I’ve been feeling nostalgic this week as 60 years of independent television are “celebrated”, with several reports focusing on the BBC’s mostly successful attempts to push their competitor’s launch off the front pages by killing Grace Archer in a fire. For those who may be (blissfully) unaware of the Archers, it’s the world’s longest running radio soap opera, now on BBC Radio 4 and originally billed as “an everyday story of country folk”, now as “contemporary drama in a rural setting”.
My nostalgia stems not (I hasten to add) from my own memories of 60 years ago, but from family folklore: my grandfather, who had been controller of both BBC radio and television, was seen by many as the traitor who became a founding director of independent television. And so I often heard the story about the day the BBC scuppered his front page glory.
Yet this week, aged 90, Ysanne Churchman, who played Grace, has broken her silence, revealing that she was killed off because she demanded equal pay to her male colleagues. So, while the timing was probably cantankerous, there was perhaps an underlying reason why the soap took that turn.
Things not being quite what they seem has been in my mind recently for other reasons too, after a flurry of communications with researchers about patient and public involvement (PPI). It’s fair to say that while some folk are very clued up about and very keen to do it, others see it as a burdensome, vexing and rather puzzling addition to their daily workloads. They worry that it’s complicated, that it’s not really very important, and – essentially – that it can wait until a time when they are less busy. What they often don’t grasp is that while it is indeed complicated (though one day I’ll write a blog about how it can also be very simple.. you heard it here first) – it is arguably important in part because doing it may make them less busy.
The evidence for the impact of PPI isn’t great – we are working both to build a better evidence base while also taking part in the many and complex debates around just what sort of evidence we need versus just how much is common sense. But there are (perhaps drawing together the evidence and the common sense strands) pretty compelling reasons to just get on and do it, such as, for example, that clinical trials recruit better if you involve patients in planning them.
It’s no big deal really: setting up a trial that addresses patients’ concerns, agreeing with them knotty details like just how many hospital visits they will be willing to make during the trial, and then getting them to help explain the plans to other potential participants in language they will understand, can help a trial run smoothly. And at this point I feel like a character ought to leap out of a cake waving a wand with a flourish, but actually, put like that, it’s so simple and so obvious, it really needs no fanfare.
Researchers are coming slowly to understand and embrace PPI in all its – at times – glorious simplicity. As one wrote to me recently, about a patient day he had organised – it was “moving and tremendously informative.” Grace Archer may have burned in the barn, but Ysanne Churchman recalls that “On the very night Grace died, ITV started and immediately needed people with exactly my experience to voice commercials so I was able to make a good living from voiceovers for years.”
Perhaps as we see the slow but steady decline of the “researcher knows best” model of medical research, so we are all, professionals and patients alike, starting to find new and unexpected opportunities.