because a teacher said, Mr. Balsilly said, I think you should look at going to university. And in those days, of course, you could go, you know, I had no, we had no money. You went to university on a full grant, which is what made it possible.
00:39:34
Speaker
And that really was life-changing. I mean, without that, I wouldn't be here really genuinely. And I know you even more than I am, a passionate advocate for the power of education and the impact that the work that somebody like you do in your organization does to you is just phenomenal. My first paid role in the voluntary sector was working for the Church of Scotland, of all things, as a rehab worker in a drug unit. And I will say now that I was terrible at it.
00:40:03
Speaker
I lasted about nine months. I just, I'm not built for that kind of work. And it's why I have so much admiration for particularly nurses and healthcare assistants. My closest friend is a carer. That's what she does. And she will kind of, you know, downplay the work that she does in comparison to mine. And actually my job's easy in comparison to ours. So yes, I did that for about nine months and was terrible at it.
00:40:30
Speaker
Then I worked in drugs projects in Glasgow and sexual health for a while. Then in my late 20s, I went to work for an organization that doesn't exist anymore that was called Scottish Aids Monitor. That would have been probably the mid-80s, mid to late 80s, and that was really eye-opening for me. At that point, I knew that
00:40:57
Speaker
I wanted to work in the voluntary sector, definitely. That was kind of my path with no sense of what that might mean. But working in HIV and AIDS at that time was such a powerful lesson in the power of a community and a community rallying round because nobody else would. And working to support
00:41:26
Speaker
people who were going through terrible, terrible things. It was about their experience of their sexuality of society's perception of their sexuality, about society's perception as to whether their love had the same value as the love of heterosexual people, just at its most basic.
00:41:50
Speaker
And people who were dying without their family knowing that they were gay or that they had HIV. And just that sense of just watching how the community of the LGBT community just rallied round because nobody else would do it. I mean, the Scottish AIDS monitor existed like Tenors-Higgins Trust because that community did it for themselves because nobody else would. And it was a really powerful
00:42:18
Speaker
learning experience for me about... It goes back to that thing, it's why I'm so passionate about it, why charities exist, why the charity sector, the voluntary sector is here in the first place. And to see the power of that, and you can still see, I would say the impact of that on some, at least for example, of what the NHS does now and how services are designed.
00:42:43
Speaker
So what used to be called 20 or years ago, patient and public involvement, the continual push, and we still don't do it well enough, but the continual push to hear the voice of the patient, the service user in designing services and how services are delivered and how charities spend their money, all of that kind of thing, I would argue came from the way that the HIV and AIDS sector
00:43:12
Speaker
fought, what they fought for, what they insisted on, what they stood their ground on. You can see the influence of that on the patient, what you could call, I guess, the patient and service user movement. That's not a very kind of pretty way of describing it, but I do think you can see the impact of that today. So that was a hugely powerful three or four years for me. It really was. And then I fell in love with an Englishman.
00:43:38
Speaker
And I moved temporarily to London. I worked for the Family Planning Association as training manager for a while. And then we moved to Derbyshire, which is where we've been ever since. And I worked for, I went into infrastructure in the voluntary sector for about a decade. So I worked for a council for voluntary service. Actually here I've come back to Chesterfield, which is where I started in Derbyshire. And again, that was really useful because that was very much about supporting trustees. So it started to open my eyes and kind of
00:44:05
Speaker
raise a level of awareness for me about what trustees actually did, because I'd never been a trustee at that point. And I worked in Nottingham for an organization, again, supporting networks of patients and service users and self-help and mutual aid networks. I did a few years with Macmillan Cancer Support as their daily living services manager, so kind of social workers, palliative care social workers, counseling, that kind of thing. And during that time, I also became
00:44:34
Speaker
an NHS non-executive. So I had the tremendous privilege and huge challenge, which I never really felt I lived up to, to be honest, but I kept trying, of being a non-executive director with Derbyshire Community Health Services, which is the local Derbyshire NHS Trust providing district nurses, you know, everything essentially that a non-acute service provides.
00:44:59
Speaker
maternity services, all of that kind of thing. But they're a phenomenal organization with an amazing chief executive called Tracy Allen, who was a huge inspiration to me. And I learned so much from my years with DCHS about the role of leadership in culture, about how, although I was a non-exec rather than a trustee and the roles are different, there are many similarities. And it was very much about how governance can
00:45:27
Speaker
contribute to and support and drive a learning culture, an improvement culture, a good leadership. So how to be, and that has played out into my work as a chief exec with my own board of trustees. And then I went to the Red Cross and had a fabulous five years with Red Cross, absolutely loved it, really as an operations director.
00:45:52
Speaker
covering a whole range of services. So the learning was phenomenal from kind of ambulance services through to community first aid education services and everything in between. Working with again, a really strong leadership team and really learned there. I think the, the ability to switch very quickly from one thing to another and to be able to go from the really big stuff to the really kind of detailed operational stuff very quickly.
00:46:20
Speaker
I moved on from the Red Cross when they restructured in 2016, 2017. I took redundancy. Had a kind of 18 months at home, which is the first time I've ever done that. I did a bit of work for my husband, but as a good working class Calvinist, that felt very, very dodgy. Just that I'm not used to kind of not working. I was very, very lucky to be able to kind of have that space.
00:46:46
Speaker
And then I got the job at Ashgate. I was looking for, actively looking for a job and I got a phone call from a recruitment consultant who said, I think I've found the perfect job for you. And I, yeah, I have loved this job from the moment I started preparing for the interview process. I have loved this job and I still do. There isn't a day I don't want to come to work. I mean, there are days I don't want to go to bed. That's a different issue, but there isn't a day when I think I don't want to come to work today.
00:47:16
Speaker
I just love this job. Wow. And looking back at that incredible leadership journey, Papa Anne, what advice would you give to yourself on day one of first coming into a real leadership role?
Advice for New Leaders
00:47:32
Speaker
Oh, that's a really interesting question. Can I give them a whole... What I'd want to do is give myself a huge shoebox of advice. Go for it.
00:47:44
Speaker
I think, actually, do you know a really practical piece of advice I would give myself, which I did actually do, but it took me a couple of years to do it, is buy yourself a copy of It's Tough at the Top, one of your previous podcast guests, Debra, all the time. Yes. Deb's tattoos. I carry that book. I have given it to so many people and recommended it to so many others. I think there's something about you applied for the job. This is the job. You have to do it.
00:48:15
Speaker
You know, there are times where, you know, it happened a couple of weeks ago in this job where I think I don't know what to do with this situation about this situation. I don't know. I don't know if I am going to be able to get the organization through this. I don't know if I'm going to be able to fix this. Maybe I'm not the right person and maybe I'm not, but the reality is I applied for this job. Nobody invited me. Nobody said, Oh, please come and be Ashgate's chief executive. I said, I really want to do this job and this is the job.
00:48:45
Speaker
Actually, if you are in that place, the thing to do is to talk to other people. It's okay to say to your team, I don't know what to do. Can we talk about it? Can we unpick some ideas? The other piece of advice I would give myself, which I didn't do until a few years ago, is get a coach.
00:49:07
Speaker
Get a coach, and even if you've got no money, you can often find somebody, even if it's a kind of a colleague who will do it for you for nothing or do an appear process. But actually having a coach gives me the space to think, to talk about how it is for me to explore different options, to understand. One of the things my coach does for me, Leslie, which is really useful is to give me framework.
00:49:34
Speaker
So when I said to her recently about the pandemic stuff, and I said, I just feel like we've gone back to where we were. And she pointed out, you never go back. It's a spiral. You're in a different place. You can't go back there. So you're not back where you were. You're just in a different place. So it's somebody who has that perspective and that ability to reframe difficult challenges. And also somebody who will push at you and say, actually, I think there are different ways of doing this. Or have you thought about this?
00:50:02
Speaker
even if it's something you don't necessarily find comfortable to do, it's usually a good idea. So yes, I talk to other people, find a coach, you cannot do it on your own, but you do have to do it. That's what I would say to myself.
00:50:16
Speaker
Yes, I think so many leaders sometimes, particularly in the past couple of years, have come into situations and just feeling out of their depth and thinking, oh my God, how do I navigate, not just myself, but the entire organization through whatever crisis the organization may be facing. And I think your practical advice there, Barbara Ann,
00:50:38
Speaker
particularly around talking to people, you know, getting support, having a coach who can help reframe challenges is all really, really important. And of course, you know, buying Deborah Alcock Tyler's book, it's tough at the top, which I definitely have a copy of. But you know, you can't, I'm a firm believer, you can't lead alone.
00:51:02
Speaker
I could take a bottle of gin and go down and sit in a dark room for a while and try and come up with what I think Ashgate needs to do and what it needs to look like, but it wouldn't be nearly as good as the answer that I would get from going out and talking to Ashgate's people and indeed our local community and stakeholders and saying, what do you think Ashgate should do? What we've had over the last couple of years absolutely shows the value of that.
00:51:22
Speaker
And there's something in there I think about, I'm a great fan of Margaret Wheatley and I love her whole kind of approach to leadership. And one of the things she talks about, which I think is really important is having more faith in your people than they do in themselves. So putting people into a room and saying, actually, I do think you have the answer. We just need to find it. I think is really, is a really powerful, and it goes back to that, you know, the future you get is the future you're
00:51:51
Speaker
creating. It goes back to all of that. Absolutely. And I think there's something also there about getting trustee boards to see the broader picture because oftentimes there is so much place on the shoulders of the chief executive as the single individual person to deliver everything. And trustee boards by their very nature are slightly a few steps away from what's happening on the ground and how we can help trustees really see
00:52:18
Speaker
really, you know, straddle that bridge so that they're able to do their, you know, very critical duties of governance and oversight, but also in a way that supports the executive team, particularly through challenging times. Absolutely. And one of the things that I learned from my NHS non-exec work was the value of what we, in the Ashgate context of trustee development, of spending time, them spending time to develop their own skills.
00:52:47
Speaker
and to develop their understanding of what leadership looks like for our board of trustees at Ashgate and what governance looks like and therefore what do we and what do I as a chief exec need to give them and provide them to enable them to do that governance role well. But governance and leadership is a skill in its own right and they need time to develop that.
00:53:08
Speaker
Indeed. Well, thank you so much, Barbara. And it's been so lovely speaking with you. And in closing now, do you have any final thoughts or reflections that you would like to share? What is one thing that you would like listeners to take away from this conversation? Oh, might need a bit of time to think about that. Actually, that being a charity chief executive is a really, sometimes a really, really hard and it is a lonely job
00:53:37
Speaker
in the way that in many ways. But it's also an immensely rewarding role. And I am very busy. There's no getting away from that. But actually, I suppose this is more for my staff and my volunteers. I'm no busier than any of them. I'm just differently busy.
00:54:00
Speaker
Ashgate is a system and I have a job to do within that system and so do they and the hospice would fall over if any of those pieces didn't work. So I think sometimes the kind of chief exec title comes with a bit of a, oh, it's the chief exec. I'm just an ordinary person who happens to be lucky enough to be in this job. But my work is no more important than that of one of our nurses or one of our housekeepers. It's just different.
00:54:29
Speaker
I love that frame that you put around that, that we're all part of a system and we are just one cog in the wheel, except have the title of chief executive. And arguably I'd be missed. It would take them a lot longer to miss me than it would to mess a nurse in our community team. Well, on that note then, Barbara Ann, thank you so much for sharing all of your wisdom and for being asked on the show. It's been a real pleasure. Thank you, Divya.
00:55:01
Speaker
Barbara Ann Walker's brand of leadership is so inspiring. I came away from my conversation feeling energized and with so many takeaways. You can't be a leader without followers, and you certainly can't lead alone. And as a leader, it is important to demonstrate that you have more faith in your people than they sometimes have in themselves. As Barbara Ann says, being a charity chief executive can be a hard and lonely job, but it is also immensely rewarding.
00:55:29
Speaker
I love how she talked about the role of being CEO of Ashgate Hospice as just one piece in a bigger system and is no more or less important than one of the nurses. Just different. And whether we are leaders or followers, we are all just people striving to do our best.
00:55:47
Speaker
I hope you enjoyed this latest episode of the Charity CEO podcast. A show that, thanks to you, our listeners, has repeatedly reached the number one spot in Apple's nonprofit podcast category. If you found this conversation valuable, please share or tag us on Twitter or LinkedIn or Instagram, and make sure you subscribe to the show by clicking the subscribe button on your podcast app. If you're feeling inspired or uplifted by what you have just heard, please share the joy and leave us a five-star review.
00:56:17
Speaker
Visit our website, thecharityceo.com, for full show details, information on previous season episodes, and to submit ideas for future guests. In order to balance my personal and professional commitments, the show will now come to you once a month instead of fortnightly. But I assure you, it will be worth the wait. Thank you for listening.