Wild Card - Whose Shoes?

52. Dr. Matt Hill - creating the conditions for healthcare teams to flourish

March 03, 2024 Gill Phillips @WhoseShoes
Wild Card - Whose Shoes?
52. Dr. Matt Hill - creating the conditions for healthcare teams to flourish
Show Notes Transcript Chapter Markers

Today, I invite you to meet Dr Matt Hill – I hope you enjoy the warmth and wisdom he brings to this  podcast series as much as I do!

I heard Matt speaking at the online NNAP conference, the National Neonatal Audit Programme, which showcased best practice in neonatal care. 

Matt is the Clinical Adviser on Safety Culture for NHS England and was one of the keynote speakers.

He was talking about creating the conditions for a perinatal team to flourish – but it became clear to me that what he said would help ANY healthcare team to flourish.

There were so many practical examples of what makes a good team, and how is leads to well-being and a positive safety culture. 

There was an emphasis on collaboration, inclusion, empathy and relationships. 

There is huge synergy with our ‘Whose Shoes’ work, particularly around our core principle that you have to create the conditions for meaningful conversations, coproduction and teamwork! 


Lemon lightbulbs 🍋💡🍋

  • Health care in its broadest sense is about people - people caring for each other. 
  • Be curious about people; nurture and invest in them; share personal stories
  • Look for those moments of human interaction
  • Create space to get to know people as human beings and build trust among colleagues
  • Learn about and recognise the value and unique contribution each individual brings
  • Kindness and compassion helps good team dynamics, and improves culture and safety
  • Create a welcoming environment for new staff members
  • Introduce yourself as a person, rather than solely by job title, to foster a more inclusive and connected environment
  • Flattening the hierarchy in workplace conversations makes it easier for junior members to share their thoughts and feelings with more senior colleagues
  • Recognise and value diverse perspectives in healthcare, rather than prioritising a narrow view
  • Understand patient experiences and preferences - ask what matters to each person to provide effective care
  • Small gestures matter, such as using people’s preferred names, in building trust and psychological safety
  • People may have different interpretations of the same words or actions
  • Establishing positive relationships improves care outcomes, especially for the most vulnerable people
  • Focus on doing things differently, rather than just measuring what we do!

If you have enjoyed this episode, you'll also love:

Episode 32. Dr. Bob Klaber - kindness matters!



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

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

Gill Phillips  00:10
My name is Gill Phillips and I'm the creator of Whose Shoes, a popular approach to co-production. I was named as an HSJ 100 Wild Card and want to help give a voice to others talking about their ideas and experiences. I'll be chatting with people from all sorts of different perspectives, walking in their shoes, if you are interested in the future of health care, and like to hear what other people think, or perhaps even contribute at some point, Whose Shoes wildcard is for you.

 Matt Hill  00:40
Thank you, thank you for creating this space for us to share some thoughts and see where the conversation takes us, I guess. For those that's a really key thing for me how we create these spaces and spaces for conversations to understand each other and yeah, share what's in our heads and understand each other better. And I think that flows through throughout the work in teams as well.

 Gill Phillips  00:46
So today, I had the pleasure of talking to someone whom I only met recently, but who blew me away with the talk that he gave at a conference. There was just so much synergy with our Whose Shoes work, particularly around the core principle that you have to create the conditions for meaningful conversations, co-production and teamwork. I've been working hard to reignite our Family Integrated Care project, which lost a bit of momentum when I was diagnosed with breast cancer last year, which is the main reason for the recent pause in the podcast series. In order to re-energise and hopefully meet some interesting people, I attended the online NNAP conference, the National neonatal audit programme, which looked at best practice in neonatal care. Dr. Matt Hill, my podcast guest today was one of the keynote speakers. Matt is the clinical adviser on safety culture for NHS England. The title of his talk was 'Creating the conditions for perinatal teams to flourish'. So I tuned in to see what I could learn. There were so many practical examples of what makes a good team, a good culture, and how it leads to well being and a positive safety culture. There was an emphasis on collaboration and nurturing individuals, both families and staff. I loved what I heard. So not to put too fine a point on it. I accosted Matt to see if he would like ait conversation. And here we are. So welcome, Dr. Matt Hill, I'm so looking forward to chatting with you, and sharing some of your warmth and wisdom with my podcast audience.

 Gill Phillips  02:52
So what kind of things do you think ..  I mean, what I loved about your talk was that you were saying it's not a tick box, you can't just have a list of things like safety, huddle, or handover and work down them and tick them off. And hey, you've got a good culture. It's  more the subtlety, isn't it? It's  about people and relationships? How does all that work?  

 Matt Hill  03:13
So, as you say, certainly when I first started off, working in and around culture and safety culture, I thought that if I grabbed the next intervention and we did the intervention, that would improve our culture, because that’s what the evidence said. It said that if you do this, then it will make things better. But I soon learnt that it’s not just doing the processes, it was everything it was wrapped around, that coming together of people of understanding is that is that an opportunity to have a better conversation, really understanding each other and building that? Those relationships between us, that are fundamental to us as people and humans. And I think so much of healthcare has become about doing. We focus on the doing, measure what we're doing. And we get in a way rewarded for what we do. And it's just taking that step back, think about how we do things. I think we sort of lost sight of some of that. And I think recent events and a pandemic, being one of those has refocused our thoughts about how we are as people. And there's a lot of other work that supports this. So aspects of civility, learning from excellence, the kindness work as well. It's really trying to emphasise, I suppose, that real human element that we sort of sometimes lose in the work, and it flows through to those we look after as well. They notice if we're not kind and compassionate to each other, then they sense that and it raises their anxieties as well because if we're not kind and  compassionate to others then the extension is we may not be kind and compassionate to them in their most vulnerable states that they are,

 Gill Phillips  04:10
it's, I agree completely, and it's every transaction, isn't it that people see what's going on around them, not just the words, but the manner in which they're said, the body language, the emails, whether they're abrupt or whether they're, you know, a little bit more, more human. And how that might vary at different times, according to whether people are under pressure or perhaps different staff, so if you were say, a parent on a neonatal unit, I'm sure you must have people that walk in and your heart either hopefully, feels better, or sinks, because you see that the person who kind of lifts the team or who, who has perhaps the opposite effect, for whatever reason. It's fascinating. It's all the different human interactions and how people feel about that, isn't it?

 Matt Hill  05:51
it? So as you say, is that exactly that, and it's that was watching the response of the rest of the team members that really gives you an idea about how it feels to be part of that team? You know, it's it is, so it's those little gestures, you know, knowing something about each of us on the team, what matters to us, not just that we're a doctor, a nurse and midwife, whatever we, it's knowing something about us as people and what motivates us and that connection to us so that you can touch base with people. So if it's about, you know, their cats being unwell, then you can talk about that, and it shows you value them and what matters to them. Which means that when we come together, so Manitoba escalation, so escalating something about a concern about the sick, neonates, then when we say that, when we escalate, what happens is it's a very different response, because we're invested in that relationship. So rather than becoming purely transactional, there's a lot more, I suppose water understanding there, that brings about a better conversation and hopefully better care, because we're actually really coming together, rather than it being I suppose. slightly colder, and less, less warmth, empathy within that conversation. Yeah,

 Gill Phillips  07:20
yeah. I know one of the examples that stuck with me from your tour, which I found just eye opening in a way or just thought provoking was the train journey, when we're talking about the train journey. Tell us about the train journey and how that might help.

 Matt Hill  07:36
So yeah, so I was taught so as part of the national programme, the perinatal contribution programme, all the quads, so that's a neonatal lead, and obstetric lead, and Midwifery, lead and operational lead, are coming together to take part in in some development. And I was talking to our local quads, and well what they were members well over the quality said, the travelling to stop to Birmingham. So it's a three and a half hour train ride, just those three and a half hours spent together, understanding each other getting to know each other, were invaluable in really sort of bringing them together. And she said that, they would never have put aside three and a half hours to come together in Plymouth to get to know each other, it just wouldn't have happened. So even the process of getting to where they're going to do something was invaluable to them and getting to know each other. It, it's credit to them, because there's various ways that we could, they could have travelled the trip, they could have just sat with earphones in or reading a book or, but the fact that he said, Well, actually, I want to get to know you, I want to understand you and you as a person. So that, you know, I think it's wonderful. That's how they were entering into as as well as seeing each other as more than just the job titles. So that that gesture that was made in that train journey, is really, really set up the rest of the work that they're doing now.

 Gill Phillips  09:08
And that could be people, I think typically that could be people who are perhaps more senior or more junior and perhaps travelling together for the first time. I can think of an example of how that's been very influential in my work in that I came back from I can't remember where it was, I think it was Leeds with a woman called Catherine McLennan who I'd met at a conference. And I'd heard a little bit about her story about, sadly, a series of baby losses and including in the middle trimester. And Catherine was telling me about this. And we continued the conversation on the train in a way that we'd never have done just from a casual kind of coffee queue chat at a conference. And by the time we got to Birmingham, I said if there's ever any chance that I get through Whose Shoes of doing something around this very specific area because she was telling me that, obviously a very sad topic. But if you have an early miscarriage, there would be a certain type of support, and people understand that, and obviously a stillbirth, but this middle trimester was, like no no man's land. And obviously, there's the the complexity about dates and how many weeks pregnant and whether you end up on a maternity ward or gynae ward, and how arbitrary that can be, Honestly, it went on and on and on. And within two weeks, we got the chance to apply with NHS England for our Nobody’s Patient project, which was about specific groups of women or families falling through gaps in systems. So for example, maternity and neonatal care at the time, we were able to add that topic in as a powerful extra topic which we explored with women and families who had been affected. And honestly, it's one of the most powerful things I've ever got involved in. So that was from a train journey,

 Matt Hill  11:04
I think it's … so I think there's, there's so much of in what you're describing there about, say your I suppose your natural curiosity about how it's was for Catherine. And then again, I wonder how much she benefited from sharing her story with you. It’s a way of feeling that you know, someone else was listening and cared. So that really empathetic approach and compassion within that, that you described then. Yeah, I suppose the bit that struck me there is that almost chance conversation that if you planned to sit next to her on the train on the way home,

 Gill Phillips  11:42
It was definitely a chance that we’d met in the first place. And I think by then we perhaps walked to the station and planned to travel back together, we certainly, we didn't know each other at all before that day. So luckily, there was a spare seat.

Matt Hill  11:56
But it’s taking those moments, I guess, and some of the work we're doing is called ‘moments’ about how you have the best conversation - and there again, as you've said answers, we could have a really interesting conversation and understand how it's been for you. And you … the gestures you made of walking to the station together, getting on the train together. And how that then creates a sense that you have a trusted, safe conversation, when you've only just, I suppose met each other? Yeah, it's quite a lot to share. It's a very vulnerable story to share, I'm guessing.

 Matt Hill  12:30
Yes, very

 Matt Hill  12:33
This is part of it …  a lot of these conversations are unplanned. We don't set out to say this is what we are talking about. This is what we want out of it. It's like you reaching out to me and saying, We just had a conversation about this and see where, see where things go. And it's it's that, I suppose that curiosity to understand and see where the thoughts take us and spark. And then where the links go and the development? It’s

 Matt Hill  13:07
that sort of complexity based thinking that really excites me?

 Gill Phillips  13:12
Yeah, and me too. And I don't know whether you know, Mary Salama, she's a paediatrician in Birmingham. But she's an active member of the Q community, which I know you are Matt. And we met through a coffee queue, and we set up … so if you look on Twitter. And it never really took off in in a big way. But hashtag #IntentionalCoffee. And that's exactly what we're doing here in a way - you find someone you're interested in. And so often you …  I think a coffee queue is a great example, or probably train less so because you probably sit with, you know, your own space on a train, and you're a bit scared of talking to other people, because you might be stuck with them for the next three hours. But like in a coffee queue, you talk to somebody and then you think wow, and then you just go your separate ways. I remember at one Q community event, I ended up chatting to a GP from Devon, and we both missed the next session, because we were just having such an amazing conversation. And I'm sure I remember that. And the links that came from that more than, you know, however good the next session would have been. It's just taking the moment isn't it loving and I think that word, ‘Curiosity’ is key. So Mary, and I set up intentional coffee. And the idea is that you deliberately link with someone that you … or link somebody else with somebody that you know that these people just have to talk and it's intentional and that you're bringing them together. But exactly as you've just described, there's no agenda, there's no expectation, there's no pre planned outcome. It's just sparks, isn't it and seeing where it goes together.

 Matt Hill  14:47
Because it's, I'm just thinking about that, you know, initial gesture of talking to the person next to you in the coffee queue. And, you know, so much of that is about just … we’re two people, and because there's often, at coffee, you don't know, the backstory about them, there's no hierarchy there. You’re both in the coffee queue. And, and so sometimes at work, I think that hierarchy gets in the way of conversations. It can feel slightly, er … difficult for more junior members of a team to spark up conversations about other aspects of work or life with their more senior people. And I guess it's how we create that flattening of the hierarchy, so that we’re much more approachable. And how we have those spaces where we come together, certainly a really important space for us at work. It might surprise you, but anaesthetists drink an awful lot of coffee, is our coffee room. And it's a place where we get support, we share stories, we can be vulnerable there and say, … “I’m having … I’m struggling today”, or “I’ve got a difficult case”, you know, seek advice and peer support. And that’s the same across the whole department, from for more junior members through to the senior members. What was that … we’ve created the space where we feel that people can have these conversations, you know, what we talked about there is what matters to us. And there's conversations about work … stuff outside of work. And I suppose what I hope is that by role modelling that approach where we are vulnerable, we are asking for help, then everybody else as they come through, sees that as a positive thing as well.

 Gill Phillips  16:36
So I'm sure and you were talking there about hierarchy, and we've got a hashtag hashtags, you probably gathered that, #NoHierarchyJustPeople and with our Whose Shoes work, and it's funny to see how other people interpret it and what they add. So I remember the first hospital, I think it was Guy’s and St. Thomas's, who actually put a STOP sign at the door, and ‘take your NHS lanyards off’, you know, and encouraging people to come in their normal clothes rather than in uniform, which obviously isn't always possible in terms of busy units, and so on. But as far as possible, no hierarchy, just people. And we say, Please don't artificially introduce yourselves around the table, just start a conversation. And then it's not about hiding who you are. But as part of the conversation, it might come up that, you know, as a midwife here, or as an anaesthetist here, and your role is part of what you're saying about yourself, and why you're making that comment rather than, you know, just defining yourself by a label. And it can be incredibly powerful. Because if I say, “Oh, I'm the chief executive, and remind me little person who you are,” that sets a certain tone around the table. Whereas the chief executive,  say if it was a workshop around dementia care, might have her our own mum or dad with dementia. And she can join it as .. or he, she can join it as a person bringing their whole self rather than defined by the role that people have, you know, seen them as at the beginning. It's fascinating. And I think that the work that you do to sort of break down hierarchies and how it feels to be perhaps that new person entering your coffee room, when you're very comfortable with it. And I know you're very aware of that. 

Matt Hill  18:26
It is and it's two things, there’s something about Ask and Hello, which rather than you're introducing yourself as your job type, introduce yourself as a person. 

 Matt Hill  18:37
Yes,

 Matt Hill  18:38
Your personal values and what matters to you outside of your work world. And that's the bit about understanding me as a person not about my my job title. I think Ask and Hello is a wonderful, wonderful thing and we’re certainly using them more and more, just so people see me. And certainly some of the NHS England work where there is a hierarchy straightaway. And it's really, really important that they sort of get beyond that and get down into that human connection. And the Ask and Hellos certainly help with that. And you said something else … you asked another question, which I skipped.

 Gill Phillips  19:23
I think it was about bringing new people into your coffee room and how that might feel I remember you talking about that. And if they were felt threatened or …

 Matt Hill  19:32
Yes. So I've been here for 20 odd years as a Yeah, first of all, trained down here and as a consultant, and I'm very comfortable in that coffee room. But I can imagine walking in there for the first time. It feels very different. And it's almost that whoever's in there being being a host. So some of you don't know introducing yourself, saying hello. Offering a coffee. Just those little gestures, make a massive difference to how that person feels when they come in. So they are welcomed into it, rather than it being Oh, this is a bit uncertain. Am I welcome here? Is there a seating plan that certain people sit in certain seats? Or is it just a free for all, which it is. And you know, one of the other things is that coming in there, there's often mugs are missing, they often end up in theatres and disappear. So someone coming in and not knowing how to find a mug and get their coffee, it’s Oooh … how do we help that process where they feel welcomed and can get a coffee to get them through the day. So little gestures matter massively. And something that I think we don't do enough of is then ask people how it feels, how it feel when you arrived? What can we do better, so that we can welcome those who come later, in an even better way. So they do feel the warmth of the department and cared for and nurtured. But I must to do more of that, and digging in and being more curious about how it feels to people when they first arrive.

 Gill Phillips  21:10
Because I think you're naturally curious. So you will do. It’s interesting, I was thinking, I know, you obviously do a lot of work around teamwork. And something that fascinates me is, who are the team. And that became a topic for me if you like when I did some work with a hospital in London, around operating theatres. And I get involved in all sorts of really interesting things. So I feel very privileged with that, and I was being shown, I was in scrubs and being shown around the theatres and so on. And the person showing me around said very proudly, “this is the team” and they had got photos of the team on the wall. And it turned out the surgeons weren't on the the photo board, because they were there was this description around, it felt like, this is our house. And these are the people who live here. And these are the lodgers , and these are the kind of occasional visitors. And it just blew my mind really, in terms of you know, like to do something as definitive as a photo board. And it's great, you know, you see people smiling faces, you see names, you see perhaps who's who. But at some point for me, with my sort of interest in different perspectives and grey areas, there's someone who makes it onto the board and someone who doesn't, you know, or where does this team end and the the whole kind of culture of collaboration and working with other teams. Say take the example of maternity and neonatal. And obviously, the closer people are working together, the better it is for the families. So I don’t know, I'm sort of babbling on a bit. But that whole sort of concept of teams is interesting, 

Matt Hill  22:50
No, it is but I don't think it's the only place you'll see that. I guess sort of the the challenge of what’s happening in health now is that the teams aren't stable. They're really dynamic. Just by the way, we staff and we work together, in the shift systems. It's changed over times. But I guess, that dynamic nature means that how we come together matters even more. You often don't have those relationships developed because we're not a stable team. So when we do come together, we should almost be spending more time understanding each other before we start the work. And I suppose this is some of the moments we're trying to create, a lens into how we do the work. So we have lots of sort of structures. So we'd have a … we may have a huddle, or a safety briefing or ward round. But they often focus on the work, on transfer of knowledge. And just spending five minutes at the start just talking to each other, getting to know each other. They're really, really crucial elements that set up the day to be much better. But we almost don't see that as the work. We see that as just chat.

Matt Hill  24:52
Well, I suppose how we shift the focus though, is coming together as people is seen as part of the work And hopefully the moments work does that by sort of giving us a lens to understand not just what we're doing, but how we're doing it, and how, in those moments, we're enacting our values. So thinking about as we come into a ward round, are we being inclusive, compassionate, kind, civil? All the bits we know, really, really matter. When we say, well, course we do that, but unless we pause and step back, and then … are we? Is that everyone's experienced in this team?. We don't know that, unless … we don't know how it feels, across the team, unless we ask them, and they feel safe to be able to share how it feels. And that building of trust takes time. Unless we invest that time and coming together, then that trust element can be very, very fragile indeed.

 Gill Phillips  25:58
It's so interesting, and I think I might be wrong. But it feels to me as if there is more understanding these days, if you like about the fact that those things do matter. You know, I'm obviously older, and it used to be you came to work and you left your family and you left your kind of personal situation at the door. And it really wasn't encouraged to bring any of that kind of vulnerability into work. And you’d confide in your mates at work, but not … you know, it was a different culture. And I think it does feel as if people realise the value of  …  I mean, I suppose just the whole work that we've done around say, patient experience, maternity experience, and whether that's sort of a fluffy add on, or whether it's fundamental to patient safety. And that seems to have been quite a shift over even the last 10 years that the two are kind of intrinsically linked rather than two separate things, and that the experience is a nice to have extra. Whereas Actually, no, it's not, that's what opens people up to speak more honestly, and to, to avoid tragedies, ultimately. 

 Matt Hill  27:04
And that ability to speak up, that understanding of experience really, really affects outcomes as well. And we know this, we see it, in different aspects of care. But we know that that experience will shape the future, in so many ways. And we're different, we're all different people, unless we ask what matters to each other, we don't know, and what I may want, and what may make me feel comfortable, will be very different to somebody else. So what is that experience on a person by person basis, rather than I suppose, generic,, this the package we have given? There we go. So it's just that wanting to understand what makes a difference to people. There's those gestures that we make, there’s speech, written, however it may come across. But how are we received? How are we perceived by those we're interacting with? Is it positive, or is it less positive?

 Gill Phillips  28:15
And it's so individual, isn't it? One of the examples that's come up, I mean, this is exactly what we explore through Whose Shoes … to try and get people to see the subtleties and how you can't just have a blanket, you know, one size fits all. And it always intrigues me how, you know, obviously me attending these perhaps different workshops and events and hearing different conversations, and then you suddenly get a new take on it that’s different from perhaps the majority. So for example, you might have a scenario about … oh,  they kept calling me mum, they couldn't be bothered to learn my name. I've got a name … it’s so dehumanising. They just say, oh, you know, how are you doing today, mum or whatever? And then you can kind of take that as read. But then I spoke to somebody else who said, Oh, no, no, actually, when they call me mum, you know, I didn't, I was a brand new mum with this premature baby, I didn't feel like I was a mom at all, it was like the best thing. And then you get into well, perhaps how those words are said, whether it feels as if they can't be bothered to learn my name or whether it's feels as if they're trying to empower me in my new role and relationship. So this is what fascinates me really. 

Matt Hill  29:30
I guess it's one of those bits about how you introduce yourself and I work with … this is about colleague conversations, which … I’m called Matt, my colleague is most definitely called Matthew and my response to being called Matthew is, almost looking over my shoulder, looking for my mum! I’m in trouble again!

 Gill Phillips  29:50
Like me with Gillian! I’m in trouble!

 Matt Hill  29:55
But it's that ... how do we want to be known? How do you want to be ... And then people have names they like to be called, which aren't their given names. So just by asking that, but taking the time to ask how people want to be addressed, called by which name and how that affects them is really, really important. Otherwise, that connection is not there. 

Gill Phillips  30:24
Exactly, yeah, one of the things I discovered ... so we had a Whose Shoes scenario around dementia care, and it was a teacher, who liked to be called Mrs. Carter. And we have that as a kind of example of chosen name, dignity, respect, and so on. But then somebody said, "Well, actually, it's also a safety issue, because supposing one of the things that she has in her mind that someone who calls her by her first name is someone she knows really well, perhaps a family member and a friend. And she's a bit confused about who's who, if random people are suddenly calling her by her first name". And I hadn't even thought of that. So you suddenly get layers and layers of what these things mean, the true meaning? 

Matt Hill  31:15
Absolutely, it's, you're talking about how we gain insights. Now, we welcome this diversity of view perspective, to help us make better sense of what's happening. But we need that input to help us challenge some of our thoughts that may be fixed, or just be incorrect and I don't know, what sits underneath. So we need other people to help us see it. How do we welcome a diversity of views? 

Gill Phillips  31:48
And we call it 'lemon light bulbs'. I don't know why they're lemon, but that's another story. But you see people sometimes, you know, people experience people, good people, they care. And suddenly you see in their eyes,  that perhaps that those words that they've used for so many years, you know with good intentions, and perhaps how they're perceived by somebody else. I know, Florence Wilcock, my big friend and co-founder of #MatExp. And I've got Florence into being more creative. So, for example, she now has 150 episodes of her podcast series, The ObsPod, which is amazing. But as part of that journey, of Flo becoming more more creative, which is brilliant. She started writing some poems, and one of them was called 'Reassured'. And it was one of those lemon light bulb moments where, as a consultant obstetrician, she would have a woman come to her with various concerns. And that she knows: "All normal parts of pregnancy, I explained". And she'd write in her notes or clinical notes, "Reassured". And basically, the story is that she never ever writes that now, because it's not up to her to say whether that person was reassured. It will be more, "I tried to reassure her ... I explained the facts", but it's the other person's perspective as to whether they went home and said, "I don't know what she was on about, I feel even more worried than I did before". Who knows? So words language ... 

Matt Hill  33:24
They matter massively, and it's often the little, the little comments that make a difference. And it's those little bits that people ... just jar with their being, sometimes. It can be interesting how what they think is innocuous comment to us, is felt very differently by somebody else. Understanding that language matters. 

Gill Phillips  33:52
Language matters. So I think sort of to wind up because I'm conscious that we could talk forever. And so you talked about moments. And I'm interested in moments and it links in with the work that we're doing at the moment developing an app around Family Integrated Care. And we're toying with different names. So that Whose Shoes voices because it's audio based, but then I don't want voices to sound kind of spooky. And moments, like a moment in time, and Whose Shoes moments, like the moment of realisation that your baby's going on to neonatal care, that's a moment; different situations are a moment and then bringing in different genuine voices that support that experience in terms of what makes it better or perhaps what makes it difficult, and trying to bring in a series of perhaps different perspectives. So that's something we're working on at the moment. And I know you've kindly agreed to offer one or two snippets in terms of, in particular psychological safety and the kind of things we've talked about today. 

Matt Hill  35:02
Yeah, it's, I suppose, as you think about though those moments that ... it's what people remember as well, when they're coming through. In those moments of human interaction, it's how we start to develop trust, psychological safety. And these things don't happen by chance. We don't build psychological safety, just by coming together. And, as we talk about those unstable teams, it has to be sort of crafted, created and nurtured so that we all flourish in delivery of brilliant care. But to do that, we need a space to come together, to have time to pause, invest in each other. Without that time, it becomes really, really difficult to form those relational bonds with each other. And that's where so much of the best care happens. It's very, very different - when times are difficult when you're working with someone who you know very well, those elements of trust, understanding, ability to challenge and go, "Hey, Matt, have you thought about this?" is much much easier if we have established positive relationship? Without that, it'll becomes much, much trickier. And this flows through all the work we do, so it's  maybe escalation, as I said earlier. It's about how parents, families, those we're caring for feel as well. If we haven't spent the time getting to know each other and understanding each other, then everything becomes stickier. And things tend to go wrong more often. Because it's just harder to just say ... "I'm not quite sure". "Is this how it's meant to be?"  "I'm feeling like this. I don't know why I'm feeling this, but I just feel a bit uncertain or anxious about where things are". And that,I  suppose just that ability to just pause and go, "Oh, is it just me?" is really, really powerful in improving care. Because it's those moments of just stepping back  and understanding everything that's happening? Rather than just focusing on one part. Think about the 'reassured' comments, and sometimes we seek reassurance, rather than "Yes, be more curious about everything that's going on". And that plays to different parts of our personalities. 

 Gill Phillips  37:46
Yeah, that's a different take on reassurance, isn't it? It's a really good example. I think that's a brilliant note to finish on. Matt, I think what I've picked up from that, in terms of lemon light bulbs, is let's look for those moments of human interaction. Be really curious about people. And I think some of the key words that you mentioned at the end there, like trust and creating space, which is just so difficult at the moment sometimes and the opportunity to to nurture people and invest in in them and in us. Is that the key message you think? 

Matt Hill  38:20
I think it is, it's this absolutely key message that healthcare in its broadest sense is about people, people caring for each other. And I think we haven't always done that well over the past ... in the recent past. And it's been recognised and without rebalancing, this really human element of care. And I'm optimistic that there's, that recognition is going to flow through and hopefully, really, really improve how we deliver health care, support those, especially those who are most vulnerable.

 Gill Phillips  38:59
And that's every which way, isn't it staff, working with staff, staff working with patients, and you've got more peer support these days, it's just people with people, isn't it?

 Matt Hill  39:03
It is. And recognising everything that they bring and how valuable it is. Rather than it being that hierarchy, we spoke about earlier, getting in the way of that. So how do we bring all those diverse perspectives in, that are so essential to understand the full picture, rather than a narrow piece that I may see in front of me? I need that breadth of vision. Otherwise, I'm only doing part of the job. 

Gill Phillips  39:36
Brilliant. Wow. Okay. Well, thank you so much for talking to me, Matt. I've really enjoyed that. And I'm sure our podcast guests will learn so much from that. So thank you, and I'll let you get back to your day job.

 Matt Hill  39:50
Thanks, Gill. It's been a wonderful conversation, and thanks for creating the space for us to have a conversation. 

 Gill Phillips  39:54
Brilliant. Thank you.

Gill Phillips  39:56
 I hope you have enjoyed this episode. If so, Please subscribe now to hear more of these fascinating conversations on your favourite podcast platform. And please leave a review. I tweet as Whose Shoes. Thank you for being on this journey with me. And let's hope that together we can make a difference

Creating conditions for meaningful conversations and positive safety culture in health care
Improving team dynamics through improved relationships
Sharing personal stories to promote empathy
Breaking down hierarchies in workplace conversations
Team dynamics and inclusivity
Understanding patient experiences and preferences
'Top tips for psychological safety in NHS teams