Series 2 Episode 4. Partha Kar. The super hero who made sure Type 1 diabetes technology was for everyone

Professor Partha Kar has made sure the technical advances in measuring blood sugar are available to everyone living with Type 1 diabetes in the UK.  Partha had to overcame massive hurdles to make sure the technology was not just available to a privileged few. He discusses with Maggie and Andrew his inspirational leadership style and philosophy that have helped him to move mountains in the NHS.

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Transcript

Welcome to One in 6 Billion. It's a very special episode today for me and Maggie because we've got our number one hero, Professor Partha Kaur, who's going to be talking to us today about how he changed the lives of everybody living with type 1 diabetes. So we heard last time from Jill and Jean, who'd both had type 1 diabetes for over 50 years, the real difference it made to their lives having continuous glucose monitoring.

having gone from no testing at all or testing the urine to finger pricking to measure their blood glucose to now having the Libra and being able to monitor blood glucose all the time. And that had really made such a fantastic difference. For those of you who don't know about continuous glucose monitoring, this is a very special system that has been developed over the last 10 years. And what it does is to sit on the arm and

record on a continual basis what the blood glucose is doing. And it's doing this through a patch in the skin. And really it has transformed not only Jean and Jill's lives, but almost every single patient I see in the clinic who comes in the time after they've gone on the Libra and say, this is the biggest improvement in my care that I've ever had. And that's all down to you, Partha.

So as Andrew said, we're absolutely delighted to welcome you to this episode, Partha. I wonder if you could introduce yourself to our listeners. Yeah, firstly, thank you to both. It's, I don't know, slightly surreal as well as humbling to hear both of you calling me some sort of hero after the work that you guys have done throughout not just the UK, but globally to change so many lives. But yeah, so for the listeners, my name is Partha Kaur. I'm a consultant in diabetes. I work in Portsmouth.

and have held a national role in diabetes, specifically in type 1 diabetes, technology access, et cetera, for the last eight years or so. Brilliant. So I think it would be helpful for us to know how you first got into diabetes, Partha. So, I mean, I always say this tongue in cheek. It's because, you know, in those days in Worcester, when I was being an SHO, I was trying different specialties and I wasn't very good at most of them, if I'm very honest.

which sort of brought me towards diabetes. But I suspect the real reason, I would say, I always acknowledge two people in my lives. One is Dr. Tony Zalin, who was based in the Midlands, and the other was Dr. David Jenkins. And I think what I loved about them was their philosophy that you could be a person in somebody's journey in their lives and that you could play a part. And I've always liked to speak and talk. So that sort of all worked well.

combination of factors, but I definitely would say those two individuals had a big part in me picking this specialty as something to do. Yeah, I particularly know David because I trained as a lecturer alongside him in Birmingham and he's a lovely man and he really cares about people and about his staff, so I could see why that would inspire anyone to follow him. Absolutely amazing man. I think

You people leave their imprints in your life. And I think the way he was with, you when you used to sit in with clinics with him, though, just the way he was and how he used to always find time in spite of all the pressure, just to listen. I think he taught me something that it wasn't about the diabetes when he saw them in clinic. It was more about just trying to understand what was causing their diabetes not to be great. And that was a skill he had. So that was always very attractive for me. And you became a consultant in Portsmouth

I think fairly early on you started doing more than being a consultant in diabetes and general medicine in Portsmouth. Yeah, I mean, I think I've always been attracted even before I became a consultant. I've always been attracted into sort of management or leadership roles. I used to lead the Young Diabetologist Forum, which you will remember Andrew, you and Maggie, you both came as speakers to us as registrars in those days. And after that, I became a consultant and I took on a clinical director role. And in those days, it was more about how would I

diabetes care. And I always thought that diabetes used to be like a poor cousin to everybody. You know, when you sort of stacked yourself up against cardiology or gastroenterology. And it was a big passion of mine to sort of say, no, we do we do things others can't, you know, and that was a big sort of role. So we developed a community model working in the hospital and it still stood the test of time. It was fondly known as the Super Six model, which since then has become more of a Pizza Hut deal, the Super Six deal.

But I think the fundamental of this was defining that diabetologists, and I say that across a team, know, specialists, nurses, pharmacists, everybody, we have a role inside a hospital. We can do things that others can't. And that was probably the first four or five years of my management life before I went into a national role. And I really liked what you said there about we do things that other people can't because I think really you've made such a difference.

for patients across the whole of the UK and there must have been a huge amount of barriers to instigate change at all sorts of levels within the roles you've been doing. absolutely. mean, think leadership role has to be about facing barriers. I think a lot of people mistake leadership roles for, I would say, popularity contests and their desire to be liked by everybody. I think you miss out who you're doing it for. I think I've always tried to stay consistent to that, which is

Leadership is not about being loved by all. Leadership is about, you know, I think the reward of the question is, so for example, you do work in the world, you do with the people. I think it's the feedback from them which matters most. What is the majority of people saying to you? So obstacles are normal. I think that's human psychology. Some people will resist because they don't like you. Some people resist because they don't believe you're doing the right thing. And I think the job is to try

convince the vast majority of people that it is the right thing to do. It takes time. at the end of the day, I've always believed in one thing, which is leadership is about outcomes, not about certificates from other people. So if the outcomes are OK and the people who you are serving are saying you're doing OK, then I think it's a job well done. And so how did you get picked up as a young, talented leader in Portsmouth to take a national role? Because that was quite a

step and often the people stepping into those roles came from London or other bigger centres. Yeah, I I must take my hat off to two people. Again, I've always been blessed by people in my journey who have been great supporters. And I always say that to people is that this is not a singular journey. And in those days, I had Bruce Keogh, who was the medical director of the NHS, who had a lot of time for because of the work he had done in cardiothoracic surgery outcomes and all


And the chief exec at the NHS at the time was Simon Stevens. And they had come to Portsmouth to listen to me doing some rabble rousing talk or some sort of, you know, doing my usual thing. And I remember Simon Stevens saying, why didn't you come and see me in London? And I went there and I met Bruce Keoghan. For the first time, I met Jonathan Valabji, who had just joined about a year or two before me. And Jonathan looked as shocked as me to be in the same room. was thinking, what is he doing here?

I remember Simon saying to me, we need a bit of mavericks in the system and we would like you to shake it up. And I still recall my answer saying, yeah, but that has its flashbacks. You know, I don't want to be asked to do something and not be given the support because the last thing you want is to be left out to dry. And I remember Bruce Keeo saying that we'll give you all the fire cover you need as long as you have the patient's interest at heart. And in fairness to the man and Simon, they did.

You know, I've had so many complaints about me in my life. I could probably write a book just on complaints and every step of my career. But they helped me. They always wrote back to the CCG chief or to the listener, that's the systems in the NHS. And they would always write back and say, tell me he's not doing it for the patient and I will talk to him. And they didn't ever reply back. so they are very important in those initial steps of your leadership journey.

that you have the fire cover given by your seniors, seniors who have got more privilege than you. So that's been quite important. And I remember very early on, you were asked to talk at the National Diabetes Meeting and Stephanie Amiel had been involved in the committee for the NICE guidelines for type 1 diabetes. You were asked to do a reply for

Yeah, I mean, that was actually just before I'd taken the role and Stephanie Amiel will always be a very important person in my life because it was taken as a challenge. And I think I stood up and did my usual thing of saying, what is the point in having guidelines which nobody can have? And I always say this to people nowadays, I see it even more. And I say this to lots of academics and lots of people who do guidelines that your academic work or your nice guidelines, whatever you've done, if you haven't got into people's lives at the end of the day, it's

just a bullet point on your CV. It's made you famous. It's not helped anybody. And at that point of time, when I said it, that was in 2016, March, Diabetes UK, I still remember it very well. It got covered by Medscape. It was such contentious because I challenged Stephanie Amiel, who was literally impossible to challenge in the public domain. And what Stephanie said to me was very important at the end of the meeting because we had our to and fro, and she was talking about our people. Type 1 diabetes should have 10 strips a day.

And I was like, well, that's not based in reality. Nobody can check more than twice a day because it hurts. And she, at end of the meeting said to me, if you believe so passionately about it, why didn't you step up and do something about it? And we still talk about it. You know, we still talk about it because I took it on and I said, yeah, fair enough. That's a fair challenge. Why don't you? And as think Stephanie said to me, we can give you all the bullets you want with the research and academia.

fire them from a gun if you can and make people better. So again, another person who I owe a lot and that's what sort of probably fired me into getting into that field of continuous glucose monitor, the sensors and all that technology side of things. So can you tell us about that journey, Partha, of starting off trying to get continuous glucose monitoring up and running in the UK? Yeah, I mean, I think what I've learned, the UK is a very interesting place. The science we do is phenomenal.

except that we just seem to be quite hesitant in implementing our own science into lives, which is fascinating to see. And I'm sure you must have both gone through that where you do all the work and you go like, I just don't understand. You all love it. Why don't you do it? And that was quite interesting because in 2017, I'd taken the job in 2016 and my first year was just about trying to understand the politics of NHS England, making allies and meeting lots of people. 2017, I remember.

looking at an online thing where they said, oh, this device had come out in the US. It was called Freestyle Libra. And I said, oh, and then I saw it had come out in 2014. I was like, whoa, it's three years already in. We don't even have it. So I asked the team, was saying to me, what's our uptake of sensors in this country? And they looked around, they said, oh, we use a bit of Dexcom in some people and it's about 2%. And I went like, well, that's pretty low. And then somebody said to me, well, you know, I think if Nice approves it, will be


Then I looked at what NICE had approved and NICE had approved, it was a TA151 back in 2008 and it was with insulin pumps. And I said, oh, then surely lots of people must be on it. And then I found that only 11 % of people were on it. So my fundamental philosophy with continuous glucose has always been as the same right now that we are doing with hybrid closed loops, AK, the artificial pancreas and all that, which is I personally believe that in a chronic disease setting, especially something like type one in this context,

There are three planks, I always say, there are self -management, peer support, and access to trained professionals. And the NHS is forever trying to do number three, which is let's get more professionals. At the moment, we seem to have ditched the word trained as well. We're just getting any professional we can. But beyond that, you just can't find enough trained professionals. There's just not enough clinicians, doctors, nurses, pharmacists, podiatrists we need. But what I learned was

In a world of type 1 diabetes, you would spend only 0 .01 % of your time with a clinician. That's all the NHS can give you. 99 .99 % you're on your own. So if we could give them something which would improve their self -management and then get them to talk to each other, the philosophy was it would make life better. And that's where CGM came into play. And I looked at it, I played around with it, and I said, an eye

always believed in one fundamental thing and it's I always use this example whenever I go and talk to any policyholder anybody I always go like pick your most loved one in your life and they would say it's my husband it's my daughter it's my son it's my mom and I said this device did you want them to have it if they had type 1 diabetes the answer is always yes and I go like well if you want your loved one to have it we have a response we give it to people whose we serve how we do it is a different debate but we must do

So that was my philosophy. looked at it and I went like, you if my children had it, then no question, that's what I want. I want them to have this device. And that's the journey started. I think we worked with the company, the company Abbott in those days were very good, I must say, about looking at pricing structures, trying to reduce it, what market share we would get. And that's how we got it into what we call tariffs so people could prescribe


And then started the journey, which was the fun bit, which was about trying to see who was doing it and who wasn't. So that caused a lot of kerfuffle because I would just put out maps and people would get annoyed. But that was the time I go back again, Simon Stevens, other saying, well, he's trying to do something, which is fine. And working with Nice in the background was helpful because I said, what do you need from me to make this universal? And then working with policy to put it into the NHS long -term plan.

So that was sort of the journey that we got through, but I think a lot of it was about data accountability. But I'll mention the probably the most important thing, and this is probably my lesson to anybody does policy roles. The biggest supporter I had was people with type 1 diabetes and their carers, full stop. It's all very flattering to hear leadership and how I've delivered it. But the reality is that I think it's that community which has done it. They would drive this. It was amazing. I mean, they find people, would harass people. They were amazing, especially

errands. So I think that sort of drove it through gradually and then came the journey of trying to track it, see, sit, each system. And then once you cross the threshold, a certain threshold, the system was ready. And then everybody started coming on board. So it's a bit like, you know, you have a threshold after which suddenly you fall over and things start to happen. So that was the journey, I would say. But, know, a tricky journey, interesting journey. Didn't make a lot of friends along the way, but now time goes along.

I've had a lot of people come up to you and go like, never liked your style, but you know, I'll give you grudging respect to you delivered it. And I always say that, listen, I think this is the problem people make is that I'm not looking for anybody's approval. The only people I'm looking for, and I generally say this, people who type one diabetes, it's good that you find I'm somebody you like now, but never bothered me when you didn't like me either. So that's fine. It's how it is, right? The people who need to like me are my own family.

and my very, very good friends and they still like me with, so that's all okay to be honest. So yeah, that's my view. So what you were trying to do was to change an organization, which is not good at change. And there must've been some real barriers and did they get personal when people felt that they didn't want to change?


Very personal. mean, think I always have to say, and I think for the listeners, I always say this to anybody who wants to think about how do you impact change? And I've got a very simple rule book and that works quite well. We in the NHS or anywhere in life, we've got four groups of people. Let's say in this context, right, there'll be group one who immediately will like it. So let's take the work that you have done. You will meet people who go like, Andrew, Maggie, totally. Genetic screening, come on. Precision medicine, come on, has to

Then you've got a group two who will go like, well, this sounds very interesting. Is there any data that makes things better? And you go like, well, there's plenty. And they go like, but can we do a little bit more? And you get a bit fed up and you go and do a bit more data. Then there's a group three who will go like, is everybody else doing this? Am I like an odd one out? This is quite embarrassing. I should do it. Okay. And there's a final group of people who will say, I don't believe in this. I just don't believe in this nonsense, right? What's precision medicine and all that? Come

Let's forget about all that stuff. I'm sure we can sort it with some insulin. Diabetes is diabetes, right? And you're frustrated with all that because you're looking at them going like, okay, what is going on? And I think what the NHS gets the mistake that they get stuck at, they always devolve to group one because it's an echo chamber, right? You'd like meeting people who say your work is brilliant and they love it and they're doing it. So my strategy has always been not to waste any time on group one because they're already

So in the world of type 1 diabetes, you'll have the usual suspects. You'll have Pratik Chaudhary, Alistair Lum, and Emma Wilmot. And they're already there. I don't need to convince them the importance of... So don't waste time with them. Second group of people, and I think it's important to always say, at what point of time are you happy? Don't use more data as an excuse to push it back. Tell me at what point of time I have satisfied you, because otherwise you're just using excuses.

The third group is very important to have data. That's what I did. If you show people that you are falling behind and you are now a laggard, they will come on board because they do. Because that's the competitive spirit of doctors and nurses. And they go like, well, that's a bit odd. The final group of people is always the most difficult. I don't want it. And I think that's where I think it needs a bit more punch, a bit more power, a bit more sort of having this conversation. So you've all to a point where I said, if you're not doing technology and type one diabetes,


I don't think you should do type 1 diabetes care because you are providing lesser care at this point of time. And I think my understanding, having worked with lots of specialties is that I think diabetologists are a very interesting bunch because our quotient of suspicion or conservatism is much higher than a lot of other specialties that sometimes works in our favor, but lots of times it doesn't.

And innovation gets blocked because a lot of people think, hey, listen, I made people with type one diabetes do their blood sugars on an abacus and they're all doing well. And that's how it's going to be now. So I think the journey has been about segregating people into those four groups and having a strategy for each one of them as I've made my way progress. And that's why the maps, that's why the conversations. So to your question, do people get personal? Yeah, group four have got personal, you know, I think.

That's just natural human instinct. I don't take it personally because I've learned over the summer. mean, of course you do in the beginning, you go, I'm not quite sure why, you know, I'm just doing a job. I've learned not to take it personally anymore because I've just said, everybody's doing your job. You know, if you've got a very constructive answer, and I think people go personal when they've lost the argument more often than not. So I'm quite relaxed about these things nowadays. I think as I've grown older as well, so I don't fire back. just go like, yeah, okay, well, how are we solving the problem?

once you got past the thing that you don't like my hairstyle or whatever it is. yeah, so that's how it is. And just picking up on the maps that you've mentioned a couple of times, because this was a really visual way of getting people to realize where across the UK was using the technology and the sensors and where wasn't. Could you describe those maps a little bit more, how you put those out? Yeah, so I think it was a very simple philosophy, which is we just tracked percentage uptake in each area.

and said, if you were between zero to 10, you are red. If you were between 10 to 20, you are amber. If you're more than 20. And then I moved the dial accordingly. So then after that, 50 % became the red and all that. And red, amber, green is very powerful visually, because I was, and this is not even a joke. One area who was in the red said to me, can you like make them different colors? And I said, oh, like what? And they said, what about different shades of lilac? And so I was like,


Not really, that's not the point of the maps. This is not pretty colors, But this is about saying that you are not doing very well. So that was the concept of the maps. And I think what it did do, apart from people, apart from transparency, that's important. It also brought a lot of people with type one into the game, because they would go around and say, why are we so low? Why is it

I could go to area X and get it and 13 miles down the road, I would go to area Y and not get it. That was really powerful. And I think lots of systems really did not like that. And the NHS has always got a problem of exposure of bad news, right? In that sense, they always try to do defensive things. So I would regularly have meetings with CEOs of ICS and also integrated care systems or clinical commissioning groups saying that was unfair. And my response was always the very same. It's like,

There's a very simple way from going from red to amber and then to green. Just give access and you will become green and I will congratulate you and I will say you're awesome. And I'll tell you one funny story. And this is also about gaslighting that you get whenever you raise any issues, Sexism, racism, whatever. And this is the same same principle applied. I had a call from a certain area and they said, we need to have a meeting. We didn't have a meeting. And they started off by saying, I think what we need to be is it's important. Remember, we need to be

each other. And I said, what do you mean? And he well, we feel like we are working really hard as staff and you're not being kind to us. And I said, okay, I'll do you one better. I'll come around and give you all a hug. But you need to start by being kind to the people you and I are both serving, right? Kindness is a very interesting thing, but the kindness you need to show towards the people who need it outweighs your need to be feeling

loved by everybody else. So I think those are the robustness that you need to have and push back and say, so the maps were incredibly powerful. And I do see a lot of other areas are starting to use this in some areas, but why not? know, transparency, if we want to tackle variation, you're not going to do it behind closed doors. And in fairness, I always give people an opportunity. I always talk to them behind closed doors first. It's when they just disregard you or don't listen to you, you move to maps and more public data. So that's fine.

Brilliant. And I think one of the things that you've always done is to tackle things head on with people. I know that through social media, people with type one diabetes have been able to have access to you and you haven't held back in going to their consultants and saying, why is this person not getting it? And that's very unusual for somebody in a leadership role because often the individuals are not represented.

Yeah, mean, think so my my view of leadership is incredibly relaxed. And I'll tell you why. When I came to this country, the biggest ambition that was set to me by my parents, who, as everybody knows, I've been very close to, was that I became a consultant. That was it, because my mom had become a consultant. But my dad was said he couldn't become a consultant because the color of his skin and all that sort of stuff went back. And my dad always said, I want you to become a consultant in the NHS.

So what people don't realize is that 2008 was the pinnacle of my life. I became a consultant. After that, everything is fun. Right? So I literally have nothing to lose because when people go like, I'm a consultant in the NHS, right? What else do you want? Possibly. So I think when people come to me, I find it quite easy.

I find a lot of people don't do it because they're worried about the next step of progression or other career thing they need to do or they need to keep people happy. I have none of that, right? I'm like, okay, it's the job. So I would have conversation. And I think that's what has built the relationship I have with the community, which is amazing. I have a relationship with the type one diabetes community. I wouldn't exchange for anything, any award in my life or anything. I mean, it is simply phenomenal. was recently at a meeting conference and it was just lovely.

I get stuff that people would dream to have in their lives and I'm very blessed from that point of view. doing that, there's no skin off my nose. It's easy for me to pick up a phone and ask people. And I think also what happens is that when you ask a clinician and they say, well, this is the reason, i .e. my system is blocking it, I would say to them, well, let me help you. If you're struggling to do it because of the politics and with the relationships, I don't have that. Let me help


And that's quite powerful. But I think I'm very public and open about it. And I've said that to everybody with type 1 diabetes. And I do it still. I still do it all the time. If you're having problems, come to me. I will pick up a phone. It's not a problem. But I still think that takes an awful lot of courage in kind of challenging the system. And there's a lot of people who perhaps wouldn't have the confidence to do that. So, you know, that's something I really admire you for, to have that courage to actually speak up and take those opportunities. Yeah, I I think I

got better at it as time has gone. And one thing my mum always used to say, and I think I always have kept true to that, where she used to talk a lot about the value of privilege. And she used to say to me, you got, you're born with privilege, you're a man. That's it. Your privilege is set. Right. And what she always used to say to me, whenever you get to powerful positions, use your privilege for something good. And I think I've got a lot of privilege in the system at the present moment of time.

I think courage comes over time. Courage comes about, and I must say at this point in time, my colleagues who I work with in Portsmouth, who are like my absolute rocks, right? They're phenomenal. And I always bounce it off them because they used to be my consultants and they go like, yeah, fine. It's okay. It's all right. We'll stand by you. And they've always have. And when they're tough times and stuff, they will take me out for a drink or get me a bottle of whiskey. And they are my family friends now over the course of time.

I think you have to learn a little bit about your support structure is important. I've got a very lovely family of my own who look after me. I think I always say to people, if you want to be brave and bold and go out there, it can burn, but make sure you've got enough people around you to when the time is needed to give you that wraparound so you can come out of it a bit more repaired. So that's important. Don't go off on your own.

people burn out when you do that without any coverage. think that's really important. And another thing that you've done really well is to kind of role model that leadership in terms of supporting the younger generations of colleagues and bringing them on as well. I know that's very important to you, isn't it? incredibly. I think the system doesn't allow a lot. I've been, as I said, I've been very fortunate to have those opportunities at very young point, part of my career, suddenly plucked out to go into the national role and fly.

So I try and do that with people I meet and I think I try and do it as much as I can do, especially women, because I think women have a really raw deal in the system sometimes. So I will try and help out as much as I can with the younger generation to say that. And I think that's where the privilege kicks in, whereby you can stand by them and say, it's all right, you can do that. And it's doing the same thing that...

suppose Bruce Kiyoke did for me once upon a time. So it's like the pass it on thing. So no, I do firmly believe in that sort of thing. talk about having privilege and accepted your male, but there are other ways in which you're not the typical privileged male in that you're not white and you're not old. And I guess you must have had quite a lot of reactions against those over the years. Yeah, absolutely. But I think I always say one thing.

This country is a by nature quite a tolerant country. I have been blessed with more better experiences rather than the lesser ones. That's important, right? My all these mentors I mentioned, they're all white, right? Tony Zerlin, David Jenkins, all my colleagues I work with, know, Mike Cummings, Daryl Meeking, Ian Cranston, Evelyn Nicholson, all white. Simon Steed, everybody I mentioned is white. So it's not as simple as that. Yes, people.

You know, as I always say, there are some people, we are all part of society and that's what I've learned. And NHS is also filled of people from society with their foibles, right? So there will be people who are sexist and racist and homophobic and this, that, everything. So I think you need to learn to sort of say that, okay, you know, what is the vast majority like? And I think what is the system like? And I always say to people is that,

I also wouldn't be where I am if the system was just blatantly racist and didn't want people to progress. Right. So you have to learn to balance it out a little bit. I think the age thing, you know, I always brush off, if I'm honest, because I always will bring a degree of humor to it by saying, look at the world of football. You know, you can have a Carlo Ancelotti. You can also have a Pep Guardiola. Right. Yeah. You can also have Jose Mourinho. You can have young people doing well. You can


experience people doing well. So I don't think that's a set thing. But yeah, it's breaking the norm of the NHS. And I think as Maggie mentioned, I get a lot of contacts from people who come from non white backgrounds who say that, you know, we find it inspiring, which is good, nice to know. And but my fundamental message to all of them is that, but you can do it by collaboration. You can definitely do it by collaborate. There more people willing to help you than not. That's the important thing to remember. I think we've talked around

type 1 diabetes. But for me and Maggie, you made a very special intervention. And as you say, we'd been in that situation of doing the science, but also wanting to make it happen and want to make it happen throughout the country, not just in Devon. And finding the barriers, we finally got national testing, but we needed to have expertise. And Maggie reached out to you and you changed things.

Yeah, absolutely, Parthi. You put us in touch through your role with NHS England, with Karen Kennedy and others, to help come up with some funding to help us train diabetes professionals across the UK in monogenic diabetes. And that's made a phenomenal difference. We now have 95 % of trusts in the UK with the diabetes service who've got a named diabetes consultant or diabetes specialist nurse who've been trained in monogenic diabetes.

So that's made a massive difference. So we're really grateful for your input in that area. Yeah, I I think that's very kind of you, but you know how much respect I have for both of you and both of you do amazing work. I always keep an eye on work that's going on around, right? Even though I give the appearance, I only read comic books, believe it or not, I do read actually academic papers and things that are going around. And I always look at it from a policymaker point of view, right? I always look at it and go like, is it possible?

to make it happen. When I look at the work you have done, I always go like, there is no reason this can't happen, right? When I look at the work, for example, Helen Murphy has done, I'll go like, this can happen. Of course it can happen, right? Why can't we give women CGM to make life better? So I think it goes back to the work you have always done. And I've been to one of your training courses as well. And I go like, well, why is it not possible to do it everywhere? And I think there was an opportunity there and


Karen Kennedy, who you mentioned is probably one of the most excellent managers I've ever had the pleasure of working in my life. And I spoke to her and she said, I think this can happen. I said, well, let's make it happen. So I think, as I was saying, the best science in the world is the one you get into people's lives. And I think not all academics or scientists have the privilege of having that connection. It's not because they're not trying. lot of people just don't have, don't know the way to how do you get it into people? The passion is there.

So think that's where we come in and you go like, can open one door and then over to you. you know, for example, Shivani Mishra is doing something similar, a young type two diabetes. And I said, yeah, go on then, you know, open the door, we'll get some money. Let's see how it works. So that's my philosophy. So good science must get into people's lives is my view and my own patients have been, I've got people who've come off insulin and you know, you get their letter.

And it says what you've got and you know, why you can come off insulin and why the glycolyside or the sulfonylureal help. And it's fascinating to see patients like that and you're changing lives. And I'll give you one example recently, and he won't mind this at all. He was picked up because his niece had Modi and they said, oh, we'll do screen of the family. And he's a type one for 11 years. Chef came in and he's now doing amazingly well on sulfonylureas. And he's like, my God, if somebody had told me this. So that's

changing, genuinely changing lives and everything. So that's fantastic to sort of watch as well. So, you know, that's the science and everything you guys have done. I just opened up a few doors. Yeah, that made a massive difference though. So hugely appreciate that opening the right doors for us. So I think that's been brilliant, Partha. You've really shown what leadership is and what it can do. And we've just touched

a few of the spheres in type 1 diabetes and then in monogenic. It's really good to hear the philosophy behind it because I think it's possible for everybody to do. mean, certainly within our research, we see all the future lives in the young people coming up and the support of them because without that, there is no future. That's what you're doing. Also, if the patients are going to benefit, then there isn't anything that you won't


to make it happen? I mean, I always say, you my leadership tip always is that don't mix up collaboration with collusion. That's what a lot of people end up doing, right? In the effort to look at the bigger picture, whatever the bigger picture is, if you're ending up sacrificing the one you serve, you have failed. And I think that's an important lesson that I always say, that's number one. Number two, I always say, be humble to those you

You know, I'm known to have a, you know, can have a fiery disposition. I'll challenge everybody, but I can't recall where I would be out of step with anybody with type 1 diabetes or the carers. I just wouldn't, right? Because that's who I serve. And you try your best for them. And their frustrations isn't something I would know because I don't live with it. I think if you follow those two things and the final thing which I said about make sure you are protected, have a really good, cool group of friends and family. And I've been blessed with a group of friends, none of whom

comes from medicine. They're probably the best friends I can ever have because they don't even know what I do probably. I don't think they care, but they're very proud of me. Those are the type of friends, you know. That's what you need in your life. I think if you have those two or three principles in life, you'll do okay as a leader. So that would be my sort of feedback. So just from myself, Partha, just a massive thank you for everything you do in diabetes. I think your style of leadership is phenomenal and what you've been able to achieve has been fantastic.

As you say, know absolutely the Type 1 community are right behind you, but a big thank you from me. And I know you support a lot of diabetes specialist nurses too. So thank you from all of us. Not a problem at all. Specialist nurses, Maggie, you know, I keep on saying, lynchpin of diabetes care. I've always said we need more of you guys. You need to, you need to try and encourage more of yourselves into our profession. That's what we need. So yeah, thank you. Very kind of you both.

aware with Partha that we really only scratched the surface of some of the work that he's been involved with, but just to see the leadership that he's shown in terms of making a difference for patients with type 1 diabetes and working within a system that's sometimes quite difficult to make a change. The NHS is a massive organisation and introducing change is not easy, is it? Yeah, you're absolutely right, Maggie. What he's achieved

really such a little time because we know it's taken over 20 years to get from the science to bringing things in. And he's made things happen for everybody living with type one diabetes. And it's about his style. And the thing that really struck me was that it was always about, this the best for the patient? And if that's the answer that it is, then he was going to say it, he was going to do it, he was going to make it

Yeah, absolutely. That really came across, it? How important it is that the patient is central to the decisions. And if it's important for the patients, then absolutely to make this happen and be a mover and a shaker within the system. Yeah. And I'm really impressed how he is able to separate the things that are said to him as he tries to bring about change, to not be put off by it, to not let it stop him from his path that he's going to make things better

for patients. And that's easy to say, but needs enormous strength to actually do it. Yeah, I think that must actually be really, really difficult. And what was interesting is how he talked about the importance of not only the having a really good team around him, but also good family and friends for that level of support as well. But I think he picked up on the importance of teamwork too. And that's something we've mentioned in a number of the different episodes how

making a difference is often about teamwork as well. Yeah. And I think he also illustrates how he recognizes people that are going to help him make change and works through them. And we saw him helping us to make changes for bringing in genetic testing throughout the UK. And he enabled things to happen. Yeah. And those connections, the doors that he opened for us in terms of monogenic diabetes,

made things happen remarkably quickly and seem remarkably easy once you had the right people involved. Yep, a true leader, a man who knows what needs to be done and also knows how to make it happen and deals with any barriers that try and stop it happening. Yeah, hugely inspirational. What a man. And we can't promise you we'll have Path for Car every week, but if you'd like to listen again in two weeks

podcast will be back with some very special guests.


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