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Episode 10- Laura Neilson

Season 1, Ep. 10

An interview with Dr Laura Neislon, Hope Citadel CIC.

As a medical student, just over 10 years ago, Laura saw ‘health being done badly’ and having a big impact on her friends and neighbours. Laura decided with a team of colleagues to set up her own GP service which was the founding of Hope Citadel. She is now responsible for running 9 GP surgeries across greater Manchester.

Show Notes

I was so excited about talking to Laura as I personally find her inspirational. Her dedication to the people in her community and team is heart-warming. Whenever I see Laura I leave with a feeling of belief that change can happen. Laura starts off our conversation by telling us what is so special about Hope Citadel and how it compares to normal general practice (3m30s). She shares her experiences working in one of the most deprived areas of the country (8m15m) and how important, particularly working in areas like hers, to be fantastic generalist (10m30s).

We discuss co-planning, patient centred care and bargaining (12mins) and how important primary care is in all of this. We also hear about focused care at Hope Citadel (14m45s) and how they are using their incredible focused care workers to help with some of their more complex patients.

‘If you go to outpatients are you going to see an SHO and is that worth half a day off work on a zero hour contract?’ (13mins)

Laura is rightly proud of her team and what they have created. She shares with me her insights into how she chooses her team at Hope Citadel (18m40s) and where this all sits in the bigger picture of Manchester and beyond (20m40m). We touch on the complexity of politics and the role of doctors and health professionals in speaking out about what we see (23mins). Laura tells us how she feels her voice has developed more validity over time (24m20s). Her confidence has increased with experience and she sees a huge value in working with one community over a long period of time to really understand the context and place.

Laura’s career so far has been anything but conventional. We discuss her courage of stepping off her medical career journey and choosing to do something to make a difference (26m40s). She says she wishes doctors were braver, but she admits that she is not sure if she knew then what she knows now whether she would have created Hope Citadel (30m30s). She describes her naivety as being really freeing and shares some of her lessons she has learnt along the way (32mins).

We discuss Laura’s faith (37mins), her family and friends (40m30s), and how these all play a part in making Laura who she is. Laura shares her insights on values, imagination and vision as part of all of this (38m20s). Despite all of this, Laura still finds time to have fun too (42mins). We discuss making time to relax, being bad at your hobbies and finding joy in the space you are working in.

Intro about Laura (1m45s)

Laura’s Best Book (50m45s)

Growing pains by Dr Mike Shooter

Genie question (48m10s)

Recommended reading- Harry Potter

‘If you do the right thing clinical outcomes will follow’ - Laura Neilson

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5/13/2020

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Episode 13- James Matheson

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Dr James Matheson shares his experience on what is going on at his practice in Oldham, Greater Manchester, during this worldwide pandemic. James highlights how we are uniquely well placed in primary care to identify those most in need.James shares some of the positive stories of support during this crisis. He gives an example of how those living with homelessness have been housed almost overnight after years struggling to achieve this. We also talk about what we can learn from this crisis to support the most vulnerable in the future.Alongside seeing patients with Covid-19, James discusses the importance of continuing day to day care especially for the most vulnerable. He shares some of the things individual GPs can do to support these vulnerable people and how we can identify and reach out to those people most in need. We discuss the risk of Covid-19 for patients living in deprivation, but also the impact of little or no financial reserve during this time. He talks about some of the vulnerable groups that are particularly likely to suffer during this crisis. He mentions those living with homelessness, Gypsy and Travellers, refugees and migrants.To finish James tells me why he is feeling positive about the future.Please check out a recent blog post Fairhealth in the time of Covid-19 from Dr Tom RatcliffeThe RCGP are releasing some guidance on supporting vulnerable patients very soon. Keep an eye out on their resource hub and I will also post a link here.
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Episode 12- Sir Michael Marmot

Season 1, Ep. 12
An interview with Sir Michael MarmotShow Notes I was honoured to have a conversation with Sir Michael Marmot just a few weeks before The Marmot Review 10 Years On is due to be released. He told me the report has been performed in ‘the spirit of self examination’ to see if there has been any impact or if any good has come from the original report (2mins). He mentions the importance of the report amid the current context of worrying life expectancy figures (2m45s) and sheds some light on the reasons behind these worrying trends (4m40s).Sir Michael Marmot is world renowned as a specialist in the impact of inequalities on health with internationally acclaimed research, writing and public speaking on the topic. The professor talks to us about how he perceived his role in all of this (8mins) as someone who synthesises evidence and chains of reasoning (10m40s) to formulate recommendations. Despite being an international spokesperson for such an important issue, Michael tells me that he doesn’t see himself as particularly political (12m50s) but does feel able to present information ‘in the spirit of social justice.’ We discuss if the moral case is enough to inspire or create political change (13m30s) and how to create action around health inequalities. With years of experience of sounding the claxon for this important issue, he gives his views on how we unite people around this goal and how to deal with actors in the system that might not prioritise equity (15m 30s).With government promising more spending we talk about current opportunities for spending in areas that are most in need (17.30) and gives hope that there will be clear recommendations coming out of the report for where government should direct their resources. We talk about practical action for health professionals too with six recommendation of how we as health professionals can take steps try to tackle health inequalities (19mins).With climate change likely having the biggest impact first to those most disadvantaged and in need, Michael is aware of the current importance of climate change and environment. He shares with us how he is involved in trying to bring the environmental and social determinants of health agendas together and how actions to improve health can contribute to meet carbon neutrality (23mins).To finish we ask for Michael's book recommendations (24m10s) and his genie wish (28m10s)Michael's book recommendations (24m10s)Development Is Freedom – Amarta SenCapital Twenty First Century- Thomas PickettyGreat Expectations by Charles Dickens (first 2 pages if nothing else)Further readingWorld Medical association report- Doctors for health Look out for the Marmot review 10years on report due to be release on February 25thMichael Marmot’s five recommendations of what doctors can do to tackle health inequalities1. Education2. Seeing the patient in a broader perspective/wider context3. Health service as an employer and the health system having an impact on the broader environment and community4. Working in partnership5. Advocacy