Dame Barbara Monroe, from trousers to tutus

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Could you summarise your career to date?

I started my professional career as a probation officer in Brixton with a particular focus on working with sex offenders. When we moved to Gloucestershire, a lack of probation vacancies led me to switch to local authority social work and various roles including child protection and specialist mental health. I then became one of the first GP-attached social workers.

Following a return to London I worked as a hospital social worker at a specialist neurology/ neurosurgery centre and from there to the social work department at St Christopher’s in 1987. I soon became Director of the Social Work, Welfare and Bereavement Services and in 1997 I was appointed Director of Patient and Family Services and in 2000 Chief Executive.

Why did you choose a career in palliative care?

I took a particular interest in Motor Neurone Disease when I was working in neurology and subsequently referred a number of patients to St Christopher’s. I was speaking at a MNDA conference when I met the senior physiotherapist from St Christopher’s. Sharing the journey back to London she suggested that, as I had two young children, working at St Christopher’s would be much more convenient than the hospital as I would swap a journey of nearly an hour for one of ten minutes. A few weeks later she contacted me to say that there was a vacancy in the social work department. The rest is history. So not a sense of mission or vocation but the practicalities of childcare! However my years at the hospital had fired a serious interest in how best to support those whose illness could not be cured and how to help the people close to them. 

What can you remember about your first day at St Christopher’s Hospice?

Not being allowed to wear trousers! Dame Cicely did not approve; a ruling she rescinded some years later but a big hassle for me at the time as a lifelong non-wearer of skirts and dresses.

What is the biggest change you have seen in the hospice movement?

So many changes it is hard to pick out just one – but probably the ever increasing and welcome focus on delivering services in people’s own homes or usual place of residence.

What are the key points hospices can take from the Commission to ensure they are effective going forward?

Aim to be the best partners we can; working together as hospices, with wider statutory and voluntary sectors, across settings and with both health and social care. Focus on delivering an evidence base for innovative, cost effective services, including education and training.

We must not neglect the needs of the vulnerable and the disadvantaged and we must maintain and develop the pioneering emphasis on whole person care for the ill individual and their family and friends throughout the illness and into bereavement.

Remember to engage communities in service design and delivery as they and the volunteers who come from them offer the best chance of ensuring that everyone gets the care they need.

What are your top three tips for current or aspiring hospice leaders?

I’m going to cheat and have five!

  • Offer respect to everyone always.
  • Have eyes that ‘see’, and remember to say thank you.
  • Good ideas can come from anywhere and anyone.
  • When things go wrong, and they will sometimes, be honest and focus on finding a way forward together, not on finding someone to blame.
  • Nurture both teams and individual talents.

What are you most proud of in your career?

I am proud that St Christopher’s has kept its focus squarely on what is most likely to best support patients and those close to them and that we have not been afraid to innovate. I hope that together we have created a generous organisation. I also like to think that I have helped individual members of staff and volunteers find the ‘right’ role where they can really fly.

More widely, I hope I have helped to raise awareness and the provision of appropriate support for children and young people facing loss through bereavement.

Do you have any funny anecdotes you are happy to share?

Most of the really funny anecdotes are not suitable for the medium of print. However I am famous for my hospice pantomime performances, including one as a fairy complete with tutu, wand and tiara and one where I wore a tight leather mini skirt, fishnet tights and huge false boobs. The things we do for the cause!

Who or what inspires you to work with patients at the end of life?

There has been a strong social justice theme throughout my career. A decent society should care about offering good support to everyone approaching the end of life – (and lots of other things as well but don’t get me going!).

What does the future hold for you? Will you be continuing to work within palliative care in any capacity?

My bedrock will be looking after my delightful granddaughter, who is soon to be joined by another, while my daughter is working part time.

I will be chairing the first meeting of a new group for Help the Hospices called the Leadership Network Group. It is an outcome of the Commission and will explore the possibilities of closer partnerships between a wide range of national lead bodies to take forward some of the Commission’s practical recommendations. I am about to become a trustee of Marie Curie. I am a Special Commissioner of the Royal Hospital Chelsea and I sit on one of the Honours Committees.

That is just for starters – end of life care is in my veins and you haven’t seen the back of me yet! I look forward to continuing work with the many wonderful colleagues and friendships I have made over the years.

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