"It’s the best of times and the worst of times," says Lynda Thomas, chief executive of Macmillan Cancer Support, as she reflects on the charity’s latest annual accounts, published today.
On one hand, she says, survival rates for people with cancer are rising – half of all people diagnosed with the disease will go on to survive for at least 10 years – and new treatments and drugs are becoming available.
But on the other, the numbers of people affected by cancer "are getting more horrific by the day", says Thomas.
There are currently 2.5 million people with cancer in the UK, but this figure is expected to rise to four million in 2030 and to more than double to 5.3 million by 2040. One in two people will receive a cancer diagnosis at some point in their lifetime.
Macmillan was able to reach 1.9 million people diagnosed with cancer in 2018, up by 34 per cent on the year before. But its latest financial accounts show its income dropped by £17m as a result of a fall in fundraised income.
Thomas insists the dip is not the beginning of a downwards trend in fundraised income. But she recognises that the organisation needs to change fundamentally to meet the challenge posed by rapidly growing demand.
"It’s unrealistic to imagine that we can double everything we offer in the time we have available," she says.
Drawing on her experience as director of fundraising at the charity before becoming chief executive in 2014, Thomas recognises that the fundraising environment has shifted.
"I count myself lucky that, in my time as fundraising director, we were looking at 10 to 15 per cent income growth year on year," she says. "Happy days, but those days have probably gone now."
Instead, she says, the charity needs to look at a new way of doing things.
"Continuing to innovate is going to be the secret of success – and it isn’t just about whether we need a new running event or a new product; it’s about looking at the organisation’s strategy as a whole towards revenue generation or fundraising."
Innovation can be tricky in such a large organisation because changing systems takes time and, with so much money at stake, unsuccessful investments can be costly.
So Macmillan has a team that is able to take small-scale, calculated risks with a ring-fenced pot of money.
"Clearly, we’re a big charity and we’ve got to have rules around governance and fairly strict rationales around investing money, but enabling people to take educated and calculated risk in this area is going to be really important," Thomas says.
"We’ve put a number of products into the market this year and none of them has shown us the return we wanted to see. But you bet we’re going to carry on doing that because, if we lost our nerve and took that away, then we’d have no chance whatsoever."
The charity has also been using its corporate partnerships as both a source of income and a means of increasing its impact for a number of years.
Its partnership with the high-street chemist Boots is celebrating its 10th birthday and has so far raised a total of £17m. But it is primarily a strategic rather than a fundraising partnership, which trains Boots employees to offer specific pharmacy and beauty advice to people living with cancer.
The energy company nPower also sponsors a Macmillan advice team that helps people with cancer who are struggling with energy bills.
These dual-purpose partnerships with companies are indicative of "the way the corporate partnership model has got to go and probably the way the whole fundraising market has got to go", says Thomas.
"People will be co-creating things with us and looking at it in a completely different way. I think it’s really exciting."
Ultimately, she says, the charity has to accept that it can’t do everything on its own and will have to work alongside the NHS, the government and supporters to achieve its mission.
"We’ve also worked out new ways to work with people directly, such as through web chat and Facebook live," she says.
Digital communication – both with beneficiaries in need of quick and accessible support and with donors who want the easy and seamless online interactions they have with banks and retailers – is going to be key. And Macmillan, like many charities in the sector, needs to up its game.
"In the sector we’ve never had to be 10 out of 10 from a digital perspective," she says.
"It’s not our first language and I’m really keen to develop talent in that area at Macmillan better than we have done in the past. We need a whole new skillset in the sector to deliver that."
Ultimately, she says: "We can’t sit back and say ‘Look at us, we’ve been around for 100 years, look how great we are.’
"We’ve constantly got to be showing that to people and making sure we offer the best customer experience to everyone."