Finding fairhealth podcast

An interview with Victor Adebowale, Chief Executive Turning Point'My experiences of life have lead me to believe that in most public services the inverse care law applies, it shouldn’t. It’s an inefficient use of limited resourse’ - Victor AdebowaleShow Notes Lord Victor Adebowale is a busy man so I was so pleased he managed to squeeze in a chat with me for the podcast. He talks with honesty and humour. Every time I have met him our conversations give me so much to think about.Victor shares his experiences as Chief Executive of Turning Point. He tells me how he and his team make it their mission to try to tackle the inverse care law (2mins). He talks about the importance of a clear vision for his team and what a privilege it is to try and improve the complex lives of others (7mins). Turning Point’s role in the system is complex but made even more so by the need to run an effective business amid all the complexities of the system (9mins 10s).Victor thinks about how we can best design services to fit the system and the population. He explains the importance of having positive rather than negative value transfer (10mins) and how Turning Point put clients at the centre of service redesign. He gives an example of how they have done this at Turning Point by integrating alcohol and drug services.We discuss competition and his experience of collaborating with local services and the community (14m30s) and when this does or doesn’t work. We bring in the concepts of place based approaches and population health explaining how his team works hard to understand the needs of and build trust within a particular community to try to deliver this. He says the concept is easy but the application is rather more difficult. He explains that for him this means ‘leadership beyond boundaries’ and ‘system leadership’ (from 20m30).In his chief exec role he explains the importance of working out what the right question is (21m 10s) and says that is often questioning whether a process matches the intention (23mins). For Victor one of his main intentions is tackling the health inequity and the inverse care law (24mins). He says ‘What else are you going to talk about if you are involved in health care?’ For him he says this is a logical approach (25m 50s) for him and feels this would be the same for any sensible human being wanting an impact in the system.He talks about how we cope when other people in the system don’t share the same priorities and how we can build some accountability to ensure health inequity moves up the priority list(28mins 40s) . We discuss measuring success and impact in a system (29mins) and how trying to reverse the inverse care law should be taken into account when thinking about any measure we use for the system.As always we finish talking books and dreams. Victor gives us his recommended reading (34mins 40) and his one wish to tackle health inequalities (35mins 20s).What I really liked about this conversation is that everything we talked about came back to trying to reverse the inverse care law. We hope you enjoy the episodeIntro about Victor (1m45s)Victor’s recommended readingAnything by Professor Michael Marmot e.g. The Marmot Review: Fair Society, Healthy LivesInvisible cities by Italo CalvinoHe recommends us to read books that aren't about what we know about already but new things people that we haven’t come across before.Genie question (48m10s)‘In a nutshell, there are only three challenges that face the NHS: Equity, Access and technology, in that order.’(11mins 30s)Victor Adbeowale

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 NotesI 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 ShooterGenie question (48m10s)Recommended reading- Harry Potter‘If you do the right thing clinical outcomes will follow’ - Laura Neilson

An interview with Dr Nigel Hewett OBE Nigel is a GP and set up the national charity Pathway, a model of integrated care providing patient centred care for the homeless. He is also a founding member of the homeless and inclusion health faculty providing education and a network of health professionals dedicated to supporting health in excluded groups across the U.K. Show notesWe hear about what got Nigel Hewett interested in vulnerable groups, particularly the homeless (8mins). He talks about the health services he has been involved in and run over the years to try and help with this important vulnerable group. He also talks about staff attitudes to the homeless, quality of care for these patients and how important it is to educate and support professionals early in their careers around this topic (7mins). Health professionals working with these groups can feel isolated and we discuss the importance of forming alliances with other health professionals and supporting each other (24mins). He gives some top tips for working with homeless patients (9mins) including ways of managing drug seeking behaviour (10m30s). He also suggests using warm, understanding and empathetic scepticism rather than cynicism. He gives some tips on negotiating too (22m30s).Nigel outlines some of the problems homeless patients face when admitted to hospital (12m30s). He gives some suggestions of seemingly simple but often overlooked questions to ask homeless patients when they are admitted like ‘Do you have somewhere to go to on discharge?’ He talks about how pathway teams can take a multi-agency overview to both support and advocate for these patients while in hospital and before discharge.We discuss the fact that the health of the homeless identifies emerging trends in health and the system (27mins), politics (28m20s), legislation (31m35s), housing (32m20s), picking your battles (35mins), and something that he feels is key to all of this, child poverty (41mins).With years of experience working with marginalised groups, particularly homeless patients, both on a one to one and national level, Nigel gives us an insight into some of his learning along the way (39m20s) and how professionals working with vulnerable groups can protect and look after themselves (46m25s). We also hear about what is new on the horizon for Nigel and his team (50m40s).Nigel gives such a great overview of the challenge of supporting and providing health care to vulnerable groups in the UK. We hope you enjoy our conversation.Nigel’s one book (51mins 35s)Even the dogs by Jon McGregorFurther readingHomeless service standards for commissioners and providersProfessor Suzanne Fitzpatrick at herriot watt- pathways into homelessness-PathwayFocused healthcareBuurtzord system, Netherlands