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So Who Cares Anyway - E38 Our experiences are never wasted · SoWhoCaresAnyway

• 0:04
  Welcome to So Who Cares.
• 0:06
  Anyway, a fortnightly podcast exploring stories that shape care community and the systems we live in.
• 0:12
  I'm Ruth Germaine, and in each episode I'm joined by my guests, people from behind clinical doors to the North York malls, whose experiences open a window into how we care for one another.
• 0:24
  Together, we explore care through creativity, connection, and the strengths we already hold.
• 0:31
  Because care isn't small.
• 0:32
  Care isn't soft care shapes the world, so who cares? Anyway, it's time to talk about it.
• 0:41
  Hi, it's Ruth here.
• 0:43
  I just wanna say a quick hello before we get started.
• 0:45
  Today I am seeking with Dr.
• 0:47
  Tony Jones.
• 0:47
  He's a GP educator that I've known for quite some time, and is someone who turns out, has been listening to my podcast, which feels like a real honor.
• 0:55
  Tony reached out 'cause he wanted to share some of his experiences in these beliefs that who we are is shaped by everything we live through.
• 1:02
  Even the painful moments, nothing is wasted.
• 1:05
  We cover a lost ground in this conversation.
• 1:07
  It's worth staying to the end as Tony leaves us with a message about kindness that feels especially needed in health and social care right now.
• 1:16
  So let's get straight into it.
• 1:17
  Hope you enjoy.
• 1:20
  Hello, and today I am speaking to Tony Jones.
• 1:23
  So welcome Tony to So Who, Geers.
• 1:26
  Anyway, lovely to be with you.
• 1:28
  Thank you.
• 1:29
  And um, Tony, I'm just gonna look, give a little brief before I ask you to introduce yourself.
• 1:33
  We've known each other, um, we were just about saying, weren't we? I remember meeting you back in 2013.
• 1:39
  You probably don't remember particularly, but I came to a conference just before I started in my role.
• 1:44
  Okay.
• 1:44
  As a primary care workforce development lead.
• 1:47
  As it was, um, called when I first started, uh, back in, back in the time and there was a conference down at Crawley and I met quite a few people there.
• 1:56
  And to me it was a fascinating world 'cause it was world way beyond what I was doing in general practice.
• 2:00
  You know, the day to day seeing people.
• 2:03
  Um, and suddenly there was this whole world of people trying to create change and do things.
• 2:07
  And I don't think we were actually on the same table at that conference, and I was quite new and there was lots of people there.
• 2:12
  So I don't whether or not you remember me from that, but from that really was our journey into developing the training hubs where you became a training hub lead.
• 2:21
  And, um, I know you were probably, I think you were a program director at the time and then a GP tutor, but I'm not too sure.
• 2:27
  So I wonder if you want to give a little bit of a brief about yourself, um, Tony and, uh.
• 2:32
  Tell us a little bit about your journey.
• 2:34
  Yes.
• 2:35
  Well, thanks Ruth, and uh, thank you for the invitation.
• 2:39
  Um, yes.
• 2:40
  So, I mean, first thing to say is your memory is kind of far better than mine, but I'm, I'm now 68, so, um, I'm ancient and kind of getting concerned about my, my memory, but I've always looked back and tried to remember, um, the different.
• 2:56
  Dates for when I started, um, different aspects of GP education.
• 3:02
  But um, yeah, so I was program director for six years back in the days when it was called course organizer then became GP tutor.
• 3:13
  Um, then the GP tutor function kind of, uh, evolved into developing training hub as we all remember.
• 3:21
  Um, and kind of slightly in parallel to that, I was a CCG governing body member.
• 3:30
  Um, and um, and then when CCGs.
• 3:37
  A, um.
• 3:46
  Um, non-practice, uh, journey, really.
• 3:51
  Thank you.
• 3:52
  And I think just to clarify for listeners, I mean there's lots of different things that you said there, program there because director to gp, GP tutor, different roles that you've gone through.
• 4:01
  But I think what's important about those is you say this is your non-practice, so this isn't your clinical work day to day.
• 4:07
  As a gp, this is your work where you, you.
• 4:10
  From what I've seen of you and know of you, Tony, is where you've been really passionate about how do we develop our future workforce.
• 4:17
  And of course, training hubs didn't exist.
• 4:19
  So that's what now provides or facilitates education in primary care.
• 4:24
  In general practice.
• 4:25
  But that didn't exist back then.
• 4:26
  So we were quite lucky in Kent in that there were some, um, things in place, but there still wasn't that grow your own workforce from the beginning mentality.
• 4:36
  It was more about, um, grow your workforce once they're here.
• 4:40
  To me what I saw that day and the reason why it's in my mind, um, that conference I mentioned at the beginning, which may be, um, you don't remember so well, um, and it wasn't a TESS by any means, but was because I went down there and just saw a room full of passion of people that were wanting to address an issue that I'd seen.
• 4:59
  Which is about the fact that we need more staff.
• 5:02
  We need to think about our workforce.
• 5:03
  We need to think about what it is we are really doing and are we doing the right things.
• 5:08
  And what came through to me, Tony, and why when you got in contact with me the other week, I was delighted, was because I could see that in you that you, you wanted that along with other people, of course, Kim Steelman, and there were lots of other people down there, but Kim Stillman had a great influence on me too, as well as yourself, was this passion to actually think, what do we need to do next? And I think all of those roles you've spoken about.
• 5:29
  We we're through that passion to try and develop our workforce.
• 5:33
  Yeah.
• 5:33
  Thank you.
• 5:34
  And that's, that's, um, encouraging and complimentary.
• 5:37
  I appreciate that.
• 5:38
  Um, interestingly, you used the word passion and um, I do remember an occasion when two people in the same week.
• 5:50
  And said, Tony, you're passionate, kind of, um, uh, it wasn't my wife.
• 5:55
  Um, uh, so I think, you know, when you get uninvited feedback so consecutively, it makes you think.
• 6:07
  About what you're being told.
• 6:10
  And um, and I think I recognized at that point that that passion or visible passion was something that others observed.
• 6:19
  And, um, so I, I almost made a positive decision to make the most of, um, you know.
• 6:30
  The passion as it were.
• 6:32
  Um, and I suppose one of the things that I didn't mention, probably the last thing I was doing, um, from a training hub point of view, um, was running, uh, a click group.
• 6:45
  I, I know that started in East Ken, but I led a a click group in yeah, west Kent.
• 6:50
  So clinic click for us being clinical leadership and integrated care.
• 6:56
  We rebranded it kind of with the demise of, um, CCGs and really, I tried to use, you know, that, that passion for, um, you know, the 10 years that I was running the, um, the, the click group to inspire.
• 7:18
  Um, as it was, I had the privilege of, um, uh, of leading that.
• 7:23
  So over those 10 years, 30 different cohorts.
• 7:27
  So yeah, so I think passion and heart and motivation and.
• 7:35
  I, I think that's one of the reasons I've landed on your podcast really, is because it is about care.
• 7:41
  It is about, um, almost the felt emotion and the drive and the, and, and that doesn't, um, that doesn't go away with retirement.
• 7:51
  It's, it's more about who you are, are rather than the job you do.
• 7:58
  Um, yeah, I think, um, you know, we, we, we really concur at that point, and of course that passion and that drive and you talk about that's who you are, but actually that, that came from something.
• 8:10
  So what did that come from, Tony, for you? What, what happened or what was that about that led you to think, actually, this is really important, this really needs to happen? What gave you that passion and that drive? Thank you.
• 8:23
  Um, wow.
• 8:24
  That's in, in a sense, that's a really.
• 8:26
  Really big question.
• 8:28
  And I was reflecting on this before, it's um, before we, um, met this morning and, um, I was thinking about emotional intelligence and some people say that that comes from the way that your parented in the first few months of life.
• 8:46
  Um, so I guess, you know, things start in, in our families of origin.
• 8:51
  Um.
• 8:53
  And my mom was a nurse, very caring soul.
• 8:57
  Um, but, uh, for me, and I did say this in our, our preamble, that, uh, for me a lot of my drive, um, comes from my Christian worldview.
• 9:11
  Um, and I think that I, I loved my patients and I think my patients loved me.
• 9:19
  Um, I, I loved my, um, my colleagues.
• 9:24
  So within the training hub, um.
• 9:28
  If you remember the, the West Kent Fourfold training hub, AIM was to recruit, train, support, retain, and um, uh, the support element, uh, the care for, for staff for me was absolutely fundamental.
• 9:46
  Um, I do remember a GP partner of mine saying if we can't care for our own.
• 9:56
  Then, you know, um, how, how can we hope to really care for our patients properly? Um, so yeah, I think that that, that care and, um, compassion I think is, is written through me like a stick.
• 10:21
  It, it, it's something that kind of comes from Yeah, my worldview.
• 10:25
  And I think surely that's gotta be true for all of us, um, isn't it? Um, I remember chatting to a colleague of mine, um, who was saying, if you trying to decide which practice to join, look at.
• 10:49
  Financially driven, whether it's, um, about training, whether it's about patient-centered care, whatever.
• 11:00
  And, um, I, I agree.
• 11:02
  I think that it's possible to see what the heart of even a practice is.
• 11:08
  And I chose to join, um, a Christian practice back in, uh, 1989, where I was blissfully happy for the 30 years.
• 11:19
  Um, and it wasn't that, you know, it was pushy in any way, but, um, yeah, we, we prayed every morning before.
• 11:32
  We ask God to, you know, give us a heart for our patients.
• 11:35
  And, uh, um, yeah, that's, that's kind of where I come from really.
• 11:41
  Okay.
• 11:42
  And you've given a lot there, and that's quite a lovely thing, you know, whatev, whatever people's views are, are listening.
• 11:47
  Just the fact that you spent time to sit down.
• 11:50
  And pray for the people that you were going to see and for the people that you cared for.
• 11:55
  I think that is, is, um, quite an incredible thing to take that time to just, just think and reflect and feel is really important.
• 12:03
  Yeah.
• 12:03
  Yeah.
• 12:04
  I think looking back, I, I always remember, um, you know, when we were GP training, we had, um, people from a variety of, uh, faith backgrounds.
• 12:17
  Um, and our, our kind of policy was, you know, if you don't wanna join us, don't worry.
• 12:22
  That's fine.
• 12:23
  Um, I don't have to say anything, don't have to contribute or don't even have to be there.
• 12:28
  But, um, uh, I remember talking to one of, um, my Islamic trainees, um, and.
• 12:43
  Are we kind of putting pressure on you guys or you know, is this something that's uncomfortable for you? And he said, no, no, no, no.
• 12:51
  It's kind of, um, fine.
• 12:53
  Subsequently he told me he went home and, um, discussed it with his parents and explained kind of, um, and then he came back with his, a message from.
• 13:04
  His parents, uh, who obviously were, were Muslim and saying, no, no, keep going, keep doing it.
• 13:11
  Kind of, uh, I thought how interesting that, um, you know, one of my, um, Muslim colleagues was that felt that it was a real strength and we had more in common at that point than perhaps I thought.
• 13:27
  Um, and that goes back to what you just said, that core of, you know, isn't that we're what we're all about.
• 13:32
  Whatever religion we might be or not be.
• 13:36
  Actually the core is that most people that go into a care and profession are there to care and are driven by that care and love and supporting people to do things.
• 13:46
  It's, but in your practice, you took that time to actually think about that.
• 13:50
  And do that, and that was something that you were doing.
• 13:53
  I just want to ask you, Tony, as well, you spoke about your Christian worldview and then you mentioned a second time about worldview on its own that time, and I'm just wondering.
• 14:03
  What that is, whether that's, that might be completely tied in with the, with the Christianity and your Christian faith, or it might be more about that, um, a worldview in a different way.
• 14:14
  But yeah, I just wanted to understand that a bit more.
• 14:17
  That's a new concept to me, bringing those things together.
• 14:20
  Um, it, it is about.
• 14:23
  Worldview, which, which I think is very shaped by, by that.
• 14:29
  Um, and I.
• 14:39
  Our worldview is, we probably would need to ask ourselves the question why? Um, because I think that, um, um, a lot of worldview for me, maybe, maybe it's my perspective is about, um, why we do things.
• 14:57
  Um, and I don't think it's a question that we ask ourselves enough.
• 15:04
  Um.
• 15:05
  I think sometimes, you know, life just Chun on and we, we go from, you know, school to university to job to family, and we, and, and it's a bit of a conveyor belt and, um, yeah, may maybe, and for me, I suppose various things kind of, um, led to, uh, to me coming to that.
• 15:34
  Conclusion.
• 15:35
  Um, and I had a bit of a Damascus road experience, kind of when I was, um, actually doing a biochemistry degree prior to training for medicine.
• 15:46
  And I have to say my life changed.
• 15:48
  And, um, uh, again, I remember somebody, um.
• 15:55
  Saying to me in a personal conversation, um, she said, Tony, your, your compassion is a gift from God.
• 16:02
  And, um, I thought, oh, interesting.
• 16:04
  Kind of, um, and, uh, clearly her view was as somebody that knew me, that.
• 16:12
  You, perhaps it was part of my gifting, part of my calling because I suppose I do and have regarded career as, as calling.
• 16:24
  Um, so I'm rather traditional in in that sense.
• 16:28
  Um, just to give another little bit of a, a perspective on that, um, this weekend I've just been on a, a conference on, um, preach the word to tell the story kind of.
• 16:40
  Um, and it's about use of stories and illustration, um, in sermons to a large degree.
• 16:55
  I think compassion is about love.
• 16:58
  If we, if we use kind of, you know, perhaps a bit more spiritual jargon, and if compassion is about love, Jesus said, you know, what are the two greatest commandments? Love God.
• 17:09
  Love your neighbor.
• 17:12
  And someone in his audience at the time said, who is my neighbor? And of course, then Jesus tells the story of, um, the, the Good Samaritan.
• 17:23
  And, you know, what's that? That's a healthcare story.
• 17:26
  Um, when he wants to illustrate, um, love, then, um, he talks about three people, uh, one of whom.
• 17:36
  Looks after the physical and wellbeing needs of, of the individual.
• 17:41
  And that person, of course, is from a different, um, religious background, um, to, um, the priest and to the, uh, other people who pass, pass by the person of need.
• 17:54
  So it's very inclusive.
• 17:57
  And I think it's a great story, um, to help us to understand, um, what, what compassion is.
• 18:04
  And it's those kind of stories from the scripture I suppose, that have contributed to my worldview.
• 18:11
  If that's not too rambling, a way to put it.
• 18:14
  Not at all.
• 18:15
  Not at all.
• 18:15
  And um, it gives a real, a real picture.
• 18:17
  And what you've spoken there about there, and I'm just gonna sort of summarize a little bit, is that we all have worldview.
• 18:22
  And one of the things we need to do is we need to ask why we do things.
• 18:27
  And that, that's a really important thing.
• 18:28
  I, I pass myself, why I do things all the time.
• 18:30
  Yes.
• 18:30
  To make sure that what I'm doing actually fits with my own personal why.
• 18:34
  You know? So I think it's a really important thing to be able to do.
• 18:37
  'cause that's what gives you a sense of direction.
• 18:39
  And that compassion is being a gift.
• 18:41
  I think that's a really nice way of framing it because, you know, health and care, whether we are healthcare, social care, or anybody who's pro providing care in whatever way it might be actually, to have that compassion makes so much difference.
• 18:53
  If you can be compassionate, uh.
• 18:55
  To other people, but more importantly, be compassionate to yourself.
• 18:59
  Then actually, aren't we just making a a better world? And what you've gone on to talk about, then you've talked about the story of the Good Smith Martan, which people may or may not know, but it is about healthcare and it is about inclusivity and how somebody gave care to somebody who was their neighbor, but might not have the same view, the same opinion, or the same ideas of them.
• 19:17
  But that came through compassion and came through love.
• 19:20
  Um.
• 19:21
  So I think, I think that's a really, a really lovely, uh, way that you've put it.
• 19:25
  So thank you for answering that.
• 19:27
  And I want to move on now because you spoke a little bit earlier on about that support part within your, and I'm not gonna be able to say them all, but, 'cause I couldn't write 'em down quickly enough, but I should know them, Tony, 'cause I've known you long enough, is recruit, retain with support and recruit, train.
• 19:45
  Support, retain, recruit to train and retain.
• 19:48
  Thank you.
• 19:49
  Yeah, I write that down correctly.
• 19:50
  And you spoke about that support bit and the importance of support.
• 19:53
  And one of the things when we met to talk about you coming on the podcast is you spoke about those, those issues about.
• 20:00
  Mental health, particularly of practitioners, people providing care and that emotional toil and labor, which I know I've spoken about before.
• 20:09
  So I wondered if going from this part of where you've talked about this, why and compassion and that being a gift.
• 20:16
  If you, if you want to talk a bit more about, about that area, which is one of the main reasons that.
• 20:20
  You've come on today, if that's okay.
• 20:22
  Yeah.
• 20:24
  So yeah, I think I've had a, a career long interest in, in, in mental health.
• 20:31
  And, um, if I can just tell a little bit of, um, my background.
• 20:35
  So when I was at med school, um, I had.
• 20:40
  What a difficult time, uh, mentally, um, in that I, you know, one started ward rounds and all the rest of it, um, uh, have experienced anxiety and stress, bit of depression and whatever.
• 20:53
  And, um, and I think.
• 20:56
  As ever, our, our experience is never wasted.
• 20:59
  And those experiences, um, went on to, um, really I suppose, inspire me to kind of, um, support others with similar challenges, hence my interest in, in mental health.
• 21:17
  And that lasted for a whole, whole career and goes on now with some of the, the things that I'm now doing in retirement.
• 21:27
  Um, but if the journey goes on a little bit from when I went to med school, when I was a gp, um, trainee, I was still very unconfident and a bit of a shivering heap.
• 21:40
  You know, if you ask me to stand up in front of a group, um.
• 21:47
  I found that really, really difficult.
• 21:49
  Um, and, um, so part of the excitement of what my, the, the role including, um, the educational role has done for me.
• 22:01
  I think it's been around personal development and, um, I'm just a very, very different person.
• 22:09
  What I was then.
• 22:13
  In the click group, I would, I would always tell that story about, um, uh, uh, my personal journey.
• 22:20
  Um, we talk about kind of therefore imposter syndrome and, and don't make the same mistakes that I did.
• 22:29
  Um, uh, you know, don't lack confidence when actually there's no reason to just.
• 22:37
  Be yourself, be, be strong.
• 22:39
  And um, I remember, uh, as training hub leads, we were asked to record a brief message to the first cohort of medical students, um, going into, into canter.
• 22:55
  And so I chose to yes, talk about that kind of message and, um, about my personal journey and encourage them not to have imposter syndrome.
• 23:06
  So, um, and that kind of support, I suppose, giving a couple of illustrations of, of where that's, um, been possible to apply that learning.
• 23:18
  Um, but yeah, I think that our training hub team.
• 23:24
  I think that my aim now is to model mutual care and to, to build a, a family, um, a family as team, um, who cared for each other and therefore could go out with confidence and strength and be our best and, um, et.
• 23:46
  I think in various kind of, uh, illustrations of how perhaps that kind of aspect of support and authenticity, I think, um, is important when helping to, to encourage.
• 24:03
  Other staff in their journey.
• 24:05
  Thank you.
• 24:07
  And click is one of the things that you've spoken about a few time, which was that, um, clinical leadership, wasn't it, around that leadership area and care.
• 24:14
  And I wonder if that.
• 24:16
  If that leadership, did that come outta the fact that you felt that people needed to have that support around their own? Because you've spoken a few things there.
• 24:24
  You've spoken about mental health, um, and your own personal development, and I really like that bit.
• 24:29
  Our experiences are never wasted.
• 24:32
  You used those experiences to help support and shape others.
• 24:36
  So what did it, what was it that you felt that was important, or why did you feel that it was important that people had that leadership? Because you've talked, talked about navigating imposter syndrome and about having family as a team.
• 24:49
  But then you've come back each time to that click.
• 24:52
  So what, what was important about the leadership in that mental health dev or supporting people's mental health? I, I, I think perhaps coming back to click, um, when people say in retirement, do you, you know, do you miss, do you miss your work? Kind of, um.
• 25:11
  Generally speaking, I, I would say, no, no, no.
• 25:14
  I'm very happy with what I'm doing.
• 25:15
  Um, but then I would kind of reflect, I, I kind of miss the Click group.
• 25:20
  I kind of miss that cohort of young GPS at the beginning of their career.
• 25:28
  Um, and, um, I think that it, um.
• 25:38
  It was a, a cohort that was with me for four months and moved on.
• 25:42
  Then I'd have another cohort and you know, just the principles of evaluation, um, was able to develop something over 10 years.
• 25:52
  Which I proud of.
• 25:54
  Um, and the, the remit of the group was not to teach anything clinical, um, but simply to look at, um, to try and help, uh, train GPS to understand the, the biggest system.
• 26:11
  Uh, to try and teach them something about leadership, management of change, um, and things that would equip them to be, uh, clinical leaders.
• 26:25
  So that was the, the broad aim of the group, uh, and.
• 26:34
  You know, when looking, just say specifically at, at leadership, um, we'd spend a couple of sessions looking at leadership and, um, I'd used a, um, a kind of a timeline of, of leadership development and, and I think that.
• 26:55
  Emotional intelligence is on that timeline.
• 26:57
  Authenticity is on that timeline.
• 27:00
  Um, collaborative leadership is on that timeline.
• 27:06
  Um, so a lot of these things are about, um, you know, who we are.
• 27:12
  And, uh, our heart and coming back to that kind of, um, you know, compassionate perspective.
• 27:21
  Um, so I think it all comes together in that, in the atmosphere we create, in the confidence that we impart, um, the insights that we give.
• 27:40
  Yeah, I mean hopefully, you know, you see from that, I know that probably integrates into the leadership training that we were trying to do through Click.
• 27:50
  Yeah.
• 27:51
  So I think that leads into the leadership training and, and what you've described there is how important actually that emotional intelligence and supporting people.
• 27:59
  So whilst you weren't talking about clinical things, you were talking about.
• 28:03
  Um, managing change and about being clinical leaders and thinking about that bigger system.
• 28:07
  So rather than just seeing that day-to-day, and I say just, you know, very lightly, lightly there, but actually that's, you know, it's important work that day-to-day, seeing people and providing that care, but actually seeing the bigger system that's around that in order to be able to provide the support and care for those individuals to need.
• 28:24
  So that's why the leadership is really important to think about that.
• 28:27
  But what you've described there is the, um.
• 28:30
  Is that emotional intelligence and understanding who you are, that, um, authenticity and then having that bigger picture around them.
• 28:38
  So I think that's probably really realing some of the bits you've said earlier on, but, but describing it more.
• 28:43
  So I'm wondering, Tony, you, you've obviously had lots of people go through with these cohorts.
• 28:48
  I'm wondering if maybe to give a little bit more of a picture for people and for myself to be honest, if you could perhaps describe somebody.
• 28:55
  Without sort of names or anything like that because obviously we don't want to sort of bring people into this podcast if they dunno they're going to be on here.
• 29:02
  But I'm sure that there must be people that you saw at the beginning that perhaps came in and you saw that, you've described your journey, how you, you know, you sort of quivering at the beginning and I, I can absolutely, you know.
• 29:13
  Go with that with you.
• 29:14
  I can remember quivering the first time I went onto a ward or anything like that to sort of that journey.
• 29:20
  So you've described yours, but have you seen that journey in somebody else and what, what difference did that make to them or what, what difference did that make to what they were doing and how they managed that? So that wider impact.
• 29:33
  Thank you.
• 29:33
  Yes.
• 29:34
  Um, yes, certainly I can think of, um, you know, a couple of examples come immediately to, to mind, but, um, uh, I remember just if I might mention one other thing, um, in one of the evaluations that I did of, um, uh.
• 29:54
  One of the guys said, um, I've learned the answer to questions that I didn't even know were questions.
• 30:00
  Um, and yeah, I think that was quite a common experience for, um, for, for the groups that actually we were looking at things that just possibly had never been touched on in anywhere else in their training.
• 30:16
  Specifically an answer to your question.
• 30:19
  Um, I can think of two people.
• 30:23
  Um, one, uh lady, one man.
• 30:27
  Um, um.
• 30:33
  Let's, let's go back without being specific.
• 30:36
  Um, uh, somebody came into one of the very first cohorts, um, and, um, was clearly very, um, very gifted.
• 30:48
  Anyway.
• 30:49
  Um, and, um, I remember this person would just attend CCG meetings outta their own interest.
• 30:59
  So this was a, a highly, uh, motivated individual.
• 31:03
  Um, uh, she did a project, um, uh, during her click work and um, I remember, um, the evening where we.
• 31:18
  The project and ab then Dean pitched up to, to listen to these, um, presentations and I was almost in tears.
• 31:30
  I was so proud of, um, these guys and girls and several people.
• 31:36
  In the room, um, that evening had done really inspiring, um, work.
• 31:42
  The girl in question, um, no more for, uh, for her than for anyone else was, was very inspiring and she used that.
• 31:51
  Um, the work that she did, um, as she.
• 31:55
  Then went on, uh, eventually to become a clinical director and, um, uh, the, the principles that she was using and possibly had learned kind of, um, uh, during that, that project.
• 32:13
  Um, uh.
• 32:17
  A significant part of, um, some of the elderly care strategy within West, um, an exemplary.
• 32:32
  This podcast is all about collective voices.
• 32:35
  So if you're enjoying it, please subscribe and share it across your networks, your friends, your family, your colleagues.
• 32:42
  This way we can amplify the voice, share the stories further, and it will help to keep the podcast going.
• 32:48
  Now back to the conversation.
• 32:52
  Another, the guy that I mentioned, um, he was, uh, an interesting fellow who, um, bless him a, a portfolio as well, and he, at the time that we met, was actually thinking about giving up medicine.
• 33:15
  Um, just to, to focus on his alternative career and in retrospect, um, he came back to me afterwards and said, you know, Tony, it was really the click group and what I learned that that retained me to, um, a career in general practice.
• 33:36
  And I said.
• 33:43
  Take opportunities early.
• 33:44
  If you have an opportunity to do something, extend yourself, then just go for it.
• 33:51
  And he reflected on that, told me that that had really influenced his thinking and that he too had, um, become a clinical director.
• 34:02
  Um, and stepped up when his PCN had had need.
• 34:07
  Um, so, um, a couple of examples, but, um, uh, yeah, I think multiple examples of, of people going on and using perhaps some of the public health insights, some of the leadership insights, um.
• 34:26
  And I know that's, that's very much true of the East Kent, um, group as well, where I think within our ICB area, there are people who've been through, um, like cohorts who are now in, in key leadership roles.
• 34:43
  Um, so yeah.
• 34:47
  And what did those cohorts.
• 34:50
  Um, uh, can you describe, 'cause you, you have said about, you know, that emotional intelligence, but can you see any of that because they're really good stories that you and, um.
• 35:01
  That you've given there, that we've had people that were in clinical roles that actually stepped up.
• 35:06
  You've, you've retained one of them.
• 35:07
  They were planning to go, but they both stepped up and they both took on a challenge.
• 35:12
  But I'm interested as well in that emotional intelligence or that ability to, to cope with that.
• 35:19
  Um, you know, emotional labor of the work that we do of the gps do that they.
• 35:26
  How did the click support that, and how did you see that in either those people or somebody else that you think, yeah, it was that bit that really gave them that ability.
• 35:36
  So it wasn't just the drive it gave them, 'cause it sounds like it gave them drive, but it must have given them.
• 35:41
  For want of a better word, some coping mechanisms to actually be able to cope and do that, because it's quite hard, isn't it, to stand up.
• 35:47
  You and I both know that, to stand up and say, actually this is what we need to do.
• 35:51
  And to have the conviction to be able to say this is what's needed, or to step into that clinical director role.
• 35:58
  And I should say for people listening, that clinical director is where the, um, the general practice has come together and they need a leader so that they have a clinical leader, in most cases, a gp, but they are other people as well.
• 36:10
  But, um.
• 36:10
  Yeah.
• 36:11
  What is it that was behind that that gave them that emotional? Intelligence and ability to be able to do that, that you supported them with? I think, um, a couple of thoughts come to mind, uh, with that question.
• 36:25
  Um, one of the aims for, um, the click group from my point of view, I, I would unashamedly promote partnership, um, and I would unashamedly, um, uh, suggest that people consider.
• 36:43
  Um, roles because it's very much been my experience that that, um, maintains interest, prevents burnout.
• 36:53
  Um, and so I, I think that's one aspect of, and we would talk a lot about career choice.
• 37:03
  Um.
• 37:06
  And how you, you make your ultimate decision.
• 37:09
  Um, we would sometimes invite people in, someone from who is in a partnership role, someone who is in a salaried role, someone who is in a LOC role.
• 37:21
  Pros and cons of elements of that.
• 37:24
  So that was a very practical way of helping um, people to decide, um, what was the right kind of place for them.
• 37:35
  Um, I think another.
• 37:39
  I try very much to encourage, um, a reflective approach to, to, to the whole experience.
• 37:48
  So I would encourage them to, to ask, you know, what, what type of doctor are you? Um, you know, where do you lie on the, kind of the spectrum of risk aversion? Um, and another of the, kind of the, the questions I would ask would be, um, how far will you go? And so my, how far will you go question was, was aimed to.
• 38:19
  Tease out, you know, when you're in general practice, are you gonna be the doctor who looks at the blood and um, uses the algorithm to.
• 38:34
  Someone in practice to contact patient are, you have a patient and says, I wonder if speak to hospital about, you know, the fact I haven't had an appointment.
• 38:56
  Um, uh.
• 39:00
  Then I would encourage those trainees to, to say, well, how far are you gonna go? Are you gonna be the person who says yes and accepts the kind of the, the role of becoming the middleman? Or are you gonna perhaps push that back to the patient and say, um, no, you can, you can ring the secret.
• 39:24
  How far will you go? I saw very much kind of worked out within my own practice where, um, I had, um, a partner who would always go the extra mile.
• 39:41
  Um.
• 39:42
  So used the biblical kind of, um, uh, terminology.
• 39:45
  Um, but actually that probably was to her detri detriment, um, because she would always go every extra mile.
• 39:55
  Um, so it was little tips like that that, um, I hope helped those gps to reflect on what type of person they were, but you know, how they were going to respond in in the future.
• 40:10
  Um, another example would be, um, how are you going to respond when your first complaint, um, comes in? And it's, it wasn't a question of if, but when.
• 40:24
  So we would tease apart, um, people's experiences of their response to complain of criticism, and um, hopefully to empower them to be stronger.
• 40:39
  Um, more effective clinicians for that inevitable experience.
• 40:45
  Um, interestingly, my, my daughter is, um, she's just, um, become a, uh, counseling psychologist in a, an intensive care unit in a London hospital.
• 40:59
  And, um, I gave her the, what are you gonna do? When you have your first complaint story, and then she found it really helpful when it happened.
• 41:09
  Um, so I, I hope that there are, you know, legions of GPS out there who've heard the story and kind of, um, been equipped.
• 41:20
  Therefore, um, again, it stemmed from my, that latter example stems from my own experience of, um, a peer who had a complaint and said, if that happens again, I'll need to leave the profession.
• 41:34
  I, I heard that said in a GP support group that I've been part of for 35 years and um, uh, and that was probably 34 years ago, and I made a decision that day that I would never allow myself to have that response.
• 41:55
  And, um, so I've, I've tried to work on that principle and I've tried to teach that principle.
• 42:02
  Um, so hopefully a couple of examples of, um, uh, practical things where we equipped those guys to, you know, to, to be more resilient.
• 42:14
  Um, and yeah, to be effective in day-to-day practice.
• 42:21
  That's fascinating.
• 42:22
  Tony, you've, and you've shared some really key things there, so I'm just gonna work through each of them, if that's okay.
• 42:28
  Okay.
• 42:28
  Because the first one was about, you spoke to people about.
• 42:32
  Perhaps becoming partners in general practice.
• 42:34
  So for people that don't know, general practice is owned quite often by gps.
• 42:39
  Other people now are partners as well, nurses, practice managers, but traditionally it was gps and they would take partnerships who actually own.
• 42:46
  Part of the general practice that they worked for.
• 42:50
  But in that role there was, um, and I think that sometimes you don't always have to be a partner, but we don't have to go into that so much really.
• 42:57
  But in that role, it gave time to think about how is this run? What are we doing? How do we work the cult? What is our culture like? But actually time to think.
• 43:06
  And reflect, and you talked about taking that a reflective approach.
• 43:10
  And I think that's so important within clinical work, wherever people are or any work.
• 43:15
  Where we are providing supports and care is we talk about reflective practice and as a nurse I have to show that I'm doing reflective practice and I know that yourself as doctors and other people as well will have to show in order to sound their.
• 43:27
  Um, on their professional registers that do reflective practice, but so few of us actually have time to do that.
• 43:35
  And it does two things that you spoke about there.
• 43:37
  One is it gives that time to reflect and think about is what I'm doing the right thing.
• 43:42
  Is that what we really need to do and are we in the right place to be able to do that? So that comes down to culture.
• 43:49
  But the other thing, when you have time to reflect, actually that supports your mental health, that supports your resilience, um, and your increases your emotional intelligence.
• 44:00
  And there was a paper some years back, I don't know if you, I can't remember what it was called.
• 44:04
  It was after, it was about 20 16, 20 17, and it was talking about all these nonclinical roles that.
• 44:10
  Happen in primary care and how we can get clinicians to be doing more of the clinical work.
• 44:16
  And I can remember then thinking, but actually we need ti.
• 44:20
  Clinicians have so much understanding of the clinical work that they are the ones that need to be thinking and reflecting.
• 44:26
  Yeah.
• 44:26
  We don't need to be doing all of those extra mile things that you spoke about and all of those, you know, perhaps paperwork and or various jobs like that.
• 44:34
  There are jobs that other people absolutely can do, but we do need to be taking a step.
• 44:40
  To think, and we do need to be allowed time to do that because if you're just doing clinical from the minute you start your week shift or your week's work pattern, whatever that might look like till the end, then actually you can't see.
• 44:54
  You can't think, and you haven't got time for that emotional intelligence either.
• 44:58
  And then you talked about that reflective approach and you asked him, what type of doctor will you be? And I think that's a, that's a really good question.
• 45:05
  Um, or what type of clinician are, will you be, what type of carer will you be? Um, are you the person that's gonna go the extra mile? And how often are you gonna go the extra mile? So how far will you go? And um, I was thinking then when you were talking about that, I dunno if you listened to Cormack Russell's episode, but he talks about asset-based community development and in his book about, um, rekindling democracy, he talks about how.
• 45:34
  As a society, we've come in and we said, right, you know, you don't need to worry about health.
• 45:38
  We can, we can look after health for you.
• 45:40
  Here's the NHS, who's general practice, all this.
• 45:43
  Here's all these things happening to the point that people come along and say, oh, I just need you to do, can you do? And actually, we've almost created a dependency and if you want.
• 45:54
  A community to appreciate its assets and it comes into that bit about co-creation and co-production.
• 46:00
  Then actually just sometimes handing back and saying, actually, that's fine.
• 46:04
  You can do that.
• 46:05
  Or Why don't you, and and empowering that person actually gives them a sense of purpose and them a sense of, oh, actually I'm in charge of this.
• 46:13
  And that's not about giving people less care.
• 46:16
  Doing less for them, loving them less.
• 46:18
  However, however you'd like to put that.
• 46:20
  That's actually about supporting a person, and this is where I personally don't like the word patient, and people have probably heard me saying that on here before, and certainly they've heard it elsewhere because once we say somebody's a patient, they are somebody who's dependent upon us.
• 46:35
  They are a person and supporting the person.
• 46:38
  To just make a phone call or to think about what it is that they want or need to do, and supporting them to do that is so different than just saying, oh, yes, I do that for you.
• 46:48
  I do that for you.
• 46:48
  I do that for you.
• 46:49
  Because not only do you deplete yourselves, but what we do as a society is we deplete our communities and them seeing the assets and their abilities of what they already have.
• 47:00
  Um.
• 47:02
  And then you moved on.
• 47:03
  So I'm going through all of these and I can see you nodding, but just while I'm thinking, Tony, you moved on to that term.
• 47:08
  Bit about when you get your first complaint, and I know that the first time I got a complaint, I think I just felt pieces, you know, I just was beside myself and it wasn't really a complaint.
• 47:18
  I'd done something wrong.
• 47:19
  I was on the wards, I'd realized what I'd done.
• 47:21
  The person was a little bit upset about it, but actually, I.
• 47:25
  Looking back on it, I managed it quite well, but I was, besides myself, that this had happened because I hadn't thought about what happens when I do something wrong, or what happens when somebody complains about me, hadn't occurred to me.
• 47:38
  So I think sometimes having those thoughts around what you going to do when.
• 47:43
  It goes wrong or when something happens is a, is a really good tool to think about it in advance.
• 47:49
  And I liked what you said, Tony, about how you thought about that earlier on because of a negative comment by somebody and thought, I'm never gonna think like that.
• 47:58
  I'm never gonna allow that to be something that makes me think, well I won't, I won't do this.
• 48:03
  If somebody complains again, I won't do this anymore.
• 48:06
  So they're just my thoughts.
• 48:08
  But yeah, some ring interesting points that you brought there.
• 48:10
  You know, your reflection on that triggers all sorts of thinking in my, my mind.
• 48:15
  Um, I just.
• 48:17
  Taking on that latter point about complaints, I remember as GP tutor running a, a session in the post grad center, it must be 25 years ago, 2020 years ago.
• 48:31
  And, um, the NHS had just published a, um.
• 48:36
  A, an organization with a memory.
• 48:39
  And it was about, um, how the NHS develops no blame culture.
• 48:44
  Everyone's free to, um, to own up to their mistakes.
• 48:48
  And, um, and then we kind of submit those, those complaints and reflections in our appraisal and we'll all learn together.
• 49:00
  And, uh, so I, I'm not sure how far we've come with the no blame culture.
• 49:06
  In those 25 years.
• 49:07
  But, um, and, and of course it isn't just general practice, I think general practice on the whole is quite supportive, um, of each other.
• 49:18
  But, uh, one of the points in my career, I got very involved with paramedic education and at that time.
• 49:29
  They, they worked in a quite a punitive culture and therefore, um, uh, fear of, of, of risk, of litigation are professional discipline drove just about every decision they made.
• 49:48
  The large numbers of people who have been taken into hospital, so.
• 49:54
  Focused around the urgent care agenda, um, and looking at how risk culture is driving the urgent care system.
• 50:04
  Um, so I think it's, it's a very broad question.
• 50:08
  Our kind of response or fears of, of criticism, a complaint have massive implication for us.
• 50:17
  I probably talk all day about that one, but, uh, I mustn't Yeah, I was just thinking that's a, it's another podcast in the making, isn't it there? Yeah, because we're, we're definitely getting to the end of the time there.
• 50:27
  But yeah, that risk aversion and how does we support people through that because actually when we become risk adverse, we increase our workload and we deplete our communities.
• 50:38
  So I think, I think that's another podcast.
• 50:40
  So maybe you'll have to come back, Tony.
• 50:42
  Um, so.
• 50:43
  But for today, 'cause we are getting to that time where I'm thinking we need to start drawing to a close.
• 50:48
  Is there anything else that you were thinking before you came on today? Do you know, while I'm on with Ruth, I want to talk about, or I want to bring up, is there something that, in asking my questions and guiding you through that I may be, have missed? I don't think it's a question of missing anything, but perhaps one other little illustration, um, uh, from the contents of, of.
• 51:10
  I've once done any type of research in general practice and that was to ask, um, my patients and I think iFLY, I had responses this questionnaire, um.
• 51:26
  I ethics committee and done all the right things.
• 51:30
  And it was questionnaire done on the back of, um, another questionnaire that was being rolled out in the practice.
• 51:37
  So it wasn't kind of any selected individuals who are targeted, but I asked the question, has your illness experience ever caused you to, um, question, meaning and purpose in your life? And I also asked them whether they had been treated for mental health problem, whether they had a long-term condition and a variety of other little kind of smaller sub-questions.
• 52:04
  Um, and the, the, the bottom line was that, um, 30% of, uh, patients, um, that illness experience.
• 52:17
  Their sense of meaning and purpose in their life.
• 52:20
  Um.
• 52:22
  And that didn't change whether they had a long-term condition or not, but if they'd been treated for a mental health problem, that figure rose to 60%.
• 52:32
  So for me, that was, um, I, I was quite surprised by that figure, but to me that indicated that people who have had mental health experience often ask much more existential.
• 52:48
  Questions.
• 52:49
  And to me that that's kind of spiritual.
• 52:54
  Um, and uh, and my conclusion was I think the health services missing something.
• 53:02
  You know, some aspects of of the system have chaplaincy, but not many.
• 53:08
  Um, actually.
• 53:10
  You know, I think it's worth bearing in mind that, um, uh, that people with mental health problems may well be having a little bit of existential crisis kind of linked in with, um, their experience.
• 53:24
  So, and I would then, I'd use that question, I used to teach a session on holistic care.
• 53:32
  Group and I would mention, um, the results of that questionnaire as part of what we were, we were doing.
• 53:39
  Um, and you know, looking at culture currently, I think our society is in the midst of a meaning crisis.
• 53:50
  Um, so that's informing.
• 53:53
  Some of what I'm doing in, you know, the, the tail end of my swan song, of my, not my career, but, um, so some of my work with now mental health charities, um, that would inform that, that kind of thinking.
• 54:08
  Yeah.
• 54:09
  And I'm, you can probably see, I'm just speaking back 'cause I, that reminds me of a podcast, um, with.
• 54:14
  Jane and I'll, I'll have to put it in the, uh, show notes.
• 54:17
  Um, not Jane Room.
• 54:18
  Oh, Jane Stevenson.
• 54:20
  Who's the Stevens? Sorry, who's the, uh, medical director at, um, Darren Valley Hospital.
• 54:26
  Okay.
• 54:26
  And she's talked about nephrology and I'm just reading, um, because of what she mentioned then, and it's taken me a while to get round to it, man.
• 54:34
  Search for meaning, but it really talks about that spirituality and when we.
• 54:39
  Um, is many of us as clinicians will talk about physical and mental health, but within that we talk about spirituality.
• 54:47
  I can remember, remember it being spoken about in my nurse training, but actually it was something that we touched upon about, and, and the question was, oh, just ask people.
• 54:55
  If they're religious or not, and if they are, what the religion is.
• 54:58
  And that was almost the end of it.
• 54:59
  That was the end of spirituality.
• 55:01
  But actually, as you say, it goes much deeper than that.
• 55:04
  And it isn't about what religion people are or aren't, or whether they have a belief or not, but it's about those, those questions.
• 55:11
  And actually it's a really important point.
• 55:13
  So again, that's probably another podcast, but if people are interested in that, I would definitely say go back to, go back to Jane's one because it was, um, it really did touch on that.
• 55:22
  Um, area quite deeply.
• 55:24
  Um, but thank you, Tony, you, you've shared so much.
• 55:28
  So I feel like you've left us with a couple of future podcasts to think about, um, with yourself or somebody else, but it's been really interesting having you on today.
• 55:37
  Ah, thank you so much.
• 55:38
  I just wonder if, before we go, do you have a message that you would like to share or whatever that might be a measure stage of positivity or of something that you think people would take away or, um, something that you think that.
• 55:51
  A call, maybe a call to action, but whatever feels more com most comfortable with you.
• 55:55
  Um, just a gut response, I think, um, be kind to each other, um, is, um, you know, one of my reflections in, in looking after each other as the wider health community, whatever role and function.
• 56:17
  If people are in a kind of a, um, a bit of a grumpy state, there's probably a reason for that behind it.
• 56:24
  So rather than just kind of acting on the basis of, basis of what you see in their behavior, um, you know, might be interesting to explore why they're behaving like that.
• 56:36
  I think, um, not only, uh, applies to patient care.
• 56:44
  Um, you know, some of our patient's behaviors are that kind of, um, uh, you know, can at times be extreme, but I would always encourage staff to look, you know, what's the explanation for the behavior? And similarly, um, just being kind and, and patients and supportive to one another as healthcare professionals.
• 57:04
  And thank you.
• 57:05
  Thank you and thank you for that lovely message to end on.
• 57:09
  I really appreciate your time today, Tony.
• 57:10
  Thank you so much.
• 57:11
  Thank you.
• 57:14
  I hope today's conversation gave you something to think about.
• 57:17
  If it did, please share it with someone.
• 57:19
  Ripples matter.
• 57:20
  You can also follow the show so you don't miss future episodes.
• 57:24
  And if you have reflections or ideas, then please leave a rating or to support my work head over to my link tree, which you can find in the show notes.
• 57:33
  But for now, stay caring, stay connected, stay curious.
• 57:38
  Thanks for listening.
• 57:41
  I hope you found that conversation as thought provoking as I did.
• 57:43
  Tony's final message about kindness has really stayed with me.
• 57:47
  It's a reminder that however people show up, there's usually something sitting underneath that.
• 57:52
  And if we can meet that with kindness toward others and ourselves, we'll make the world a little gentler every day.
• 58:00
  So until next time, take care.
• 58:03
  Be creative, and be kind.