Be Healthy Autumn 2016

SPECIAL REPORT

WHY END-OF-LIFE CARE NEEDS A RETHINK

The Magazine for the Benenden Community | Autumn 2016 Issue 36 | www.benenden.co.uk

Live life well

MODERN DAY ILLNESSES (AND HOW TO TACKLE THEM)

CLAW T X E T O T M U B ’S T IS L C FROM CY Cyclist’s bum

Win!

A LUXURY FOUR-NIGHT BREAK IN BORDEAUX

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Travel Insurance for the holidays you love Holidays are meant to be special and knowing that you are properly protected means you can make the most of yours. With Benenden Travel Insurance you can set off on your holiday reassured you’ll be in safe hands with a brand you can trust.

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*Benenden reserves the right to alter, amend or withdraw this offer at any time. †For the full terms and conditions of the Prize Draw, please visit our website www.benenden.co.uk/healthytravel4. Lines open for Sales 8am-10pm Monday to Friday, 9am-5:30pm Saturday and Sunday. Lines open for Customer Services 8am-8pm Monday to Friday, 9am-5:30pm Saturday and Sunday. Calls may be recorded for our mutual security and for training purposes. Benenden is a trading name of The Benenden Healthcare Society Limited and its subsidiaries. Benenden Travel Insurance is offered by Benenden Wellbeing Limited which is authorised and regulated by the Financial Conduct Authority (FS Register No 593286). Benenden Wellbeing Limited is a wholly owned subsidiary of The Benenden Healthcare Society Limited.

Benenden Wellbeing Limited is registered in England and Wales (Company No 8271017). Registered Office: Holgate Park Drive, York, YO26 4GG. The insurance is underwritten by MAPFRE Asistencia Compañía Internacional de Seguros y Reaseguros, Sociedad Anonima (MAPFRE Asistencia). MAPFRE Asistencia is authorised by the Dirección General de Seguros y Fondos de Pensiones and is subject to limited regulation by with the Financial Conduct Authority and the Prudential Regulation Authority (FS Register No. 203041). Details about the extent of regulation by the Financial Conduct Authority and the Prudential Regulation Authority are available on request. For any Benenden Travel Insurance policy which includes an insured person aged 66 or above, the insurance is arranged and administered by AllClear Insurance Services Limited which is authorised and regulated by the Financial Conduct Authority (FS Register No 311244). For all other Benenden Travel Insurance policies, the insurance is arranged and administered by Insure & Go Insurance Services Limited which is authorised and regulated by the Financial Conduct Authority (FS Register No 309572). Insure & Go Insurance Services Limited is a wholly owned subsidiary of MAPFRE Asistencia.

AD/TRAVELJUL16/JW/07.16

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Welcome

Welcome to the latest edition of Be Healthy, our members’ magazine.

I am delighted to report that we had a very successful conference in Brighton back in June.

Some far-reaching decisions were taken and these are summarised on page 45. Importantly, we have Our revenues grew to achieved another year of growth financially, just over £102m – which is key given our plans for future an increase of 7% investment on behalf of members. In 2015 our revenues grew to just over £102m, an increase of 7% on 2014, and our net assets rose by more than 9% to £103m. We helped nearly 160,000 people across our group with a range of services, and our members’ satisfaction remained high. Our combined insurance subsidiaries, boosted by the integration of Keegan and Pennykid, returned a profit for the society, which augurs well for the future.

JAMIE MURRAY At Brighton we also said goodbye to Ted Elsey, our The top doubles player on why chairman of the past five years. Ted has been instrumental tennis is a winning activity for all in driving the business forward and we would like to take FACT This year, the 30-year-old the opportunity of thanking him for his significant left-hander became the first British contribution over that time. While he is a hard act to man under the modern ranking system to reach No 1 in the world follow, we look forward very much to working with our new chairwoman, Gwenda Binks, and taking the society on the next stage of its journey.

TIGGY WALKER Finally, we are delighted to report that we are now caring The producer tells how she and her for patients in the new Bensan Ward at Benenden Hospital. husband, Radio 2 DJ Johnnie While the redevelopment has been a challenging build, this Walker, battled cancer together is a great milestone as we move into phase two of the project, FACT Tiggy recovered from breast which will be completed in 2017. cancer while Johnnie overcame non-Hodgkin lymphoma I hope you all enjoy the rest of the summer.

Inside this issue

THE NHS CHOIR An A&E consultant, a nurse and a vascular surgeon describe how it feels to step out of the ward and into the recording studio FACT: This year the choir opened the Pyramid stage at Glastonbury

CHRIS BLOTT; PAUL STUART; BELLA WEST; SHUTTERSTOCK

René Fraioli Society secretary

Step into autumn

1

2

3

DIFFERENT STROKES Tackle a 2k or 5k sponsored swim, alone or in a relay team, raising money for Macmillan Cancer Support www.macmillan.org.uk

TAKE A HIKE Enjoy guided walks in picturesque parts of Perthshire during the Tryst Walking Festival from 8-15 October. www.droverstryst.com

RIGHT ROYAL RUN The Royal Parks Foundation Half Marathon on 9 October winds past sites including Buckingham Palace and the Houses of Parliament. www.royalparkshalf.com

Get in touch We’d love to know what you think about this issue. Email us at behealthy@ benenden.co.uk with your thoughts

www.benenden.co.uk 1

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Do you know how healthy you really are?

Health Assessments from just £129

£99 Benenden Health Assessments Our health assessments give you the opportunity to understand your health better. Even if you’re not feeling unwell, you may be concerned about potential health issues.

A team of healthcare professionals will review your health and offer practical advice on how you can make changes to help reduce your risk of developing common, but often preventable conditions such as heart disease, stroke, diabetes and kidney disease.

• 5 levels of assessments • Up to 25% off when you book through Benenden* • Personalised report with recommendations • 12 month plan for healthy living

Alex Marshall, 48 was generally fit and healthy but his health assessment didn’t have the outcome he had expected. Instead, his routine check-up revealed he had prostate cancer. Post surgery, he is now back enjoying an active lifestyle.**

Book your health assessment today 0800 414 8486

www.benenden.co.uk/healthyyou

Please note that your call may be recorded for security and training and quality purposes. Lines are open 8am – 7pm Monday to Friday (except Bank Holidays). *The saving of up to 25% has already been applied to the prices quoted in any literature, online and on the phone and is a reduced rate that is offered exclusively to Benenden through our partnership with Screenetics and BMI Healthcare. **Not all Benenden Health Assessment levels include cancer checks/ screening. See website for full details.

Benenden is a trading name of The Benenden Healthcare Society Limited and its subsidiaries. Benenden Health Assessments are offered by Benenden Wellbeing Limited, which is a wholly owned subsidiary of The Benenden Healthcare Society Limited. Benenden Wellbeing Limited is registered in England and Wales (Company No 08271017). Registered Office: Benenden Wellbeing Limited, Holgate Park Drive, York, YO26 4GG. Benenden Health assessments are provided by BMI Healthcare Limited and ToHealth Limited. BMI Healthcare Limited is registered in England and Wales (Company No 2164270). Registered office: 3 Paris Garden, Southwark, London, SE1 8ND. ToHealth Limited trading as Screenetics is registered in England and Wales (Company No 5107064).

Registered office: 33 Cavendish Square, London, W1G 0TT.

002_Beneden_Aut_16.indd 9

14/07/2016 10:18

behealthy Published for the Benenden Healthcare Society by Think.

This magazine is also available in Braille, large print and on audio CD. Editorial Board Group Marketing Director Lawrence Christensen Clinical Director Jane Abbott Head of Communications Paul Keenan Media Relations Manager Neil Barnes Group Head of Marketing Natalie Walker Group Head of Brand Jules Titheridge Benenden Holgate Park Drive, York YO26 4GG Telephone 0800 414 8100* benenden.co.uk Editor Kathleen Morgan behealthy@benenden.co.uk Contributing Editors Matthew Rock, Siân Phillips, Fiona Jerome Group Art Director Matthew Ball Designers Vicky Axelson, John Pender Sub-editors Sam Bartlett, Sian Campbell, Kirsty Fortune, Martin Sheach Editorial Assistant Jonathan McIntosh Advertising Sales Sonal Mistry sonal.mistry@thinkpublishing.co.uk 020 3771 7247 Partnerships Director Helen Rosemier Group Account Director John Innes john.innes@thinkpublishing.co.uk

s t n e t n o C I’ve watched the England team and I wish I was there. I’m gutted PAGE 18

AUTUMN 2016

HEALTH CHECK 04 THE NHS REPORT What does the British public expect of a National Health Service under pressure?

06 TED ELSEY The retiring chairman of Benenden on winning the Ashes ... in his seventies 08 MY EXPERIENCE Tiggy Walker reveals how cancer tested her marriage to a well-loved Radio 2 DJ

LIFE 16 JAMIE MURRAY The doubles grand slam winner shares his tips for success 18 10 MODERN ILLNESSES Health conditions sparked by contemporary lifestyles 23 SPECIAL FOCUS Why the UK needs to improve its record on end-of-life care 30 ONWARDS AND UPWARDS How two people reacted to their life-changing diagnoses 40 INSIDE STORY We find out why tuberculosis is again on the rise in the UK

Produced for Benenden by Think 8th Floor, Capital House, 25 Chapel Street, London NW1 5DH 020 3771 7200 thinkpublishing.co.uk

YOUR BENENDEN

© Benenden Healthcare Society.

Reproduction in whole or part without written permission is strictly prohibited.

The view expressed in this magazine are not necessarily those of Benenden. All advertising is accepted in good faith and no endorsement should be inferred; neither should the presence of any Benenden business’s logo in a promotion (as part of a commercial arrangement with a selected partner) be construed as an endorsement. Please check any medical or dietary advice with your own doctor.

43 RENÉ FRAIOLI Benenden members take a major step at Conference 47 CONTACT BENENDEN Key numbers and services

SPECIAL REPORT

Circulation 351,831 (July - Dec 2015) ABC

WHY END-OF-LIFE CARE NEEDS A RETHINK

88

The Magazine for the Benenden Community | Autumn 2016 Issue 36 | www.benenden.co.uk

*Please note, calls may be recorded for our mutual security and also for training and quality purposes.

(AND HOW TO TACKLE THEM)

FROM CYCLIST’S BUM TO

TEXT CLAW Cyclist’s bum

Find us online www.benenden.co.uk CHRIS BLOTT

Live life well

Copy eerwekrhw MODERN DAY ILLNESSES

Plus keep up to date with all the latest news on Facebook, Twitter, YouTube and Google+

Win!

A LUXURY FOUR-NIGHT BREAK IN BORDEAUX

COVER STORY Ten conditions triggered by modern lifestyles www.benenden.co.uk 3

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health check ]News you can use i

Money talks when the public make lifestyle choices The public would eat a better diet and exercise more regularly if offered cash or tax breaks by the government, suggests research

by Benenden.

In a survey of 3,000 UK adults, 80% indicated a financial incentive would encourage them to live more healthily.

Asked if obese people should

Medical director John Giles

contribute extra to the NHS to cover any potential medical costs, 67% agreed.

The survey was carried out for the National Health Report, published annually by Benenden following research into lifestyle habits, perception of health and wellbeing, and views on the NHS. More than half of respondents in this year’s survey thought advances in medical science would combat health problems

associated with being overweight, such as type 2 diabetes and strokes.

Regardless of whether they had lived a healthy lifestyle, 83% of respondents believed the NHS would provide care for them when they were older.

Only 8% of those surveyed correctly identified the annual NHS budget as £115bn.

John Giles, medical director of Benenden Hospital, said: “This survey confirms that

SHUTTERSTOCK

Cash breaks could affect diet

4 Be Healthy Autumn 2016

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Building on excellence A state-of-the-art ward has opened at Benenden Hospital, writes Siân Phillips The 26-bed Bensan Ward, including 20 single en suite rooms, has opened at Benenden Hospital in Kent. The building also includes three theatres and an ambulatory care unit.

Graham Goddard, the hospital development project director, said: “Our design concept took on board evidence from healing environment research, which concludes that the physical healthcare environment can make a difference in how quickly the patient recovers.

“Patients are able to control their environment, such as the room temperature, and they can enjoy natural ventilation and light. Some of the rooms have

magnificent views across the Kent countryside.”

Work continues on phase two, with the entire project to open in spring 2017.

Phase two will involve a diagnostic suite with MRI and CT scanners, a new outpatient department, an eye unit, a physiotherapy area, a pharmacy, a spacious atrium, a restaurant and car parking.

Hospital director Jane Abbott said: “It is wonderful to see our first-class facilities now being used. Maintaining services over the last year, alongside the building work, has been a challenge, but staff have responded magnificently, continuing to provide excellent care to patients.”

Fast facts

£2m

The amount invested in CT and MRI scanners for a new imaging suite

20

The number of single en suite rooms in the Bensan Ward

1907

The original Benenden Hospital was opened to treat postal workers with tuberculosis

The Benenden Hospital development (left) and (below), one of 20 new en suite rooms

t many individuals expect the government to assume responsibility for their health and wellbeing rather than it being a personal responsibility.

“They expect others to make a contribution for their poor choices, yet have no clear idea about the costs and limitations of modern healthcare.”

To see the National Health Report 2016, visit www. benenden.co.uk/healthreport www.benenden.co.uk 5

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healthcheck

The big hitter What does it feel like to beat Australia at cricket? Ted Elsey, the retiring chairman of Benenden, tells Steven Lynch He might have stepped down this year as chairman of Benenden, but Ted Elsey has shown he is at the top of his game – on the cricket pitch.

Besides taking a leading role in the society since retiring from the civil service, Ted has made his mark in seniors cricket, latterly as part of England’s over-70s team.

He relishes the memory of his team’s performance in the Ashes 2015 series. Having beaten the Australians at home in 2013, he says, it was time for the rematch. England won the series 2–1, clinching it with a thumping victory at the Manuka Oval, Canberra, a ground that is shortly to stage its first official test match.

“We also played in Brisbane and Sydney, at grounds used for state cricket,” says Ted, who has enjoyed cricket since childhood in south Wales.

“Two days before we played in

Ted Elsey and the 2014 Sussex seniors team Sydney, we watched a firstclass game there, and they didn’t bring the boundaries in for us.”

The success of Ted and his fellow players, the oldest of whom was 78, shows it is eminently possible to be active into your 70s and beyond.

There’s no great secret to it, says Ted. “You’ve obviously got to be sensible. We are all playing quite regularly – last year, I told my club, Three Bridges in Sussex, only to pick me in an emergency. There were only three weekends when I didn’t end up playing, so there must have been a lot of problems.”

Some advice if you’re thinking of returning to the crease: “Your metabolism slows down a little as you

get older, so you can’t do things to excess as you might have been able to when you were young. You should have a reasonably varied diet and drink in moderation.

“Obviously, you have to be careful, although most people are pretty aware of what they can and can’t do at that age. But it’s got to be good if you’re doing

something you like, and meeting other people who are trying to do it too. And the good news is you don’t get too many 70-year-old fast bowlers.”

The team does more than turn up and play: there are thriving county competitions for the over-50s, 60s and 70s.

And two of Ted’s Sussex teammates are 80.

Member rewards

You can help reduce the risk of preventable conditions such as heart disease and diabetes – and save up to 25% – when you book a Benenden health

assessment. You will be offered time with a healthcare professional at a local clinic or hospital, followed by a personalised report on how to improve

your health. With five levels of assessment, you can find the best option for you.

Visit www.benenden.co. uk/health/services/healthassessments

A health assessment consultation PAUL STUART; SHUTTERSTOCK

DISCOUNTED HEALTH ASSESSMENTS

6 Be Healthy Autumn 2016

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Ted Elsey: “You don’t get too many 70-year-old fast bowlers”

Pedal power A band of intrepid riders are to tackle a 600-mile journey from Glasgow to Kent on the Cycle GB 2016 challenge ● A team of 22 cyclists are to don their best Lycra this September for a 600-mile bike ride to raise awareness of mental health and £50,000 for charity.

1. Glasgow 2. Longtown 3. Durham 4. York 5. Lincoln 6. Peterborough 7. Cheshunt 8. Benenden

● Cycle GB 2016 is being organised by Benenden Charitable Trust and the Scottish Association for Mental Health (SAMH), with funds raised being split evenly between the charities. ● They will tackle the event across two stages. Between 21 and 23 September, they will travel from Glasgow, home of SAMH, to the York head office

of Benenden. Then, from 26 to 29 September, the cyclists will journey from York to Benenden Hospital, Kent. ● The team from Benenden, Keegan & Pennykid, and RSA include experienced and fledgling cyclists. ● Chris Cassidy, from insurance underwriter RSA, is a novice cyclist and fundraiser. His motivation for taking on the challenge is the memory of a close friend who took their own life. ● The cyclists will appreciate any support as they attempt to reach the fundraising target.

HOW YOU CAN DONATE ● ONLINE Visit www. justgiving.com/cyclegb2016 ● BY TEXT Message CYGB50 followed by a space and the amount to 70070.

All of your text donation, including Gift Aid, will be

sent to the charity. You will receive a text within 24 hours letting you know the donation was successful.

Visit www.justgiving.com/ justtextgiving for full terms and conditions

SHUTTERSTOCK

Fast fact A diet high in whole grains helps reduce coronary heart disease and cancer, according to analysis by the British Medical Journal

Find out more at www.benenden.co.uk/cyclegb2016

www.benenden.co.uk 7

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NUTRITION healthcheck Tiggy and Johnnie Walker, photographed

by Bella West

There was a very good chance of Johnnie going

My experience

We’ve seen each other at our lowest points Tiggy Walker nursed her DJ husband through cancer. Then roles were reversed, hears Damien Love When she was diagnosed with aggressive breast cancer, Tiggy Walker started crying. When she told her husband, he cried too. Then, at some point, she says: “We just saw the funny side. Johnnie said to me: ‘Well, we’re an equalopportunities marriage …’”

Ten years earlier, in 2003, her husband, Radio 2 DJ Johnnie Walker, had his own battle with cancer, with Tiggy by his side.

His non-Hodgkin lymphoma diagnosis came after three months of marriage. A producer

LIFE AND TIMES TIGGY WALKER ● 1960 Born Tiggy Coldicott in Buckinghamshire

of TV commercials, she stopped work to look after him full-time. With her illness, the patient-carer roles reversed.

“So we’ve seen each other at our lowest points,” she says, laughing. “From the vomiting of chemo through the losing of hair, vile mood swings ... all dignity goes out the window.”

It was that shared experience that led Carers UK to ask the couple to be joint patrons of the charity, a role they assumed in 2015. From Johnnie’s diagnosis to his return to radio during

● 2002 Tiggy marries Johnnie Walker

● 2003 Johnnie is diagnosed with cancer. Tiggy becomes his carer

actually ended up in marriage guidance as a result.

“I thought, I wish there had been some help for the carer in this situation. It can have a huge emotional, physical and financial effect. Carers UK really helps people’s lives.”

To help raise awareness of and funds for the charity Tiggy has published Unplanned Journey, an unflinchingly intimate diary of her breast cancer, in collaboration with photographer Bella West, whose candid, poignant images capture every stage of the process.

“A cancer diagnosis makes you realise that if you have things you want to do, you’ve got to get on with them.

Being both a carer and a patient really develops you as a human being.”

remission in March 2004 took a year. It took Tiggy a lot longer to get her life back on track.

“Johnnie was incredibly sick, there was a very good chance of him going …,” she says. “So you forget your own needs. When he went back to Unplanned work, I sort of Undergoing Journey by Tiggy collapsed. I’d never treatment Walker and Bella been more miserable.

West is available I felt I’d lost everything from www.carersuk.org I’d worked for and was known Royalties go to the charity as. Four or five years later, we

● 2004 After being declared in remission, Johnnie returns to his show on Radio 2

● 2013 Tiggy diagnosed with breast cancer ● 2014 Tiggy and Johnnie become joint

patrons of the charity Carers UK ● 2015 Tiggy is declared negative for any more cancerous cells

8 Be Healthy Autumn 2016

08 My Experience - tiggy.indd 8

14/07/2016 12:53

Enjoy an active life without hip or knee problems Members all-inclusive package price

£7,785*

Get on and enjoy life with a hip or knee replacement Your busy life is put on hold when you need a hip or knee replacement.

you back on your feet as quickly as possible, you’ll be supported by a rapid recovery programme.

Everyday activities you enjoy, such as walking, driving, weekends away, golf and sports, can quickly become a thing of the past.

You can also rest assured that we have rigorous infection control systems in place to keep you safe from hospital acquired Bacteraemia or Septicaemia MRSA or C-diff** – we’ve had no cases since 2002.

At Benenden Hospital you can see an experienced specialist consultant right away. Your operation is performed in a state-of-the-art theatre. Your stay is in a comfortable en-suite room. Your care is in the hands of highly trained and compassionate staff. And, to get

* Hip or knee replacement is not available as part of Benenden membership, members do however receive an exclusive discount off the full private patient price. This offer is only available for treatment undertaken at Benenden Hospital in Kent.

See www.benendenhospital.org.uk for the latest information on discounts for Benenden members. **As specified by the Department of Health. The Benenden Hospital Trust is a company limited by guarantee. Registered in England, number 3454120.

Registered charity number 1065995. Registered office, The Benenden Hospital Trust, Goddard’s Green Road, Benenden, Cranbrook, Kent TN17 4AX

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And, just yards away, Peek Lodge Hotel, offers comfortable accommodation for your visitors.

All of which means that you’ll be back, doing what you enjoy with family and friends in no time at all.

Find out more today 01580 242 521 www.benendenhospital.org.uk

14/07/2016 04/07/2016 10:19 15:53

healthcheck

Inside story

Hugh Turvey at work for the Benenden ward

Innovative art created using x-rays illuminates a ward at Benenden Hospital, writes Siân Phillips In the newly opened Bensan Ward at Benenden Hospital, Kent, visitors can see bespoke artwork by photographic artist Hugh Turvey.

Bensan was named after the band that used to accompany patients as they left the hospital after a long stay, and

Digitalis by Turvey

Turvey has created a vinyl image to match the ward’s musically themed name.

On an eight-by-two metre section of curved wall in the centre of the ward, Turvey’s artwork combines foxgloves (“the bell-like flowers have horn overtones,” he says) and an x-ray he created of one of the Bensan band’s drums.

This spring Turvey and his photographer wife, Artemi Kyriacou, catalogued and photographed hospital museum artefacts and

the surrounding landscape for future display in the redeveloped hospital.

“Understanding the hospital’s history and heritage through the objects has been a fascinating journey,” says Turvey. “The

Fast fact

In 1906 post office workers each paid two shillings a year to join the Benenden Society

challenge now is trying to reinvigorate that body of objects in a way that befits the next generation of treatment given at the hospital.”

See more of Hugh Turvey’s art at www.x-rayartist.com

Food for thought

Just how light is your lunch?

WAITROSE Chicken caesar salad (195g) Energy ........... 309 kcal Sugar ..................... 2.3g Salt ....................... 1.17g Protein ................. 18.3g Fat ........................ 19.3g

PRET A MANGER Souper tomato soup (370g) Calories ......... 199 kcal Sugar ................... 14.1g Salt ......................... 1.1g Protein ................. 4.8g Fat ........................ 12.2g

TESCO Fish sushi (137g) Energy ........... 229 kcal Sugar .................... 6.4g Salt ......................... 1.3g Protein................... 6.9g Fat .......................... 4.6g

EAT Houmous and falafel wrap (244g) Energy ............ 471 kcal Sugar ..................... 6.1g Salt ......................... 2.4g Protein ................ 14.4g Fat ........................ 21.2g

GREGGS Tuna crunch baguette (246g) Calories...........462 kcal Sugar.......................5.9g Salt..............................2g Protein ....................29g Fat ............................7.2g

COSTA Ham and cheese toastie (138g) Energy ........... 308 kcal Sugar ..................... 5.9g Salt ......................... 1.7g Protein ................... 15g Fat ............................. 8g

Figures stated refer to the whole serving, as pictured, and come from each brand’s website

HUGH TURVEY; PAUL STUART; SHUTTERSTOCK; ALAN DONALDSON RICHARD PALMER; GETTY IMAGES

Look closely before you take a quick bite to see you through the afternoon

10 Be Healthy Autumn 2016

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Prize draw

Win a five-star stay in France A luxury gastronomic escape for two in Bordeaux, France, is on offer to Be Healthy readers in an exclusive prize draw.

The Le Saint-James hotel, part of the Relais and Chateaux portfolio, features a Michelin-starred restaurant and overlooks the city of Bordeaux, the River Garonne and rolling vineyards.

Designed by French architect Jean Nouvel, this picturesque 18-bedroom property in the

quaint village of Bouliac also features a traditional French bistro, a state-of-the-art cookery school, and a heated outdoor swimming pool. It is home to its own vineyard.

THE PRIZE ○ Four nights in a deluxe room at the luxury Le Saint-James hotel ○ Five-course dinner in the hotel’s Michelin-starred restaurant

○ Dinner in the traditional French bistro ○ Cookery class for two at Côté Cours, the resident cooking school ○ Wine-tasting session with head sommelier Richard Bernard ○ Transfers to and from Bordeaux airport Visit saintjames-bouliac.com to learn more about the hotel and its facilities.

Win!

A LUXU FOUR-N RY IG BREAK HT BORDE IN AUX WITH BE N ENDE TRAVEL INSURA N NCE

HOW TO ENTER Simply take out Benenden Travel Insurance using discount codes BENTRAVEL10 for single-trip policies and BENTRAVEL15 for multi-trip policies by visiting www.benenden.co.uk/ healthytravel4 or calling 0800 414 8301 The closing date is 30 September 2016. Terms and conditions apply and can be found at the web address above

Prize includes

Deluxe room

Wine-tasting session

Cookery class

Five-course dinner www.benenden.co.uk 11

11 Competition.indd 11

14/07/2016 12:54

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MORE 14/07/2016 10:19

healthcheck Fast food

We don’t have to be bread heads

Ditch the sarnie Check out these tempting alternatives for a tasty lunch LETTUCE WRAPS ● Cut down on carbs and boost your magnesium and potassium levels by using lettuce leaves instead of bread.

For a tasty filling mix cooked chicken breast, beansprouts, finely diced red pepper, diced water chestnuts and some thin rice noodles that you’ve soaked in hot water for a few minutes to soften them. Toss with sesame oil, low-sodium soy sauce and rice wine vinegar.

LEFTOVERS SALAD ● If you’re cooking rice, new potatoes, pasta, couscous or any other carb for dinner, make extra for a salad with leftovers the next day.

It will last for days if chilled. A tray of roasted Mediterranean veg mixed with couscous and dressed with lemon and a tin of chickpeas makes a nutritious and delicious salad.

FLATBREAD PIZZA ● Using unleavened bread such as a chapati, roti or tortilla as the base for a pizza is quick and low in carbs. Put it in the toaster or oven first to crisp up, add your toppings, and zap for a minute in the microwave.

Top with passata or tomato puree, slices of fresh tomato, olives, thinly sliced mushrooms and sprinkle over a little reduced-fat cheddar or mozzarella, one of the lowest-fat cheeses.

Why not choose a chickpea salad?

Start packing

GETTY IMAGES; SHUTTERSTOCK; REX FEATURES

Take the stress out of travel with our holiday document checklist

✓Passport for every member of the £ travelling party ✓Travel documents, tickets or £ travel cards ✓Booking or reservation letters £ ✓Itinerary and directions £ ✓Visas £ ✓Vaccination documents – check £ country requirements at www. fitfortravel.nhs.uk/destinations ✓Driving licence – plus any hire car £ driving documents

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Member discount

Remember Benenden members can enjoy up to 15% off Benenden travel insurance. Visit www. benenden.co.uk/ d/gentrav

✓Travel insurance documents £ (including European health insurance card if applicable).

Visit www.nhs.uk/NHSEngland/ Healthcareabroad Top tip

Scan or photograph your documents and email the images to yourself

Grilled salmon with avocado, feta and pumpkin seeds Try this recipe from Joe Wicks, whose 15-minute meals have made him an Instagram hit INGREDIENTS Serves 1 drizzle of olive oil 1 x 240g salmon fillet, skin on 2 tbsp pumpkin seeds salt 1 avocado, peeled, destoned and chopped ¼ red onion, finely chopped 2 tsp sesame oil 1 tbsp chopped coriander 40g feta, drained handful of watercress, to serve juice of 1 lime, to serve – optional

METHOD 1. Heat your grill to maximum.

2. Drizzle a little olive oil over the skin side of the salmon, place on the grill pan or a baking tray and slide under the grill.

3. Cook for 6 minutes on the skin side, before carefully flipping and grilling for a further 4 minutes.

Turn off the grill

and leave the salmon to keep warm.

4. While the salmon cooks, tip the pumpkin seeds into a dry frying pan and toast over a high heat for about 2 minutes, or until they start turning brown and popping. Season with salt and leave in the pan.

5. Using the back of a fork, break up the avocado in a bowl. Add the onion, sesame oil and coriander. Mix until the ingredients are well combined.

6. Slide your salmon on to a plate and remove the skin. Pile up the guacamole, slice and scatter over the feta, and finish with a sprinkling of toasted pumpkin seeds, a pile of watercress and a squeeze of lime juice, if using.

Lean In 15: The Shape Plan, by Joe Wicks, is published by Bluebird and costs £16.99

14/07/2016 12:54

healthcheck At a glance

With time on our side As life expectancy rises, we bring you 10 facts about ageing

Silver surfers

Life span

Is tinned food bad for you?

BISPHENOL A ● A chemical compound used to make protective coatings and linings for food and drinks cans has garnered worldwide attention due to concerns about possible negative health effects.

So is bisphenol A (BPA) harmful?

TRACES OF BPA ● The Food Standards Agency says: “Minute amounts of BPA can transfer from packaging into food and drinks, but independent experts have advised that these levels of exposure are not considered to be harmful.”

HORMONES ● BPA does have the potential to interact with our hormone systems. Some critics claim it could cause adverse effects on the brain, behaviour and prostate glands in foetuses, infants and young children.

EVIDENCE ● The European Food Standards Agency says there is no credible evidence of this, although it is monitoring ongoing research.

In the meantime, it has reduced the tolerable daily intake of BPA in response to current uncertainties about the compound’s potential health effects.

British women live for 83 years on average, says the World Health Organization. Men lag behind at 79 years

Retirement

Longevity

Of people aged 55 or over, 56% say they don’t want to work after 65, even if they are fit enough to do so

Jeanne Calment, the oldest person on record, lived to 122.

She met Vincent van Gogh as a teenager

Quality of life

Born to age

Some 65% of people would rather live to be 70 without health problems than live to 100 with them

2016

Homeowners

Extra time

Three-quarters of people over 60 own their own home, compared with 33% of 25 to 34-year-olds

5

World citizens People aged 65-74 spent 51% more on travel and tourism in 2012 than the same age group did in 2002

If you were born in 2016 you would have a three in 10 chance of living to be 100

With life expectancy rising, we can expect to live five years longer than in 1990, says Public Health England

Royal greeting PA SSP PASSPORT

OR T

Increasing numbers of centenarians meant the team sending out cards from the Queen had to be expanded in 2014

SHUTTERSTOCK; JOHN PENDER

Health myth

Internet usage among the oldest sector of the population has doubled in the last five years

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Cruise with real confidence, with

FRED. OLSEN’S ENJOYMENT PROMISE We’re so confident that you’ll enjoy the whole Fred. Olsen experience that if it’s your first time on a Fred. Olsen cruise and within a couple of days of sailing you find it’s not for you, let us know and we’ll arrange for a flight back to the UK from the next port and give you your money back*.

What’s more, book your next holiday with us during your first cruise and pay only £1 per person deposit**. You really can’t lose out. With Fred. Olsen you can book with confidence.

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To book, search for ‘Fred.

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*The Enjoyment Promise is only applicable to guests who have not cruised on a Fred. Olsen Cruise Lines (“FOCL”) ship before. It excludes Party Nights and cruises of 4 nights or less. The promise only applies to bookings made for departures more than 12 weeks ahead. The Enjoyment Promise only applies to passengers who have contracted with FOCL and excludes cruises on vessels operated by FOCL but booked through 3rd Party operators. Should you wish to invoke the Enjoyment Promise, you will need to inform Guest Relations within 48 hours of sailing at the latest. FOCL will arrange and pay for a flight and/ or transport back to the UK. FOCL will refund the cruise cost only but will not refund other costs. **The £1 per person deposit offer for the second cruise is only applicable to guests on their first FOCL cruise. The second booking must be made on board. You will be required to pay £1 per person deposit at time of booking, with the remaining balance of the cruise fare paid 90 days prior to departure. If the booking is cancelled 91 days or more prior to departure, the cancellation fee is £1 per person, replacing the standard 15% cancellation fee. E&OE.

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14/07/2016 10:20

FIRST PERSON

The good

SPORT Top men’s doubles player Jamie Murray explains why tennis and family are centre stage

t is gloriously sunny, the sort of day you would expect a world-class tennis player to be practising his shots ahead of his next tournament. Instead, doubles champion Jamie Murray is holed up in a London basement recording studio using his well-honed stamina and patience – developed over more than 12 years in top-level sport – to plough through 25 Murray meets fans consecutive interviews about at his old primary the tennis season and his school in Dunblane soon-to-be-announced OBE. Despite his busy schedule, Murray is supporting the his victorious Davis Cup year-round Benenden Tennis doubles teammate. As the Festivals, backed by the Lawn interview begins, though, Tennis Association (LTA) and Murray shares happy anecdotes designed to encourage children about the pair growing up. into the sport. Before playing “It was inevitable we got into tennis with children in Regent’s tennis really,” he says. “When Park, he sits with headphones we were about three or four, on, long, muscly legs stretched our mum would be teaching out and feet on a chair, ready tennis at the local sports club for a different kind of challenge. just across the road from our “It’s the better-looking house, and Andy and I Murray brother,” reports a BBC Radio announcer to his audience. Murray breaks into a gap-toothed grin, clearly enjoying the swipe at Andy, his younger brother In the 2015 by 15 months and Davis Cup with Andy

JAMIE MURRAY

would be round the back of the courts, picking up the balls and generally making a nuisance of ourselves. It was natural that we’d pick up a racquet at some age.”

He says they enjoyed a healthy competitiveness.

“We used to play games that we made up – this was way before iPads – and all sorts of sports too. He’s a better footballer and rugby player, but I’m the better golfer. Undoubtedly we’d sometimes end up having fights, but that’s obviously all part of having a brother.”

Murray insists the brothers were “encouraged” rather than pushed by their parents. He showed early talent and aged 12 was invited to attend the

● 1986 Born in Dunblane, Scotland ● 1996 Hides beneath a desk in the headmaster’s office as Thomas Hamilton kills 16 children and one teacher at Dunblane Primary School ● 2007 Wins Wimbledon mixed doubles ● 2010 Marries Alejandra Gutiérrez ● 2015 Wins the Davis Cup with the Great Britain team ● 2016 Receives an OBE. Wins the men’s doubles at the Australian Open

GETTY; ALAMY

I

WORDS SIÂN PHILLIPS MAIN PHOTOGRAPH PAUL STUART

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3 reasons to take up tennis

1

Tennis is a great way of keeping fit and having fun with friends.

2

It helps develop your hand-eye coordination, is non-contact and can be played

by anyone of any age.

3

With many people playing into their older years, it really is a sport for life and provides a great opportunity to meet new people.

See the Lawn Tennis Association website at www.lta.org.uk/ competitions/ family/benendentennis-festivals to find out about the Benenden Tennis Festivals running throughout the year.

Murray (left) as a boy with his mother Judy and brother Andy

‘We’d sometimes end up having fights, but that’s all part of having a brother’

Leys School, an LTA-sponsored training centre in Cambridge.

Finding being away from his Dunblane home difficult, he returned after eight months and gradually rediscovered his enthusiasm.

“If you’re doing well at a sport, you keep interested,” says Murray. “It was the same with me and tennis. I did stop when I was 15 for a few months and started playing more golf, but I felt if I wanted to have a career in professional sport, tennis was going to give me the

Finding a tennis doubles partner is like asking a girl out best chance, so I came back to the sport.”

It was worth it. In March this year, he was the first UK player to reach number one in the men’s doubles game.

“Doubles suits me – I am good at volleying,” he says, laughing.

“Finding a partner is a bit like asking a girl out. You’ve got to pluck up the courage, although more often than not you text them these days.” Since January, he has played with Brazilian Bruno Soares, and they have already won the Australian Open.

Used to playing on the international circuit, Murray is clearly also a homebody, delighted to have a few consecutive weeks in London where he lives with his Colombian wife Alejandra.

Although he sees his brother at tournaments, “it’s not as often as you’d think”, he says.

“You pass in the locker rooms.

Sometimes we go out for dinner. We both have busy lives when we’re at home – and Andy’s a dad to Sophia now so that obviously takes up a lot of his time.”

Clearly proud of his new role, he says “being an uncle is cool.

Sophia came to Paris and Rome.

It’s great to see her – she’s gorgeous. Not that I’m biased.”

As the interviews end, he gives a warm handshake and heads off, chilli chicken wrap in hand for lunch. His next job, he says, is to tell his parents about his OBE before they read it in the next day’s papers.

To see our video interview with Jamie Murray, go to www. benenden.co.uk/jamiemurray www.benenden.co.uk 17

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14/07/2016 12:55

NUTRITION

We are healthier and living longer than ever before.

But 21st-century lifestyles bring their own perils, finds Dr Stuart Farrimond ILLUSTRATIONS: PHIL HACKETT

10

HEALTH PROBLEMS OF THE MODERN AGE

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Cyclist’s bum

Bikes are the way forward, but watch out behind

1

Cycling is on the rise, with more than two million Britons saddling up at least once a week, an all-time high according to British Cycling, the sport’s governing body in the UK. But while being a good way to get fit, it can also have potential health issues. One such condition is ‘numb bum’ – or peroneal nerve compression – syndrome. Excess pressure from the saddle on the nerves near the buttocks can result in numbness, pain and tingling in the groin or legs.

Text claw

Cycling boosts fitness but can cause numbness and tingling

Maybe it’s time to get a grip on your mobile use

2

GETTY IMAGES

SHUTTERSTOCK

If symptoms are left untreated, nerves can become thickened and damaged, potentially leading to lasting problems down below.

Research shows 61% of male and 34% of female cyclists are affected. Adjusting saddle angle, height and handlebar position can help shift weight away from the vital nerves.

Daniel Lloyd, a former Tour de France cyclist, says: “Taking a few seconds pedalling out of the saddle every few minutes can allow the blood to flow and alleviate pain.”

Stepping on to busy roads while texting isn’t the only hazard for mobile phone addicts.

Text claw can affect frequent mobile users, resulting in wrist pain, thumb tenderness, hand spasms and difficulty with gripping.

Better known among doctors as De Quervain syndrome, text claw is a type of repetitive strain injury (RSI). The thumb is painful to straighten

due to inflamed tendons. This stubby digit has evolved to grip and squeeze, not for the delicate, fast movements of text typing. Overusing the thumb in this manner can eventually cause tendons to become thickened and irritated.

The condition can usually be remedied by taking time out from thumb-intensive activities, applying ice to the area and taking pain relief if required. www.benenden.co.uk 19

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NUTRITION

Information fatigue syndrome Learn to make more of less

4

Unsafe listening practices are damaging our hearing

Life in the ‘information age’ can feel like weathering a never-ending storm of digital distractions, from 24-hour television to mobile phone messages and bulging email inboxes.

Dr Sandra Chapman, chief director of the Center for BrainHealth at The University of Texas, says: “Our brain is exposed to an unrelenting stream of information via various sources of technology and media, as well as an overabundance of input from family and social responsibilities.

The sheer volume of information we are exposed to every day is nearly 200 times more than we were exposed to 20 years ago.”

This information deluge is equivalent to trying to read 174 newspapers every day, research suggests.

Trying to process the incessant

electronic jibberjabber can cause information fatigue syndrome (IFS) – also known as information overload. This can lead to anxiety, poor concentration, indecision, and a compulsion to check email, voicemail and social media.

Dr Chapman says: “Information overload degrades the brain’s ability to block out irrelevant information, decreasing efficiency and learning capacity.

Those who experience information overload become paralysed by indecision.”

Take control of technological devices, rather than letting them control you, she advises. “Practise vetting and reading a single source of information to learn about a topic or inform a decision, instead of believing the more you read the smarter you will become.”

Headphone-induced hearing loss

3

More than one billion young people worldwide risk losing their hearing through unsafe listening practices, according to the World Health Organization.

Half of all people aged 12–35 regularly listen to music through headphones at levels above 85 decibels –

the equivalent of a microwave beep – for prolonged periods.

Exposure to sound at this level for more than a few minutes damages the delicate sound-sensing hair cells deep within the ear.

These cells detect everything we hear but cannot be repaired once destroyed, and

hearing loss is permanent.

Experts recommend volume should be turned up to no higher than 60% of a personal audio device’s maximum loudness.

And listening to music through headphones should be limited to one-hour stints, even when out and about.

SHUTTERSTOCK

Why only Spinal Tap should be turning the volume up to 11

20 Be Healthy Autumn 2016

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NUTRITION

Orthorexia nervosa

Everything in moderation, including moderation

5

A century ago barely anyone knew what a vitamin was. Today it is practically impossible to food shop without feeling a compulsion to buy vitamin-enriched breakfast cereal.

The media is bloated with stories of food scares or ‘clean eating’.

This, coupled with often contradictory nutritional advice, has helped lead to the rise

Food scares are affecting eating habits

of orthorexia nervosa, an unhealthy obsession with trying to eat the ‘right’ foods.

With similarities to obsessive-compulsive disorder and anorexia nervosa, orthorexics can develop overly restrictive diets that, ultimately, can cause malnutrition.

Dr Jenny Kip, clinical assistant professor of psychiatry at the University of Southern

California Keck School of Medicine, says, “People with orthorexia fear what will happen if they don’t eat healthily.

That fear can be so extreme it consumes all areas of their life.”

Avoid labelling foods ‘good’ or ‘bad’ because all foods in moderation can be part of a healthy diet. So when compelled to buy only ‘pure’ foods, sneak in a few treats too.

Rickety bones

It’s as clear as day we need to spend less time indoors

6

Gloomy skies can have an impact on bones and overall well-being, not just our mood.

Too many hours in front of a screen and insufficient time in the sun have contributed to a rise in rickets and osteomalacia – weak bones in children and adults respectively.

As many as 15 million people in the UK are now deficient in vitamin D, ‘the sunshine vitamin’.

At particular risk are

children who shun the playground for playing online.

Our skin generates vitamin D through exposure to the sun’s UV rays. Vitamin D is needed to absorb calcium from food so bones, muscles and nerves are strong, and to allow the immune system to function properly.

Symptoms of low vitamin D levels include muscle, bone and joint pain, fatigue and depression.

Children risk stunted

growth, poorly developed bones and bowed legs.

Most people with light skin tones can make enough vitamin D by spending 10 to 15 minutes in the sun every day between 11am to 3pm from March to October, with forearms or lower legs uncovered.

People with dark skin tones need more time in the sun.

Try having lunch in the park, or swap your ‘smoke break’ for a sun break.

SHUTTERSTOCK

Take a sun break to boost vitamin D

3D viewing sickness Specs appeal loses some of its allure

7

There is a good reason 3D TV has proved a turn-off – it can make audiences feel ill, with some issues ranging from eyestrain or headaches to nausea.

Makers of 3D TV and cinema content have worked to avoid such side-effects, but it was never going to work well for the three million Britons with strabismus – a squint – and other conditions that impair depth perception.

Normally when we see an object getting closer to us, our eyes

rotate inwards to focus on it in a process called accommodation.

When watching a 3D film, our eyes focus on an area in front of the screen, making everything momentarily blurry, which for anyone with less than perfectly aligned eyes or not sitting directly in front of the screen can lead to queasy, headacheinducing optical effects.

Most of us will enjoy the odd bit of 3D exposure, but its use as a more sustained format will take quite a bit of fine tuning yet. www.benenden.co.uk 21

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NUTRITION

Sick building syndrome It’s probably what you do, it ain’t where you do it

9

Modern screens emit blue light

No-one would bat an eyelid if you complained of sore eyes or a headache after a long shift in an office. Some buildings and workplaces, however, seem to cause these and other discomforts with inexplicable regularity.

‘Sick building syndrome’ (SBS), the term used to describe such symptoms, was coined 50 years ago when tenants and workers started feeling unwell when in newly constructed buildings.

The most common symptoms are aches,

sneezes, fatigue, itchy eyes and poor concentration that dissipate when the sufferer goes outside.

Backed up by the latest research there is a growing feeling among the medical community that modern working

practices, rather than buildings, are ‘sick’.

Evidence shows sitting at a desk performing stressful and monotonous routines without adequate support are key triggers for the groggy malaise often labelled SBS.

Blue light insomnia Step. Away. From. The. Screen … and ZZZZ

coincidence, modern LED screens and smartphone displays emit light containing blue light of the same hue as normal daylight.

Peering at a smartphone or tablet before bed, therefore, tricks your brain into thinking it is day – 78% of adults admit to using a digital device before bed. A few glances can be enough to cause levels of the powerful sleep hormone melatonin to plummet and stress hormones to surge.

Dropping off then becomes much harder, and the next day’s rhythm is knocked off kilter, resulting in morning sleepiness.

The easiest and most effective answer to a good night’s sleep is to leave the phone in the sitting room after dark.

Phantom phone vibration Here’s one alert we should all be paying attention to

10

Being disturbed by a mobile phone seems to be an inescapable part of modern life.

Smartphone users typically receive about 50 alerts per day for incoming calls, messages, social media updates and calendar notifications.

Sometimes, though, prising an apparently

vibrating phone from a pocket reveals a blank screen, with some 90% of mobile owners saying they’ve experienced this ‘phantom phone vibration’ (PPV).

According to Dr Robert Rosenberger, of the Georgia Institute of Technology in Atlanta: “Mobiles are somehow changing our brains, making us

feel inclined to feel these vibrations.”

Worrisome but not harmful, PPVs can be a symptom of overwork, anxiety or sleep deprivation – just ask any bleary-eyed parent how jumpy they become when deprived of shut-eye.

Thankfully, our electronic babies are far easier to get into sleep mode.

SHUTTERSTOCK

8

You may not realise it but your body knows what time it is. A tiny biological clock, no bigger than a grain of rice, ticks continuously in a brain region called the suprachiasmatic nucleus just behind the eyes. It tells your body when it is time to wake, time to eat, time to work and time to sleep.

Our microscopic timepieces have served us unfailingly since the dawn of humankind.

Until the advent of the digital screen, that is.

Without Greenwich Mean Time to tell it the hour, our biological clock relies upon daylight to keep it in sync. It interprets yellow frequencies of light as dawn and dusk and translates blue light to mean daytime.

By unfortunate

22 Be Healthy Autumn 2016

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SPECIAL FOCUS

The final stages of life are about far more than dying – they are about living as well as possible. So why does end-of-life care in the UK fall short? Pennie Taylor reports ILLUSTRATION: THE PROJECT TWINS

D

eath is one of life’s few certainties. It seems strange, then, that end-of-life care has been such an overlooked and under-resourced discipline in the UK. Only in 1967 did Dame Cicely Saunders, the founder of the modern hospice movement, establish the first home dedicated to care of the dying.

St Christopher’s Hospice in south-east London has since been followed by hospices throughout the UK, set up to serve local communities and funded largely by charity.

The focus of hospices is on meeting the physical, emotional, psychological and spiritual needs of people in the last www.benenden.co.uk 23

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FIRST PERSON

phases of life.

Provision of such specialist care is limited, though, and it is estimated around half of deaths still happen in hospital, the least favoured location.

At any one time, an estimated 1% of the population is within a year of dying. Some deaths are unexpected, but the vast majority are predictable.

How – and where – people are cared for as they die, however, can be down to luck.

The British Medical Association (BMA), which represents doctors, defines end-of-life care as “the total care of a person with an advanced, incurable illness and does not just equate with dying. The end-of-life care phase may last for days, weeks, months or even longer. It is defined as care that helps those with advanced, progressive, incurable illness to live as well as possible until they die. It includes the prevention and relief of suffering through the assessment and treatment of pain and other problems, whether physical, psychosocial or spiritual”.

Early this year, the BMA called for the UK governments to prioritise end-of-life care as new research found current provision does not consistently match either the public’s or doctors’ expectations. The research concluded that while there are pockets of excellence in end-of-life care across the UK, there is unacceptable variation between regions, even within regions, and according to a patient’s condition.

Doctors who took part in the study generally held the view that patients dying from cancer receive better medical care at the end of life because of the way cancer services are organised. They also agreed that, due to lack of coordination of care,

Doctors need the time, support and training necessary for end-of-life care

end-of-life planning comes too late.

“Doctors need the time, support and training necessary for caring for people at the end of their life,” says BMA spokesman Dr Ian Wilson. “Patients must be able to access a high quality of end-of-life care wherever they live, whatever their medical condition.”

THE BEST NEED TO GET BETTER

An estimated 48,000 people who died last year experienced poor care when dying, according to a report by a coalition of charities – Macmillan Cancer Support, Marie Curie, Cicely Saunders International, Hospice UK, the Motor Neurone Disease Association, the National Council for Palliative Care and Sue Ryder. The charities believe this is due to too many people dying in hospital, rather than at home or in other settings.

Their report, On the Brink: The Future of End of Life Care, says some people are left unsupported at home at the end of their lives and many families receive no advice on how to care for their dying relatives. This can lead to people being admitted to hospital in an emergency.

“Too often we hear of people being marooned in hospital because they are not getting the right care at home,” says Lynda Thomas, chief executive of Macmillan Cancer Support. “Nobody wants to see this happen as it is an appalling situation for the individual and puts strain on the health service.”

NHS England said instances of poor care should be taken seriously, adding that international comparison shows that the UK leads the world in end-of-life care. Most professionals working in the field agree it has a duty to become even better.

Shabeena hugs her son Kaif

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‘We thought hospices were for older people, not Pakistani Muslims like us’

Mohammed and Majidan Akram relish time with grandson Kaif, four

When Shabeena Akram discovered her cancer had spread and was incurable she and her family found comfort from an unexpected source

SIMON MURPHY

E

very Thursday evening the Akram family gather in a flat on the southside of Glasgow. The home of retired bus driver Mohammed and his wife, Majidan, is welcoming, warm and full of family photographs. In pride of place on the mantelpiece is a portrait of the couple’s youngest daughter, Shabeena. “She was a very bubbly, happy person,” says her mother.

Shabeena was diagnosed with breast

PHOTOGRAPHS SIMON MURPHY

cancer in 2013 when she was 32 years old.

Her son, Kaif, was just 18 months. She had given up work to devote herself to motherhood, and life was full and happy.

“We were shocked because she was so young, and there was no family history of breast cancer,” says Majidan. “She thought she would get better, and so did we.”

When chemotherapy failed to reduce the size of the tumour, Shabeena underwent mastectomy and radiotherapy and was started on the drug treatment tamoxifen.

In August 2014, Shabeena learned the cancer had spread. “She kept it to herself,” says Shabeena’s sister Sheena. “That’s when we think she first contacted the hospice.”

The family admit they knew next to nothing about hospice care until Shabeena introduced them to it. “We thought it was for older people, and certainly not for Pakistani Muslims like us,” says Shabeena’s brother, Saf, a business development manager for a traffic management company.

The Prince and Princess of Wales Hospice www.benenden.co.uk 25

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FIRST PERSON

Kaif and his uncle Saf

serves Glasgow city centre and the southside, an area with a strong south Asian population. Yet in the past the hospice rarely came into contact with people from minority ethnic groups.

“It just wasn’t culturally sensitive,” says Majabeen Ali, whose mother-in-law, Musrat Begum, was one of the first Asian people to be cared for there, in 2006. “There were no halal options on the menu, no prayer mats, no suitable ablution facilities and no Qur’an to hand.”

There were sometimes problems with communication, and a lack of understanding of the family’s cultural and spiritual needs.

“We were touched by the care we received, but felt so much more could be done to make the hospice welcoming,” says Majabeen.

“So that’s when I decided to get involved.”

CULTURAL COMPETENCE AT THE HEART OF CARE

A decade on, the Glasgow hospice has addressed its cultural shortfalls: there are halal food choices, an interfaith prayer room, and purpose-built wet room for washing. People come from around the world to learn about its groundbreaking ‘widening access’ programme.

Majabeen, now the hospice’s cultural liaison officer, spends her time building and consolidating links with community representatives and keeping the team up to date on multicultural issues. There are 150 health and social care professionals delivering care across the 14-bed hospice and in the community, plus volunteers and other workers. It is vital all of them understand how to deliver culturally competent care.

“The principles are the same, no matter which country you come from, or your religion: it’s about finding out what matters to

patients and their families … and putting it in place,” says Majabeen. “Everyone is allowed to be themselves. When the end is near, some faiths want to recite from holy books to help a person pass away, and there can be loads of people around the bed. We never restrict visitor numbers. It’s up to the patient and their family how they want things to be.”

Majabeen, who speaks Hindi, Punjabi, Urdu and English, does her best to overcome cultural barriers. “There’s no word for ‘hospice’ in Urdu, so I talk about it being a good place to die,” she says.

“There can be real stigma about cancer and other life-limiting illnesses, so I work with people to help them understand it’s not their fault and we can make things easier.”

Majabeen says there are western assumptions about minority ethnic groups to be overcome. “People say ‘they like to look after their own’, which might be true, but it can also be an opt-out,” she says. “We are into the third and fourth generations of south Asian families living here, and everybody might be working. They need help to provide the best care too.”

Not everyone gets the chance to plan how they leave this world If families choose to provide care directly, the hospice-at-home team can coordinate specialist support. “People from my community speak very highly of that service and they are talking to one another about it,” says Majabeen. “Word of mouth is the most powerful advert for what we do.”

Gillian Sherwood, the hospice’s director of clinical services, says the organisation’s focus on cultural competency has had a profound impact. “It has given staff the confidence to provide the best possible care to patients from minority ethnic groups, and helps to dispel some myths,” she says.

The hospice team has held health fairs at the Glasgow Central Mosque, and Gillian describes being invited into the community as an enormous privilege. “We work hard to maintain mutual trust,” she says. “Our culturally sensitive approach is an essential component of the care.”

Dr Jonathan Koffman, senior lecturer in palliative care at the Cicely Saunders

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New era in end-oflife care

Close friends Taz Cheemy and Shabeena

First cottage hospice to be a community hub

A day out at Loch Lomond homemade food and cheer.

“Even when there were 15 of us in the room, the staff made us feel at home,” says Sheena.

In January 2015 Shabeena was well enough to go home. Staff at the hospice liaised with the council home care service and primary care team to ensure she had everything she needed there to keep her comfortable. The hospice-at-home service saw to her clinical needs, and the family – including grandmother Bibi, who is in her 90s – rallied round to say their goodbyes.

“Not everyone gets the chance to plan how they leave this world,” says Sheena. “It was a very special time.”

Institute, King’s College London, applauds the hospice’s approach. He says there is plenty of evidence that good palliative care enhances longevity, and that too many people from minority communities are not aware of that. “More hospices in areas where people from minority ethnic groups live need to open their doors in creative ways,” he says.

“It’s about enhancing the remaining life of people whose illnesses are not curable.”

The Prince and Princess of Wales Hospice stepped in to support Shabeena Akram and her family when they needed it most. “They did so much to ease our journey,” says Saf. “She visited for complementary therapies and, although he was very wee, Kaif went along to the hospice’s Butterfly project to help him cope with what was happening.”

When Shabeena was admitted the first time, it was to a family room where Kaif could get into bed beside her, and people could be with her at all times.

Friends and relatives took it in shifts, bringing Kaif clasps a phone with his mother’s image

YOU ARE NOT ALONE

In March, Shabeena started having breathing problems and seizures. She was admitted to an acute hospital where the only room available was off a men’s ward.

“That was the worst thing imaginable for a Muslim woman,” says Sheena.

There, she was diagnosed with a brain tumour and it was obvious the end was close. Thankfully, a bed became free at the hospice, and Shabeena was transferred. For two weeks, the family kept vigil, supported by the hospice staff who arranged for the imam’s wife to come in to say final prayers.

Shabeena died peacefully on Easter Saturday 2015.

Since then, Kaif has continued to receive support from the Butterfly project, and other family members have taken up offers of counselling. “I don’t know how we would have coped without the help of the hospice,” says Saf. “More people need to know about the wonderful service they offer.

No one ought to go through this alone.”

Within the gently rolling countryside of archetypal ancient southern England a quiet revolution is taking place.

The UK’s first cottage hospice is being built in the village of Five Ashes, East Sussex. Run by the Hospice in the Weald, it will allow people in the final stages of life to live and die in the heart of their community, surrounded by friends and family.

“There are many people in their last year of life who don’t want to be in hospital, and don’t need high-tech clinical facilities, but may still need specialist care and a bed for a while,” says Beth Swarbrigg (pictured), fundraising director for Hospice in the Weald. “The Cottage Hospice is for them.”

The hospice is being built on the site of a former church and First World War army officers’ hut. Some details from the church, including original stained glass windows, will be maintained in a chapel within the hospice.

Consisting of 10 patient rooms across two floors, each with a double bed and another for a guest to sleep in, the cottage hospice will provide a caring and supportive environment for patients and their families. It will also offer training for home carers and hospice volunteers.

Hospice in the Weald

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FIRST PERSON

What do you think?

Tell us your views on end-of-life care at www.bit.ly/benendencares

Relaxed chat and good food at a death cafe

The reluctance of western culture to confront mortality has inspired more than 3,000 death cafes “Anyone who wants to do it can do it,” says Underwood. “There’s no money involved. It is just about providing room for people who want to come together and talk about death in comfort. They are not told or sold anything, although they can make a donation if they wish.”

Over tea and cake, death cafe participants discuss any aspect of dying

The best way to counter fear of death is to have a great life

they want. That might involve practical issues such as planning a funeral, or more philosophical and personal concerns.

“Each death cafe is different,” says Underwood. “Once, someone shared the terror flashes she had experienced all her life when it came to considering death. She had never told anyone about it before, and opening up helped.”

He adds: “People tell us they welcome the opportunity to talk about death.

Nothing makes you feel more alive.”

Visit www.deathcafe.com for advice on holding a death cafe and a guide to upcoming events

MURDO MACLEOD

I

t was the lack of opportunity for people to talk about death in modern western society that led Jon Underwood to develop the concept of a death cafe. His theory is that by creating the space for people to consider their demise, they will be encouraged to make the most of their finite lives.

“It’s not aimed at people who are going through the fire with death, but at the vast majority who are just afraid of it,” says Underwood. “The best way to counter fear of death is to have a great life, and that’s what the death cafe brings into focus.”

Since Underwood held the first death cafe in 2011, at his home in Hackney, London, the idea has taken off around the world. To date he reckons there have been more than 3,000 death cafes in 35 countries following principles he developed.

Comfort and a slice of cake

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GAME FOR LIFE A health crisis forced Ashleigh Mills to give up her childhood dream of playing football for England and search for new goals WORDS KATHLEEN MORGAN PHOTOGRAPHS CHRIS BLOTT

30 Be Healthy Autumn 2016

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REAL LIVES

GETTY IMAGES

A

t the age of 17 she was wearing the England jersey and seemed to have a promising football career ahead of her. She had the support of her family, who shared her passion for the beautiful game – her father had played professionally.

Then, the day after her 20th birthday, Ashleigh Mills woke up to find her right foot was numb. In that moment, her life changed direction, although it would be a year until she was to learn for sure why.

Dismissing the peculiar sensation as insignificant, the midfielder began focusing on the challenge ahead – the first game of the season with her team, Doncaster Rovers Belles. “I thought I’d slept funny or something like that so I didn’t think anything of it,” says Mills. “The numbness wasn’t going away and it began coming up my legs. I contacted the club physio and he

Ashleigh Mills at the ground of Doncaster Rovers Belles

said he wasn’t coming down till later because it was a night kick-off, at 8pm.

“I paid to go and see a physio because I was that desperate to play. It started getting worse but I didn’t want to tell anyone.”

Keeping her anxieties to herself, Mills played the match, even though her legs felt heavy and the numbness was spreading.

She hoped the feeling would disappear overnight, but woke up to a frightening sensation she compares to having a snake wrapped around her legs.

“The next day it was from my hips down,” she says. “It was just awful, I can’t explain it. Both my legs … it was just a horrible feeling.”

Suspecting the Mills in situation was action serious, Mills was against nevertheless Liverpool unaware she was experiencing her first symptoms of

multiple sclerosis (MS), a condition of the central nervous system. MS is triggered when the body’s immune system attacks the protective lining of the nerve fibres, or myelin, causing scars and interrupting messages. Symptoms can include walking difficulties, fatigue, and blurred vision or complete loss of sight.

It was to be another year before Mills was finally diagnosed with MS. It took two MRI scans to pin down the complex condition.

In the meantime she carried on, trying to maintain the levels of skill that had got her noticed by a scout for the under-19 England team.

“I could see that I was behind all the girls,” she says. “I just wasn’t progressing.”

Her father, Simon, who had played for Sheffield Wednesday, York City and Port www.benenden.co.uk 31

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REAL LIVES

Vale during a 10-year career in the Football League, knew the pressures she was under.

As he watched her performance and physical condition deteriorate, he knew his daughter might have a difficult decision ahead.

“My dad was always pushing me,” says Mills. “If it wasn’t for him I probably would have quit. He’s been my biggest influence because he’s been through what I’ve been through in terms of the ups and downs of a career in football.”

Mills’s interest in football was sparked early during kick-abouts with her father and brother. At eight years old she began playing for the local boys’ team and at 13 made the obligatory switch to the girls’ league. After being noticed by the manager of Doncaster Rovers Belles, the Women’s Super League Mills made her One side, she was invited to sign for the club. debut for At 17 years old she won a place at a camp run England in 2014

by England where her potential was spotted.

Her debut for the national side came in 2014 at the Under-19 Women’s European Championship in Norway. Although England were knocked out, the experience ignited an ambition to make it in the game.

“Usually to be involved with England you have to go from academies and centres of excellence – I came through the grass Mills is about to begin the second year roots,” says Mills. of a degree in sports development with The diagnosis in March 2016 came as a coaching at Sheffield Hallam University. relief for the player, leading to her painful Her obvious skills would impress any decision to retire from competitive football. student cohort if she chose to become a “It was kind of good,” she says, realising coach, but she professes to being shy and how strange that might sound. “They were wonders whether she might concentrate pushing me and I just knew I wasn’t getting on video analysis instead. She laughs as better so a lot of pressure came off me.” she mentions a secret desire to be a Royal Acknowledging the stress she would Mail postal worker. be under to sustain high performance Since MS is an unpredictable condition, levels, her father advised her to step Mills has no idea how it will continue to back from the game she adored. affect her. She is among “I didn’t want to retire, but around 85% of people my dad told me I needed to. diagnosed with MS who have a I wasn’t doing very well and relapsing-remitting form of he just said that it wasn’t me. the condition. This involves I couldn’t run or anything distinct attacks of symptoms and he said I had to just tell Mills with which then fade or disappear the club.” her parents

My dad was always pushing me. He’s been my biggest influence

entirely. Around half of all relapses can leave some lingering problems.

Although Mills experiences leftover symptoms, including numbness in her foot and fatigue, she says they are relatively mild. “When I read about people who are really exhausted because of MS I feel quite lucky because I’ve never experienced that. I feel normal, I feel like myself. If people were to see me in the street they wouldn’t know I’ve got this. I feel all right.

I feel good in myself.”

Besides completing her degree, Mills is open-minded about the future. Encouraged by her father, she has begun playing for a local team, free to enjoy the football in a less competitive arena. “It’s good to know I can still carry on but just at a lower level,” she says. “Looking back now, I miss it a lot. I’ve watched the Doncaster Belles and the England team and I wish I was there. I’m gutted.”

Given the skill and ambition Mills has shown in recent years, it is difficult to imagine her staying on the sidelines for long – whichever arena she chooses in life.

Multiple sclerosis facts ● More than 100,000 people in the UK have multiple sclerosis (MS) ● A condition of the central nervous system, MS affects almost three times as many women as men

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● In MS the immune system damages myelin – the protective coating of the nerve fibres – leaving scars ● Damage to myelin disrupts messages travelling along the nerve fibres

● Symptoms can include problems with balance, vision, swallowing, speech and fatigue ● Find out more from the MS Society at mssociety.org.uk

14/07/2016 12:57

REAL LIVES

The watershed

The adventurer James Ketchell found his motivation a er a serious motorbike accident

I

t takes a special sort of person to row solo and unsupported for almost 2,000 miles around the coast of Britain with only dehydrated ration packs to sustain you.

James Ketchell explains he has been relishing the prospect of dried chicken and chocolate pudding as he navigates the peninsulas and inlets of the British coastline during eight long weeks this summer. His goals are to achieve something no one else has, and raise money for the UK charity Over the Wall, which provides free recreation camps for children and teenagers living with serious illness.

It is not the first time Ketchell has attempted to set a record. In what was later called ‘the ultimate triathlon’, in 2014 he became the first person to have rowed across the Atlantic, climbed Mount Everest and cycled 18,000 miles around the globe.

“People have rowed around Great Britain but nobody has rowed as a soloist,” he says, days before setting off on a two-month journey from Tower Bridge, London, in a 5m-long carbon fibre boat. “It’s quite a tough row – it’s very different to rowing across the Atlantic. The most dangerous place you can be in a boat is close to land.”

Seven years ago, Ketchell could only imagine tackling such difficult expeditions.

James Ketchell prepares to row around Britain

It’s a tough row – it’s very different to rowing across the Atlantic He was 25 and in hospital with multiple traumatic injuries, including a shattered leg, having crashed his motorbike on a speedway track at 100mph. He was told it was unlikely he would walk again.

“When I was young I thought I was invincible,” says Ketchell. “I was a strong young man and then, boom! When you throw yourself down the road at 100mph it can be problematic.”

Ketchell had been working as an account manager for an IT firm, indulging his love of motorcycle racing in his spare time. Then, two years before his accident,

he returned to a boyhood ambition. “I had always had this dream to row a boat across the Atlantic Ocean, but I never really had the guts to do it,” says Ketchell.

Amid the struggle with rehabilitation, however, his resolve strengthened. “It took about two years to walk, and make what I would class as a proper recovery,” he says.

“The underlying drive was the fact I was going to row across the Atlantic.”

The fuse had been lit and Ketchell began plotting more expeditions, beginning with a trip to the summit of Everest.

“I took a huge risk,” he says. “I left my job. I sold everything I owned so I could fund some of it and had to find sponsorship for the rest. I managed to make it happen. I got lucky and stood on top of the world.”

Then in 2013, he did an 18,000-mile unsupported cycle through 20 countries.

Other adventures have been less successful, but Ketchell is cheerful about his prospects for his latest challenge. His motivation, he says, is that his fundraising efforts will help give children the freedom and space to escape the label of serious illness.

His mantra is keep on keeping on: “Living a dream is not as hard as you think.”

For more information visit www.otw.org.uk and www.jamesketchell.net

Ketchell dreamed of rowing across the Atlantic

34 Be Healthy Summer 2016

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HEALTH HEROES

+

HEALTH

HEROES

Something inside so

STRONG With a debut album and talk of a biopic, the NHS Choir is soaring. But as they rehearse between shifts, their hearts belong on the ward

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The NHS Choir creates harmony for a video shoot

H The choir rehearses for Glastonbury at Lewisham Hospital

Neonatal nurse and soprano Elem Nnachi

WORDS PETER ROSS PHOTOGRAPHS PAUL STUART

oneyed early-evening light trickles through the windows of Lewisham Hospital in south London, giving a golden cast to the upturned faces of 20 or so men and women gathered for choir practice.

The words they sing – “something inside so strong”; “I will try to fix you” – speak of compassion and endurance, as well they might. This is no ordinary group of singers.

This is the NHS Choir. Their charity single A Bridge Over You reached number one at Christmas thanks to the endorsement of Justin Bieber and a social media campaign that tapped into the deep feelings the British public has for the National Health Service. If the NHS is Britain’s secular church, the choir is an expression of faith and theirs are songs of praise.

They had arrived one by one, from 5pm, as shifts ended. Elem Nnachi, a 48-year-old soprano, a nurse in the neonatal unit, looks after premature babies, some small enough to fit in an adult’s palm. It can be touchand-go. One child, at just 32 weeks, was deteriorating as Nnachi ended her shift, and

Vascular surgeon and tenor Eddie Chaloner

her instinct had been to stay. Yet between the ward and the rehearsal room she had an encounter that reminded her what it’s all about. A woman stopped her in the corridor and pointed to a two-year-old girl by her side. Nnachi was thrilled to realise this giddy toddler had been one of the fragile newborns she had spent weeks nursing over the threshold into life. “It’s very emotional,” she says. “You just do what you do to make sure they stay alive to see tomorrow. It’s so good to see them growing and achieving like that.” She sings to the babies. “Some songs are like a prayer.

Like Lean On Me.” The choir is in demand. They sang Abide With Me ahead of kick-off at the FA Cup final, backed Tinie Tempah on one of his songs and took to the main stage at Glastonbury. All this on top of their regular hospital work. Now there is talk of a film of their story. One hesitates to give a medical diagnosis, but the suspicion is they are running on adrenalin. The choir was set up in 2012 for the BBC2 show Sing While You Work but as the years passed their public significance surpassed reality TV and they now reflect something deeper: reality itself.

“We know it’s not about us,” says Chidi Ejimofo, 48, an A&E consultant and tenor.

“It’s about how people cherish the NHS.” The choir is a microcosm of the health service. Doctors, nurses, porters, therapists, a chaplain, administrative staff – it contains people from some of the professions who make the system run. There is, therefore, a tremendous sense of camaraderie. “It’s your team,” says Eddie Chaloner, 52, who sings tenor. “And you can’t let your team down.”

It’s not about us. It’s about how people cherish the NHS

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14/07/2016 15:28 10:21 28/06/2016

HEALTH HEROES

He arrives after a busy day. A highly From porters regarded vascular surgeon, and a consultant to surgeons, for Benenden Hospital in Kent, the society the choir is a magazine Tatler named Chaloner in its list microcosm of Britain’s 250 best doctors, describing him of the NHS as “master of delicate thread vein removal”.

Chaloner read medicine at Brasenose WHO WOULD College, Oxford, where PLAY THE CHOIR he sang evensong with the choir. During his IN A FILM OF surgical training he THEIR STORY? worked with Médecins CHIDI EJIMOFO Sans Frontières and The A&E consultant HALO Trust, treating (opposite) injuries caused during “I’d love Idris Elba to the clearance of play me. The film landmines and teaching would be yet another doctors from affected chapter in the nearcountries to do the same. fantasy of our story This took him to Angola, so far.”

Sri Lanka, Mozambique, Iraq and Afghanistan.

BETH HEMMING, “It was medicine in occupational therapist the raw,” he says. “There (bottom right) were certain physical “It would be very exciting risks. I’ve been shot if a film comes off. at a number of times.

Who will play me?

Sometimes, in Jennifer Lawrence.”

Afghanistan, they do it for fun. On two occasions ELEM NNACHI people got blown up in neonatal nurse front of me, stepping on “I used to make films in mines. Several of my Nollywood, the Nigerian friends have been blown film industry, so maybe I up that way, and lost should play myself.” limbs, some killed.” reference point when Was he able to considering showbusiness. The EDDIE CHALONER operate and save those white noise of the crowd at vascular surgeon who had been injured?

Wembley reminded him of the “I’ve had lots of “Yeah. I took their legs wind screaming past his ears suggestions from my off, but they didn’t die.” as he made a freefall from a mates. The kinder ones The attraction in this paratrooper plane at 12,500ft. include Damian Lewis or work was, in part, a A Bridge Over You was not Tom Hardy. Peter Kay, young man’s desire for the choir’s first single. In 2013 Johnny Vegas or Timothy adventure. “And part of they recorded a song with the Spall are more likely.” it was altruism, in a rapper Question Musiq, as part modest way. I was a of a campaign to save doctor learning my Lewisham’s A&E and trade, and I thought it was important to maternity units which were earmarked for contribute to places where, even with the closure. The choir does not make explicit modest skills I had at that time, I could political statements, but their rise has make a hell of a big difference to people.” coincided with a general anxiety about the Chaloner spent 10 years as a doctor in the future of the NHS, and the noise and heat of British army, having joined 144 Parachute the junior doctors’ strike. The video for A Squadron, and was deployed to Rwanda in Bridge Over You, viewed more than one 1994, Bosnia in 1997, and Kosovo in 1999. “I million times on YouTube, concludes with a loved that because it was a perfect quote from Aneurin Bevan, the Labour amalgamation of physicality and intellect.” politician and architect of the health He retired in the early noughties with service: “The NHS will last as long as their the rank of major. His military service is a are folk left with the faith to fight for it.”

The choir is your team. And you can’t let your team down So should we regard their repertoire – all those soft-focus expressions of kindness and keeping-on-keeping-on – as protest songs of sorts? “I’m not sure I’d call them protest songs,” laughs Ejimofo, who was heavily involved in Lewisham’s successful anti-closure campaign and spoke last year at the Bring Back The NHS event, hosted by Sir Ian McKellen. “What we’re about, as a choir, is expressing how much the ethos of the NHS and caring for our patients means to us.

It’s not a protest. More an advocacy. I’ve seen medicine practised elsewhere – in Nigeria, where it is not well funded – and I want to strongly advocate how great our National Health Service is. It’s a precious thing.”

Transcending politics, the truly moving aspect of the NHS Choir is that what they evoke with their mingled voices – empathy and the human spirit – is the same as what they express in their daily work. The precision of a scalpel incision, the gentling of an ill child, the cradle to the grave: this is what we can hear when they sing. Medicine is their calling; music merely expresses that.

“We’re not going to leave our bedpans behind and become pop stars,” says Eleme Nnachi, laughing. “I’m a nurse. This is me.”

YOUR HEALTH HERO

Tell us about the inspiring people making a difference in the world of health. + HEALTH l Send your nominations to HERO behealthy@benenden.co.uk

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INSIDE STORY

Return of the White Death We think of tuberculosis as a disease of the past, but the condition that sparked Benenden’s founding is once again a threat in parts of the UK WORDS FIONA JEROME

W

hat do you think when someone mentions TB? Literature offers visions of writers and artists dying picturesque deaths from consumption, or the White Death as it was romantically know. Or perhaps you think of mountain sanitoriums, with pale patients sitting on verandas in the 1920s and 30s, bundled up to take the clear alpine air. What you almost certainly won’t think of is a disease on the rise in the UK today.

Tuberculosis is much more common in the UK than most of us realise, with 6,520 new cases diagnosed in 2014, and an increasing number of people presenting with a drug-resistant form of the disease.

Around the world it kills 1.5 million people every year – more than HIV/AIDs. And yet it rarely makes the headlines.

At current rates of infection, the UK will soon have more TB cases than the whole of the USA. TB clinics in London already tackle more cases each year than occur in all the other European capitals put together and in October 2015 it was announced that TB infection rates were higher in parts of London than in Rwanda, Eritrea and Iraq.

Other conurbations – including Leicester, Birmingham, Manchester, Luton and Coventry – are at the top of the infection

charts. Around 5,000 of the cases reported each year are among people not born in the UK, but few of those are recent migrants.

Because of improved screening fewer people with TB are coming into the UK from abroad. With a World Health Organization (WHO) campaign to find better vaccines and tackle TB worldwide, hopefully this will have a beneficial effect on UK rates as well.

However, the rate of infection among UK-born residents is not going down at all.

One hundred years ago TB was a usually deadly disease that everyone was aware of – 300,000 people suffered from TB in the UK at end of the 19th century, with just 500 free hospital beds available to treat them. It was particularly common in industrial cities where workers spent long hours close together.

In 1905 Benenden was established as a mutual society to provide affordable treatment for postal workers suffering from tuberculosis decades before the creation of the NHS. Its first sanatorium, which gave it its name, was opened at Benenden in Kent in 1907. There, workers who had paid a modest subscription were able to benefit from rest and fresh air.

TB is commonly thought of as a disease of the lungs, but

it can affect other parts of the body, including the glands and nervous system, and can cause meningitis. Most forms are treatable with a six-month course of antibiotics, but for those who don’t receive treatment, TB can be deadly.

Although TB was in decline throughout most of the 20th century, thanks to new

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19/07/2016 11:31

While usually affecting the lungs, tuberculosis can cause problems in other parts of the body

Ten TB facts

Visit the Benenden website at bit.ly/TBtenfacts

treatments and the discovery of antibiotics in the 1950s, it began increasing again as early as the 1980s, and rates of infection carried on rising until the mid-2000s, by which time the UK had the second-highest rate in western Europe. If you live in rural areas there’s very little chance of your coming into contact with the disease, but in some areas it’s a much more common, and often hidden, menace.

So what’s to be done? In January 2015 NHS England announced a £11.5 project to eradicate tuberculosis through better screening and earlier identification and diagnosis. At the time Professor Paul Cosford, director for Health Protection at Public Health England, said: “TB should be consigned to the past and yet it is occurring in England at higher rates than most of western Europe. This must be reversed.”

One of the problems is that it can take up

TB infection rates are higher in parts of London than in Rwanda or Iraq to two years for symptoms to appear, and then months for symptoms to be recognised and treated. If asked to name a symptom most people would probably say coughing up blood, but this is usually preceded by several weeks of a persistent cough, symptomatic of a lot of other problems, along with several other multi-diagnosable traits such as weight loss and lack of appetite, night sweats, tiredness and running a high temperature.

For many of us TB is something that was

‘cured’ years ago, so it doesn’t occur to us that that nagging cough and fever are anything more than an annoying cold that won’t go away … TB is all too easy to overlook because it’s not the obvious diagnosis, because people now think of it as a developing-world disease if they think of it at all. But it’s out there in our towns and cities and, despite our best 21st-century efforts, the number of sufferers in the UK is still increasing, year by year.

Globally TB has been recognised by WHO as a massive threat, and one that can travel the world as populations migrate. While it is unlikely to ever reach the levels of infection that prompted the founding of organisations such as Benenden, TB remains a danger; and it is all the more dangerous if we continue to think of it as someone else’s problem, or a disease that couldn’t affect us or those we love. www.benenden.co.uk 41

40-41 inside NEW.indd 41

19/07/2016 11:31

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BEN-ZAU 08/07/2016 14/07/2016 09:51 15:24

Y ourBenenden i ] Getting more from your membership

Conference amends the rulebook This year has been a big one for Benenden. At our annual conference, held in Brighton this summer, members voted to amend the rules, modernising and reflecting changes in the society.

When the society was founded 111 years ago, the first rulebook included a simple regulation, the management fund rule, defining that a percentage of every member’s subscription would be allocated to running the society.

The rule was there to reassure members that their contributions would be used effectively and that not too much of it would be taken up in the cost of management. There was little cost in running the society in 1906 so the percentage was set at 15%.

More than a century later, the society is in transition. It is moving into areas such as travel and home insurance – necessary to keep the mutual fund alive. There are costs associated with setting up these ventures, so the management fund rule

was no longer pertinent. We needed a new rule to suit a modern business.

A branch working group, made up of volunteers, set up to look at the problem came up with a very Benenden solution, which was presented to conference in Brighton.

Members then voted to replace a very old rule with a modern rule that fitted our business in the 21st century.

This new rule, titled Society Expenses, includes all the areas of our business that should be taken into account. The percentage limit for managing the society was also raised and will be based on a three-year rolling average, allowing flexibility to cover peaks and troughs.

Most importantly, the society’s expenses will be reported to conference every year so members will be able to see clearly where their subscriptions have been spent.

René Fraioli Society secretary

Members vote at conference in Brighton

Challenges ahead for Benenden

PETER BYRNE

Conference sanctions major changes Members debated the future of the mutual society at its annual conference amid one of the most exciting and challenging periods in Benenden’s 111-year history.

This year has been mostly concerned with consolidation as the society rose to the challenge of difficult market conditions following a successful 2015. That financial

climate notwithstanding, Benenden has improved its core services; launched travel, home and corporate health insurance for small businesses; and redeveloped Benenden Hospital.

The society’s net assets have grown by about 30% while it has made these investments, and conference heard how external factors have been both a

challenge and an opportunity for Benenden.

The pressure on the NHS has started to have an impact, with members sometimes struggling to get a quick diagnosis and

treatment. As members accessed more Benenden services, the society’s surplus would be reduced, which will require careful management as the mutual looks to the future. www.benenden.co.uk 43

43 YOUR BENENDEN.indd 43

19/07/2016 11:40

Our special thank you to you as a reader of BE

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British nationals require a passport valid for a minimum period of six months from the date of entry to the United Arab Emirates. You will be issued with a free 30-day visa on arrival in the United Arab Emirates. Other nationals are recommended to apply to the Embassy of the United Arab Emirates for details of the entry requirements that apply to their country.

Please note that travel times might vary due to flight schedule changes. * Plus room tax surcharge in the dream hotels City Seasons Towers and Al Hamra Village Golf & Beach Resort currently 15 AED (approx. £3) per room and per night (as of May 2016). A deposit of 20% of the tour price is payable upon receipt of written booking confirmation. The remaining amount must be paid 80 days before departure. The price applies from 20 to 27 September 2016 and on 13 June 2017 from Manchester. For other travel periods, seasonal price increases apply as listed in the flight schedule. # Holiday price increase p. p.: £150. This tour is exclusively available for individual travellers and is valid only for the booker plus companions. The travel conditions of RSD Travel Limited apply. These can be requested from the travel hotline or viewed at www.rsd-travel.co.uk. Subject to misprints and changes. The photos show typical examples of what you can expect from our hotels. This trip requires a minimum number of 20 participants per travel date.

1 Price example was calculated on 13 May 2016 for the travel dates 27 September to 04 October 2016. Flight from Manchester to Abu Dhabi on www.expedia.co.uk, transfer airport – hotel – airport on holidaytransfers.com, hotel Grand Millennium Al Wahda, City Seasons Towers, Fairmont Ajman or The Ajman Palace on www.booking.com. Excursions „The Palm & ATLANTIS Hotel“ and „Sharjah Culture Capital“ on www.desertsafari.godubai.com.

2 RSD Travel Ltd. and RSD Reise Service Deutschland GmbH belong to a European group of tour operators that organises tours for customers from a number of European countries. The survey focused on tourists who travelled to UAE with RSD in 2013/2014. These comments were made by customers who have travelled with our group of companies.

All the flights and flight-inclusive holidays in this brochure are financially protected by the ATOL scheme. When you pay, you will be supplied with an ATOL Certificate. Please ask for it and check to ensure that everything you booked (flights, hotels and other services) is listed on it.

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14/07/2016 11.07.16 08:05 10:22

YOUR BENENDEN

Ted Elsey chairs his final Benenden conference

5 KEY DECISIONS How Benenden members voted at Conference 2016 Members’ monthly contribution rate will rise to £9.10 from 1 April 2017 – an annual increase of £4.68 – to combat a broader medical inflation rate of 6-8%

Voters embrace change Conference approves reforms as chairman bids farewell Benenden should evolve confidently but carefully during tough economic times. That was the message from the society chairman as he took a bow at this year’s Benenden annual conference.

Ted Elsey, who is retiring after five years as chairman, said that while the society had grown commercially during 2015, it was also feeling the impact of an NHS under pressure.

He said 2015 had been “a good year for the society, in financial terms and in terms of what we provided for our members”. He also assured delegates that 80% of Benenden’s activity would

be focused on “our core membership contribution to business, to provide benefits £9.10 from 1 April 2017 – an to our 900,000 members annual rise of £4.68 – and and nominees”. offering discounted selfHe added: “We are helping funding services at approved more members than ever regional hospitals across and that’s what we are the UK. about. That’s the Delegates also important thing.” voted in favour of Around 250 Benenden delegates attended considering any the conference at opportunities within the Brighton the fields of primary Metropole Hotel in June, care and GP services.

The Brighton where members had the Metropole Hotel “The healthcare chance to get together landscape continues before the business of debating to change,” said Ted Elsey, and voting. “and the society should look Motions passed included closely at the opportunities increasing the monthly that might afford.”

Opportunities within the fields of primary care and GP services are to be considered as the UK healthcare landscape continues to change Guidelines for discretionary funding support are to be reviewed within a year to ensure members are not disadvantaged according to their location Discounted self-funded services offered at Benenden Hospital are to be made available at approved regional hospitals Healthcare procedures being provided by partner organisation Bupa are to be reviewed

by Conference 2017 Kelly and Martin Turner

Membership

Appeal wins national attention

PETER BYRNE

Bid by Benenden members to fund treatment makes news A campaign by Benenden members to raise £1m so that their teenage daughter can have the chance of life-saving cancer treatment in America has won national attention.

Martin and Linda Turner have appeared in the UK media to appeal for funds so 16-yearold Kelly can travel to the USA for surgery. So far more than £73,000 has been raised.

They launched their appeal on Facebook after learning nine rounds of chemotherapy

had failed to control Kelly’s desmoplastic small round cell tumours.

Martin, a civil servant with Border Force, said: “Because there are tumours close to her liver, [the hospital] are not prepared to carry out surgery.

Without it Kelly may well only

live for two years if she’s lucky. We have to try everything for her.”

For more on Kelly’s story visit crowdfunding. justgiving.com/kelly-turner

www.benenden.co.uk 45

45 MEMBERSHIP Conference.indd 45

19/07/2016 11:42

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14/07/2016 10:22

YOUR BENENDEN

Contact Benenden Membership and service enquires 0800 414 8100

Recommend Benenden

Registered office

Pass on the recommendation cards included in this edition of Be Healthy

(Lines open 8am–8pm, Mon–Fri)

Your three-step guide to contacting us when you need help with obtaining a diagnosis or treatment

Benenden, Holgate Park Drive, York YO26 4GG

24/7 GP advice line 0800 414 8247 Round-the-clock medical advice from a qualified, UK-based doctor is just a phone call away

Psychological wellbeing 24/7 helpline 0800 414 8247 If you’re feeling overanxious, a qualified therapist can offer information about local services that can help with issues such as money worries, relationship problems and bereavement

1 2 3

First of all, you will need a referral from your GP. You will already have explored NHS waiting times.

If you’re unable to wait for the NHS, ask us if Benenden could assist you.

Health concern support 0800 414 8100 (Lines open 8am–8pm, Mon–Fri)

Independent care advice services 0800 414 8100 (Lines open 8am–8pm, Mon–Fri)

Add family to your membership 0800 414 8470 (Lines open 8am–5pm, Mon–Fri)

IN FOCUS

Physiotherapy service can help recovery Are you suffering from a physical injury or worsening condition? As a UK resident, you can access Benenden’s physiotherapy service after you have been a member of the society for six months.

The service involves being assessed by a qualified

physiotherapist who will decide if you need face-toface physiotherapy or self-managed exercises.

If they recommend selfmanagement, they will provide a course of exercises to assist your body’s natural healing processes for the

fastest possible recovery.

They will stay in regular contact by telephone to provide support.

If they decide on face-toface treatment, we will arrange for you to attend one of more than 700 Rehabworks accredited clinics.

Call 0800 414 8247 to discuss access to our physiotherapy service www.benenden.co.uk 47

47 CONTACTS.indd 47

14/07/2016 12:59

Unless you have a red flag symptom, you might be better off with a dog Stage 2 maths it will leave hospitals with crippling debts and reduced services. I’m particularly fond of “I love the NHS but it has to change”. The only change that would make the NHS loved by politicians is if it were taken off the balance sheet completely.

4. The NHS is really rather good It has had its scandals, but overall – and for the percentage of GDP we put in – it compares well to other systems. No health service can deliver the highestquality care to all its patients at all times. If we keep beating it up, though, we won’t appreciate what we have until it is gone.

You can’t have a first-class NHS with third-class funding.

Ruff treatment

Five things I wish I’d known before becoming a doctor

Backchat Dr Phil Hammond ILLUSTRATION JASON FORD

1. You can be better off relying on a dog than a doctor More than half of symptoms are medically unexplained and 90% of them get better in time. Unless you have a red flag symptom of something serious, you might be better off with a dog than a doctor. Dogs are always happy to see you. Dogs don’t mind if you get their name wrong. Dogs don’t mind if you don’t take your tablets. Dogs are delighted if you forget to wash. They love it when you bring a sample. And you can wrestle on the carpet with a dog without getting arrested.

When did you have that much fun with a doctor?

2. During a home visit, don’t assume the dog that follows you in belongs to that house Avoid kneeling down by the sofa to examine a patient without looking. You’ll nearly always kneel on a wet patch left either by the patient or the dog that isn’t his.

3. Politicians lie Indeed we all lie, it’s just that politicians do it for a living.

They say the NHS is not for sale then sell it off little by little.

They claim the private finance initiative represents good value for public money when it’s obvious to anyone with Key

5. Healthcare doesn’t run like a business For the last 30 years we have been trying to run the NHS like a business, when it doesn’t behave like one. Thanks to the NHS, as well as improvements in public health and wealth, we are all living longer with diseases that would previously have killed us.

So the more successful the NHS, the more its customers cost it and the more it goes into the red.

Which is why hospitals are having to restrict services now.

Unlike in business, in the NHS there are no profits to be made unless you want to take money away from patients, which goes against everything the NHS stands for. As patients we need to pay for our NHS and participate in our care when we can.

Dr Phil Hammond is appearing in two comedy shows at the Edinburgh Festival Fringe, 5-27 August. Visit www.drphilhammond.com

48 Be Healthy Autumn 2016

48 BackChat.indd 48

14/07/2016 13:00

DELIVERING INNOVATION

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Let us look after the people you care about

£10 M&S gift card for every person you add† Our personal healthcare puts you and your loved ones first The community that cares Benenden understands that caring about someone means caring about their health and wellbeing too.

That’s why, as a Benenden member you can add family and friends to your membership for the same low rate of £8.71 per person, per month.

We make it easy to care We don’t limit the number of people you can add to your membership. No matter what their age is, there is no medical, no excess to pay and no lengthy forms for them to fill in - just straightforward discretionary healthcare that puts your loved ones first.

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0800 414 8157 www.benenden.co.uk/benaug16a quote BENAUG16A

Some services have a six month qualifying period. †£10 M&S gift card for every new nominee added to an existing membership, quoting BENAUG16A at the point of join. To qualify for the incentive applications must be received between 9th August 2016 and 16th September 2016 and all new members must remain with Benenden beyond the 14 day cooling off period. Gift cards will be sent via post within 52 days of the new member joining. You must be a current member at the point gift cards are sent. Gift cards offer applies to people included in this promotional mailing.

Offer subject to availability. No alternative to this promotion will be offered. Please note that your call may be recorded for our mutual security and also for training and quality purposes. Lines are open 8am – 5pm, Monday to Friday (except Bank Holidays). Membership is available to anyone over the age of 16 who is normally resident in the UK. Members can add family and friends to their membership regardless of their age. Benenden is a trading name of The Benenden Healthcare Society Limited and its subsidiaries.

Benenden personal healthcare is offered by The Benenden Healthcare Society Limited, which is an incorporated friendly society, registered under the Friendly Societies Act 1992, registered number 480F. The Society’s contractual business (the provision of tuberculosis benefit) is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. The remainder of the Society’s business is undertaken on a discretionary basis. The Society is subject to Prudential Regulation Authority requirements for prudential management. Registered Office: The Benenden Healthcare Society Limited, Holgate Park Drive, York, YO26 4GG.

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14/07/2016 10:23