Episode 1 - Setting the scene

Welcome to Wild Card – Whose Shoes! Walking in the shoes of more interesting people 😉 

My name is Gill Phillips and I’m the creator of 'Whose Shoes?'  a popular approach to coproduction and I am known for having an amazing network.

Building on my inclusion in the Health Services Journal ‘WILD CARDS’, part of #HSJ100, and particularly the shoutout for ‘improving care for some of the most vulnerable in society through co-production’, I was invited to provide thoughts and ideas for the new NHS CEO, Amanda Pritchard, so here I am .... with a little bit of help from my friends.  I will be chatting to a really diverse group of people, providing a platform for them to speak about their experiences and views.

If you are interested in the future of healthcare and like to hear what other people think, or perhaps even contribute at some point, ‘Whose Shoes Wild Card’ is for you!

Today, I set the scene, talking about some of my own insights and experiences, some examples of topics we will be covering and people I'll be talking to - including an extract of my chat with Dr Farzana Hussain, GP of the Year 2020, and my special guest for Episode 2!

Find me on Twitter: @WhoseShoes and @WildCardWS.
Dive into https://padlet.com/WhoseShoes/overview and nutshellcomms.co.uk  to find out more about the #WhoseShoes approach to coproduction.

Artwork aided and abetted by Anna Geyer, New Possibilities  www.newpossibilities.co.uk

Supporting resources:
'10 Leaps Forward - innovation in the pandemic' : NHS Coronavirus Report_A4_R6 (lsbu.ac.uk)

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I tweet as @WhoseShoes and @WildCardWS and am on Instagram as @WildCardWS.

Please recommend 'Wild Card - Whose Shoes' to others who enjoy hearing passionate people talk about their experiences of improving health care.

Transcript

Gill Phillips: 0:16

Wild Card. I couldn't believe it when I was announced as an HSJ 100 Wild Card. Who is it that the new chief executive of the NHS should be listening to. Apparently it's me. And then I thought about it. I have a fantastic network and could be a catalyst for people whose voices really need to be heard. How could I do that, I could set up a podcast series. My name is Gill Phillips, and I'm the creator of Whose Shoes, a popular approach to coproduction. I'll be chatting with people from all sorts of different perspectives, walking in their shoes. If you're interested in the future of healthcare, and like to hear what other people think or perhaps even contribute at some point, Whose Shoes Wild Card is for you. So hello, and welcome to the very first episode of Wild Card Whose Shoes. Each week, I'm going to be talking to different guests. A really great mix of people from all different perspectives, which is the central concept of Whose Shoes. But today, before I get chatting to my guests I just wanted to jump in and share a few thoughts of my own. Perhaps give some insights into why I created Whose Shoes and why I'm now moving on to this podcast series, and thank you so much for all the support that I've had since I first set up Whose Shoes in 2008. 13 years ago. Wow, where did that time go. I must say, I've taken a leaf out of the book of my big friend FabObs Flo. So this is Florence Wilcock, a consultant obstetrician who co-founded#MatExp, maternity experience, project and campaign with me. If you haven't heard about #MatExp, where have you been? Don't worry, you will do soon. At the start of the pandemic Flo started an incredibly successful podcast series herself around improving maternity care, and that's called The ObsPod. I really recommend it. I've been blown away by seeing how much Flo clearly loves making her podcast. So again that's encouraged me in this space and I just want to chat with people who are passionate about improving healthcare, but the wider sense of health, wellness, not just illness, which will be another key feature of this series. I've got a fantastic network, and I love linking people up. It's just so fantastic when you know that certain people would just get on together and make even more I'm hoping that lots of listeners will have an things happen. intentional coffee. This is something I set up recently with Dr. Mary Salama, a wonderful paediatrician in Birmingham, and I'm hoping that another benefit of this podcast series is that people will want to connect with some of the podcast guests, and that these speakers in turn will want to connect with each other. It's going to be quite a party. This is already happening from the early episodes that we've been recording. I think it will really help build energy for positive change, and help people make great connections. It's going to be fun. I guess the podcast series is really a natural extension of my Whose Shoes work, which I know that some of the people listening will be familiar with. I'm going to write some programme notes so I'll share a link to my Padlet there for anybody who wants to find out more. The approach is now being used in about 80 NHS Trusts in the UK, and many other organisations including internationally. So basically, I've created a board game that looks at issues from different people's perspective, that is Whose Shoes, and I guess with my Whose Shoes brain I see tensions that exist between things and how powerful it can be bringing people together. Everyone, no hierarchy just people. So we work with people with lived experience, the staff of an organisation, the family carers and basically break down barriers, creating the conditions for them to come together and relate to each other as people. And then the magic happens. And then they can come up with solutions together, and that's coproduction. We're going to be talking in the podcast series about people and organisations living their values. So say for a big organisation like the NHS it's all very well us clapping our heroes, but people give so much. We really mustn't take them for granted, and nor must organisations and governments, and this works in all directions. So for example if a key leader goes off sick, as well as going round to reallocate their responsibilities which is obviously critically important, we need to care for them. During the pandemic I've heard the most amazing stories of teamwork, fantastic support for individuals, but I've also been saddened to hear of people who've perhaps worked for the NHS for 30, 40 years, going off sick, and then perhaps going on to retire and saying that they just felt they disappeared. Nobody even sent them a card because it had been a few months after they'd been at work. People remember how they leave an organisation, that's important for the rest of their lives. They remember how they were treated staff and patients alike, we all do. Maya Angelou said, people will forget what you said, people will forget what you did, but people will never forget how you made them feel. So we'll be talking to people doing wonderful work around compassionate care, and how to make it real for staff and patients alike, even when you're busy and really under pressure. I suppose my vision with Whose Shoes has been to try and join everything up. It's been a crazy, daunting vision really, and I guess I didn't really know that when I first set up Whose Shoes all those years ago, but it's evolved. I've seen that the key themes across our work are just so similar. Whether we're talking about improving dementia care or maternity care, subjects that seem so different, it sounds like a cliche really but it's people united in vulnerability, wanting the same things. Obviously everyone's an individual, unique. Personalised care is really, really important but everybody wants good communication. They want information in a timely and relevant manner. They don't just want to be overloaded with a pile of booklets for example. I remember when my own dad had heart problems we'd come away with about a dozen booklets, and then at the next crisis, we'd be like, given the same ones again. For me, this just felt lazy really, an easy way out, but people in these circumstances are overwhelmed and overloaded. I know we were. The stories that come through so powerfully, I find, are when somebody really took the time and effort to support you and to get the help that you needed at a particular time, rather than just give you a pile of stuff. So ... so we'll be talking about pathways, signposting, care navigation, you name it, but hopefully trying to avoid this jargon or no doubt discussing it, as I have a BIG thing about language. The difficulty, or sometimes to be honest, the sheer impossibility of navigating your way through the care and support that you need or obviously somebody that you're caring for, is probably one of the things that's come through most strongly in our Whose Shoes work. And what about not reinventing the wheel. I'm always really keen on sharing best practice. I've come across a trust recently doing really great work around helping parents know what to look for during the first 1,001 days of their child's life, and how to get support from antenatal through to age two and hopefully it looks as though it might be expanded in future up to school age. There's just so much information around that anything that can help distil it for you, is priceless. This work is so valuable. How can it be shared more readily between trusts, so that if someone does do great work, others too can benefit. I've seen a big shift in this over the years that I've been working on Whose Shoes, which is great. People used to be, I'd say even more territorial, but now initiatives like Fab NHS Stuff, and the beneficial changes network, encourage people to share good practice more. But there's so much more scope. For example we have three booklets of case studies around improving maternity care. They're gold in terms of easily transferable, adaptable best practice, but who's really helping us to share them? Who helps us distribute them and get them out there to the widest audience? Where is the repository of really good stuff? And if it exists who knows about them? And the biggest test of all, sometimes, is whether the general public know about them. They generally don't. The things that really help are not always obvious but they become obvious if you talk to people. How many hospitals for example, really think about the needs of parents with a child who's in hospital, sometimes for months. Being able to access healthy meals, for example, at an affordable price. I suppose what frustrates me is when I see that people are crying out for certain things, and those certain things exist. So for example, peer support or some practical help and the frustration is that there isn't a better system of actually joining things up. It's not necessarily about coming up with something new, it's about making the most of something that's already there. For example within the community, you see the projects that start and do wonderful things with practically no resources, and then funding moves on and they're constantly struggling with stuff rather than actually getting on with what they're good at. I mean I've actually got a friend, someone I've worked with who she just comes up with good ideas, really good ideas, and then she gets somebody else to put them into management speak so that they tick the boxes that they need with the buzzwords to get the funding. Now what, what's that about, it's a complete waste of time and money and effort and, you know, it's just depressing but that's the kind of system that we're living in. So these are the kinds of people that I'm hoping to talk to in the podcast series just grassroots people doing great stuff, people who are in a position of power who can influence stuff. Bob Webster, an NHS leader in Yorkshire, is leading the way, I think, in terms of, he's leading one of the biggest integrated care services, but I know he really focuses on people. I was on a lived experience session the other day with NHS England and a spontaneous, we need to clone Rob Webster campaign seemed to be building up. But unfortunately, obviously we can't clone individuals however good they are. We need to nurture talent everywhere. Lots of people have talent. If organisations can be flexible and encourage people to use their talents widely, rather than being locked into over prescriptive job descriptions, then we'll all benefit as passionate people just add so much. Now what we do for our Whose Shoes workshops is tap into that passion and discover it, we kind of sow the seeds throughout the workshop that people have come along, not just because they want to improve care, but because they individually are passionate about something. It might be something quite small or quite specific. We've got JFDI the polite version is Just Do It. We try and encourage people to feel that they can actually do something without asking for permission. And then they make pledges, and then people support them with those pledges because perhaps they've got that same shared passion or we can link them with somebody across the country. And this is where social media comes in so strongly, and then people feel so good, they feel rewarded that they're actually making a difference, rather than perhaps complaining that everything's just too big and too difficult. Leadership in health care is just so important and so interesting. I think the kind of leadership that I like is where people create the conditions for staff to do what they do best and to build the relationships that they need. So, again, it's all about networks and I'm hoping to build this through the networks that I've got of passionate people wanting to take part in this podcast series. I came across Professor Donna Hall at a webinar recently and she said a basic rule of leadership is to recruit people who are much better than you. Well I love that. How many people have got the courage to do that? So there's a lot of fear around. I mean I find with Whose Shoes that sometimes people in positions of formal power, it feels as if they love it, until they hate it because they talk about coproduction and coproduction is a big, big buzzword at the moment, and I'm really hoping that things move on that it does become the default position of the NHS, which is what's being aimed for at the moment which is fantastic. But when I get somebody approach me and they asked for a coproduction workshop to deliver a particular outcome, then the alarm bells go because the best coproduction, the outcome isn't clear, people work together to determine what that outcome is. And that's the magic. I'm hoping that the podcast series can really get some interesting conversations going around equalities and inequalities and some of the things that have sadly come to the fore so much more prominently during the pandemic. I think there's a big challenge for the NHS, not medicalising things such as poverty; getting behind the stories of people. If somebody is smoking, for example we found this through our maternity work, they know that smoking's bad for them and particularly in pregnancy, but telling them that isn't necessarily helpful. Somebody on the other hand, who takes an interest in their life, listens to their story, realises what's going on at home and how perhaps smoking is one of the few things that's actually making their life, you know, relieving the stress a little bit, and then looking at how they can help them as a person is far more useful. Innovation. It's hard to do innovative stuff. I know this through Whose Shoes. It's such an uphill battle. One of my favourite cartoons is where two people are talking and one says"this is a really innovative approach, but I'm afraid we can't consider it. It's never been done before". So much innovation has happened spontaneously during the pandemic. Let's hang on to it and let's build it, rather than let the stranglehold of bureaucracy take over again. I was thrilled to run a series of virtual Whose Shoes sessions during the pandemic. It just grew - it was very organic in terms of trying to share best practice. I think a big part of my work is sharing best practice. It's so much more positive to say, well, so and so is doing this and so and so is doing that rather than concentrate on what we can't do, and hopefully the momentum then builds that people feel that they can do things as well. It's interesting now looking back at some of the things that we've done through the pandemic and some of the 'Building the future' poem, I use poems a lot in Whose Shoes so I'm hoping to include those in some of the podcasts as well. It felt quite optimistic you know this spontaneity that was growing with communities jumping in and doing what was necessary, clinicians working closely as teams. Our mantra that we've had for a long time - no hierarchy just people. And then wondering whether, as Professor Becky Malby says, the old system just bites back, and I was really impressed by the 10 leaps report that Professor Malby published early in the pandemic. This is the sort of work I'd like to see embraced quickly and supported. Becky came up with the idea of a festival of ideas, but sadly I'm not sure it's gone anywhere. So how do we really support the innovators, the entrepreneurs, the forward thinkers. At every Whose Shoes workshop, we see the lemon light bulbs as people realise that they too can actually make a difference. It's liberating and it leads to extraordinary things. This is where we say the magic happens. Often they're just the small things but the small things add up and, in patient experience, very often the small things are the big things. I've been thrilled to see the 'What matters to you' campaign take off. I think Whose Shoes is always focused on what matters to you, and I've had some fantastic mentors in this respect. I'd like to give a shout out to Dr Sam Majumdar in Scotland. Sam has been a bit of a mutual mentor to me and we've become great friends. Initially I was mentoring him around social media and, to be honest, he was mentoring me around life and building Whose Shoes, in terms of having the confidence to go where the energy goes and to believe. So much of what I do is about finding and working with the right people, and I guess this is where this amazing network has come from. And to have the, I don't know whether it's courage or belief really, to drop things if they're not going in the right direction and it's becoming I'm getting drawn into stuff. And to follow the people who are really energetic and vibrant, and will really you know if I work with them, it will lead to really positive change. I want to give a voice here to people with lived experience, to family carers. I want people to hear their stories and to hear why it matters. One particularly illuminating perspective is people who have lived experience, who are also healthcare professionals, or indeed, if you turn it around healthcare professionals who are also patients. It seems they're generally far more listened to they introduce themselves as healthcare professionals, rather than people with lived experience where they can be patronised or dismissed as too emotional, or uninformed. Why is this, I'll be talking to people who can tell us more.

Farzana Hussain: 19:01

In terms of any advice that I've got for Amanda Pritchard, who I'm now delighted has been appointed as the new chief executive of the NHS, I think a key challenge for the NHS is around wellness, and how the NHS, given that obviously it's got limited resources, can be part of people's whole lives, and not just when they're ill. So that understanding the importance of good health, and for us all to build healthy habits into our lifestyles, obviously that saves the NHS, we've all heard about saving the NHS during the pandemic, but I don't think people have really understood yet the need for all of us to take personal responsibility for our own health. And obviously we'll all get ill at some point, I mean I myself have had cancer, but I suppose what fascinates me is the role of communities and supporting all these different organisations and volunteers who have stepped forward during the pandemic, to actually make a difference and not just be sidelined outside of the main beast if you like.

Gill Phillips: 20:04

I'd absolutely love the conversations to be organic, to discover lemon lightbulbs as we go along, and to link between the different episodes, perhaps to get participants to ask each other questions. I think there's a lot of scope to use the slightly quirky, unusual methods that we've used through our Whose Shoes approach, that being the combination of workshops and social media and the wider aspects, and to bring those into the podcast series and hopefully make it something that people will listen to on their way to work or kind of relaxing chatty, thought-provoking material conversations. So who are we going to be talking to, well, we're going to be talking to volunteers and pioneers, people sharing hopes and fears, medical photographers, teachers and sonographers, a wide range of clinicians - midwives, obstetricians, surgeons and oncologists, professors, and biologists, community leaders, university readers, porters, receptionists, government officials, public health gurus, nurses and students, old people and young, researchers, policymakers, movers and shakers- I'd better get started. I've only just begun. So as you've probably gathered I could go on but I'm hoping this podcast has given you an idea of the kind of issues that I'm interested in, and the type of people that I might be talking to. I don't pretend to have all the answers, obviously, but I do believe that collective wisdom is there, and that hopefully creating a space for more people to have a voice will be valuable. So, coming back to the original brief really, what messages have we got for Amanda Pritchard who's now the chief executive of the NHS. I was interested that her predecessor Simon Stevens said that listening deeply was his number one advice, I think you'll love the first podcast guest, Dr Farzana Hussain telling you about being curious and the conversation we had about her vaccination programme and how it was enhanced by actually getting into the shoes of her patients, finding out what it is that they're, they're frightened about, listening to people and what matters to them. And Farzana and I got talking about Amanda Pritchard, and I was thrilled to hear that Farzana has met her, so listen to the clip here.

Farzana Hussain: 22:33

We were talking before we came on were'nt we about what would you say to the new CEO of the NHS and of course now we know it's Amanda Pritchard and I had the privilege of meeting her before the pandemic. I was fortunate to be invited to a roundtable event on ICS and she was just so lovely she was just so like I went and said hello and she was just so down to earth it just so just normal and lovely so I think we're very fortunate to have her and obviously, the first woman to run the NHS, it's fantastic. But if we're really going to think about the wellness agenda now, we have to do exactly as you say we need to think about what can we put in and it doesn't need to be NHS, but those little interventions, I think, will have huge gains. And people around the country are doing it you were talking earlier about pockets of good practice, you know, I know in the northwest, you know, they've had mental health cafes for a number of years. And sometimes, if somebody just has one that's not a huge resource, but you might be actually saving somebody going into a psychiatric hospital years down the line, you know, you might not be, but you might be. And I think we just need to prioritise that as well because I think these are quite quick wins that aren't even particularly expensive. I think sometimes I understand when you're on a tight budget as obviously the NHS is, you probably think about your biggest spends but I wonder if we should also be looking overall and looking at the long term thing of if we keep these guys well, not only do we increase their quality of life, we'll probably save a lot of money as well.

Gill Phillips: 24:16

Lots to think about. I was reading a blog, I don't know if it's only come out today, but I read it today, Sam Allen has written a blog about the new chief executive and delighted that she's a woman, etc etc but that's only part of the story. And I was thinking you know I've set up this podcast series, specifically as a result of being named as a wild card, and the brief was basically people who'd have something to say to the new chief executive, I'm thinking, poor woman she's going to have her ears battered from every direction and whether she'll ever get a chance to listen to my podcast, but I think she'll gain something if she does. I think the three things mentioned in this article that she would need were - support, and time and resources, so we can all have all these fantastic ideas but she's only a human being as well and actually to run a service that's properly resourced and with the right priorities is key.

Farzana Hussain: 25:09

Definitely, support time and resources and that time is always something we feel very short of, and I think it's up to each one of us in the NHS to support her with that as well, you know, with the communication and the feedback, and then I guess someone like me who is a GP, seeing patients on the front line is then to also get that feedback from our community so it's a chain, isn't it, and because we do all need to do this together. It isn't like one person's issue, it's a whole society issue, and I think never more important now than the period we're in, living in a pandemic.

Gill Phillips: 25:45

So that's another key message do things together,

Farzana Hussain: 25:45

Do things together. Yeah, I'm really njoying these lemon lightbulb moments. Posi ive relationships, do things together, and certainly hat feedback we get from our p tients is pric

Gill Phillips: 26:04

I hope you have enjoyed this episode. If so, please subscribe now to hear more of these fascinating conversations on your favourite podcast platform, and please leave a review. I tweet as@WhoseShoes. Thank you for being on this journey with me and let's hope that together we can make a difference.