17 December 2020 by Sonia Sharma
Angela Culhane, CEO of Prostate Cancer UK talks to Governance and Compliance about the impact the pandemic has had on research, as well as her entry route into the charity sector and her advice for those beginning their career.
Can you talk us into your entry route into the charity sector?
I think it’s fair to say that my route to Charity Chief Executive is an unusual one, and not one which has been the result of a careful career plan. I started out as a Chartered Accountant, which was not the most obvious career choice for a Modern Languages graduate, but it was a great way to gain some much-needed business experience. I learnt the ropes initially at Touche Ross (now Deloitte) in London. Then, once qualified and safe to be let loose, I moved out of practice and into various industry roles over the next 20 years or so.
I feel incredibly fortunate to find myself in a job I love, leading an organisation which makes a difference every day for those facing prostate cancer. It is the most commonly diagnosed cancer and one which has touched my family directly, with my husband and – in years to come – my son being at a higher risk because of a history of the disease in the family.
Why did you choose to pursue a career in the sector and in particular, why did you choose to work at Prostate Cancer UK?
The ambition to work for a charity crystallised when my parents’ health started to fail, making me stop to reflect on life. By that stage, my children were more independent, which meant I had more choices again.
It was seeing my much-loved father-in-law, Tom, facing advanced prostate cancer that led me to Prostate Cancer UK, which happened to be advertising for a Director of Finance at that time.
Fortunately, previous experience in the sector wasn’t required and a fresh pair of eyes was needed for some of the challenges facing the charity. From the moment I walked into the hubbub of the busy office by London Bridge, I could feel the energy from teams working together and the passion for the cause shone through in all the staff I met. I was excited to be offered the job in October 2013. Tom was one of the first people I told and I’m glad he knew this before he died the following month. Sadly, prostate cancer claims the life of one man every 45 minutes in the UK and is now the third biggest cancer killer in the UK.
How has COVID-19 impacted research into prostate cancer and how has the pandemic affected charities overall?
Charities have been hit hard by the pandemic and Prostate Cancer UK is no exception. Much of our fundraising activity relies on face-to-face activities and social gatherings. The result is that our income is likely to be up to 50% lower than last year. We realised very early on that our business plan would need a major overhaul, not just for the current financial year, and got on with working out the new plan to balance the books.
Having just launched our new research strategy in January, it was tough to have to put on hold some of our ambitious plans for research into better diagnosis and treatments, but we had no choice, especially with research laboratories closed during the first lockdown.
Our immediate priority was to secure the future of existing research projects, so that past investments can still deliver results. The pace and scale of new research investments is where our wings have been clipped and is the focus of our renewed fundraising efforts now. We’re particularly concerned to avoid losing the hard-won expertise in prostate cancer scientific research within universities and other research institutions which has been painstakingly built-up over the past decade or so. We’re going to need all the help we can get to avoid a major setback affecting the pace of change for years to come.
How do charities work harder to explain their mission to the public and remind them of the good that the vast majority do?
The public in the UK are incredibly generous in their charitable giving and we are the envy of many other nations for the role national charities play in driving change. The governance environment has a large part to play in this, giving the public confidence that the charities they choose to support can be trusted to spend their money well, with a system of oversight which is generally effective in rooting out any ‘bad apples’.
Alongside this, charities must be transparent and accountable. Prostate Cancer UK can only expect to inspire people’s support if we can make our case to deserve it. We need to use a variety of routes to do this to be able to reach the widest possible audience.
Not everyone will want to read our Annual Report and accounts, so we find engaging ways of bringing our mission to life using our brand, sharing stories from those who are affected that we’re here to help, laying friendly explanations of scientific findings and statistics and clear simple health messages.
What are some of the biggest challenges you have had to overcome?
The period since the pandemic hit has been the most challenging of my working life. At the same time as the need for our work was greater than ever, with men facing disrupted treatments and prostate cancer referrals dropping dramatically, we faced a big drop in income and major disruption to our work on every front. We had to make extremely painful decisions to cut staff costs by about a third. Whilst it’s early days still, and the pain is still fresh, I think we will look back and reflect on how much we have learnt from this intense period: the imperative to focus on what’s really important and cut out the noise; the pace and scale of transformation; and the need for agility in our thinking.
The importance and responsibility to get this right so that we can continue to be here for men was brought home by the death from prostate cancer in September of one of our ‘super supporters’, Lloyd Pinder, who was only 49 with a young family. Lloyd and the 400,000 men affected by prostate cancer deserve better than that, and we need to be strong to carry on the fight for them.
Have you experienced or witnessed governance failures during your career? What lessons did you learn from these challenges?
Whilst I have been fortunate never to experience at close quarters governance failures like those at Kids Company, no charity can be complacent. A healthy culture is at the core of good governance for charities as it is for every business. A focus purely on rules and compliance will not cut it in my view as there will always be a new challenge, for which the rule has not yet been written. One observation from coming into the charity sector as an outsider is that many people who work in charities share strong values around compassion and empathy for others.
These attributes contribute to a positive supportive culture and excellent teamwork. The watch-out, however, is to make sure that personal loyalty between colleagues can never override the broader interests of the beneficiaries. Not only can this lead to slow management of performance issues, at the extreme, it can lead to cover up or critical controls being overridden. Misguided personal loyalty seems to me as likely to be the driver of governance failings at charities as personal gain.
Is there something all successful charities have in common in the way they are run, i.e. how does the board impact the charity overall?
Charities come in all shapes and sizes, but sustained success will always require a healthy culture and the involvement of people truly committed to the cause, both at the board level and within the executive team. Prostate Cancer UK’s board includes trustees from a broad range of backgrounds, united by the cause. Similarly, the executive team span a range of functional specialisms and personality types but are united by the vision of a future where lives are not limited by prostate cancer.
So, whilst debates are robust and there are always challenging questions, people listen to others’ views, eager to identify the solution which best achieves our aims, and decisions made are then backed so that we can progress at pace. Any grudges or grandstanding would slow us down and make the charity less effective in achieving its aims, so they have no place. This sets the tone for the whole team and ensures clarity of purpose and shared goals. This isn’t rocket science but I believe it’s key to the success of Prostate Cancer UK over recent years in achieving more impact than ever for men and in the double digit income growth which has made that impact possible.
Can you tell us more about some of the upcoming initiatives that Prostate Cancer is working on?
It is urgent to get the level of referrals for suspected prostate cancer back up to pre pandemic levels, after a severe drop of over 50% at the peak of the first wave. The reduction we’ve seen could mean that there are 5,000 men with undiagnosed higher-risk prostate cancer who would have been diagnosed if referral rates had stayed at previous levels. The major concern is that they could end up being diagnosed when their disease is no longer curable. As there are often no symptoms with early stage prostate cancer, we’ve developed a risk checker tool ‘Check your risk in 30 seconds | Prostate Cancer UK’ to prompt men at higher risk to call their GPs. This has had good response so far, but we need to extend the reach to find all those men whose diagnosis may have been missed.
The three risk factors identified are:
The longer-term aim is to get to a screening programme, similar to those in place for breast, cervical and now bowel cancer. With prostate cancer now the third biggest cancer killer, achieving earlier diagnosis will have a huge impact and could save thousands of lives each year. This is at the top of our research priorities for the coming year and why we’ll be focussing our fundraising on this.
What advice would you give to those considering a career in the charity sector or just starting out?
I try never to harbour regrets in life, but if I did allow myself one, it would be that I didn’t make the move to the charity sector sooner. So, I would encourage people to give the option serious thought, when making career decisions. The sector needs the best people, especially now that the challenges are that much greater.
Make sure it is a cause you really care about as that will bring out your best and enable you to shine. Don’t be afraid to show that and make it part of the language you use about your work. This is a powerful motivator not just for you but for those around you.
It is OK to have some fun, even if your charity is tackling a serious topic like prostate cancer. You’re part of the solution, not the problem, and human beings are most productive when they’re happy.
The shockwaves of the pandemic will reverberate through our society long after a vaccine has removed the immediate health risk. It has made many people re-evaluate what’s important in life. At Prostate Cancer UK we say “Men, we are with you”. Perhaps a shared purpose and sense of community will be a positive enduring legacy from 2020 for all of us.