62. Dr. George Winder Pt2 - how universal healthcare works in practice

Bonus episode!
Dr. George Winder and I pick up from our impactful “Don’t Medicalise Poverty” conversation (Episode 58, Universal Healthcare mini-series). 

George’s work is refreshing. It goes beyond prescriptions and appointments. 
It makes healthcare about relationships, community and plain common sense.
More human and a lot more doable!

We dive into stories that show the true power of social connection – from walking groups that tackle loneliness to blood pressure checks held away from GP practice walls. George opens up about the realities of community-based health: the greatest successes come from local ownership and the simple yet profound impact of listening to people

We explore the "why" behind the data, the risks of inactivity, the courage it takes to start where you are, gradually building networks and trust

The stories show that healthcare is a team effort – a team that includes everyone.

Lemon lightbulbs 🍋💡🍋

🍋 Walking for Wellbeing – A simple walk, a friendly coffee, and a bit of music can do wonders
The best healthcare can start with bringing people together, not with prescriptions
🍋 Loneliness as a Health Crisis – Research shows that meaningful social interactions can be as important as vaccinations
Community activities like “move to music” and chair-based yoga aren't just exercise; they’re lifelines
🍋 Scaling vs. Staying Local – Not everything is meant for mass production.
True community-based health relies on local ownership, where the community shapes what they need most
🍋 The Power of Passion – Real change happens when people lead with passion. A retired teacher running a children’s reading group from a car park during Covid19 is a reminder that enthusiasm can surmount setbacks!
🍋 Inactivity Is a Risk – George nails it with “inactivity can be as dangerous as activity.” When fear of risk paralyzes action, community needs get sidelined.
Vital support can be lost.
🍋 Meeting People Where They Are – Health isn’t always in the clinic.
By bringing blood pressure checks to community spaces, George’s team is reaching those who might never go to a GP
🍋 The Pitfall of Opt-in Systems – bureaucracy often leaves behind people in vulnerable situations. This isn’t just an inconvenience; it can mean missing critical care
🍋 The elephant in the room - honesty re NHS Resources and prioritisation can help people understand the real cost and impact of services
🍋 Trust in the Team – Multidisciplinary work means no organisational walls. George’s weekly team check-ins are open and flexible, with colleagues calling in from the real world – creating a 'team hug' that’s both supportive and effective
🍋 Healthcare needs kindness and connection at its core
George’s 'team hug' and Gill’s kindness conversations remind us that sometimes simply listening and showing empathy can transform BOTH patient and practitioner experiences

Links
George Winder – Don’t medicalise poverty
Altogether Better
Bob Klaber - kindness matters
Alvanley Famil

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Chapters

• 0:00 Reconnecting with Dr. George Winder and recapping the wonderful story of V from Episode 58
• 1:30 The impact of social activities like walking groups on mental health and wellbeing, emphasising connection and joy
• 2:06 The link between social contact and health and longevity, with examples from community activities like chair-based yoga and Pilates
• 3:42 Beyond Measurable Outcomes - Gill shares her personal story about the subtle but powerful benefits of activities that foster connection, like Pilates classes after her breast cancer journey
• 4:53 The balance between scaling social programmes and maintaining a strong sense of local community ownership
• 6:11 The Importance of Local Ownership - how local initiatives, when led by passionate community members, thrive and resonate deeply within their communities
• 7:14 Bureaucracy can hinder community initiatives, such as running a football group, and the risks of over-regulation
• 9:06 Risk aversion can be as dangerous as activity - the balance of weighing potential harms of inactivity
• 10:09 Efforts to diagnose and manage undiagnosed high blood pressure in underserved communities
• 12:16 Taking Healthcare into the Community - the proactive approach of meeting people where they are, with blood pressure checks in local settings like food banks
• 14:40 The NHS’s opt-in appointment system can exclude those without easy access to technology or stable housing
• 16:01 Systemic Barriers - George shares a story about how institutional barriers can fail vulnerable patients, sparking a call for better follow-up practices
• 17:28 ‘Did Not Attend’? Let's dig deeper - the unspoken stories behind missed appointments and the resources needed to address them
• 18:46 How limited resources impact the ability to fully support people with complex needs
• 19:31 George shares his experience with co-production and its impact on his approach to leadership and systemic change
• 22:19 We need honest conversations about the trade-offs within NHS spending and the challenge of balancing resources for maximum impact
• 23:39 The transformative power of listening and creating spaces for honest conversations in healthcare
• 24:03 The lasting impact of Gill's 'Whose Shoes?' work with the Darzi Fellows, helping healthcare professionals understand and embed true coproduction
• 26:31 George shares his approach to multi-disciplinary work, creating a welcoming space with minimal barriers to entry
• 30:08 The value of networks, social connections, and trust in creating a resilient healthcare system
• 32:15 The Power of Kindness in Healthcare - as a core value in healthcare, with a shoutout to Bob Klaber's monthly kindness conversations
• 33:37 Conclusion : the importance of teamwork, flexibility, and human connection in healthcare

Transcript

George Winder – continued!

SUMMARY KEYWORDS

people, work, leeds, support, george, sector, absolutely, shoes, poverty, group, pandemic, community, nhs, health, amazing, wellbeing, services, networks, universal healthcare, access

SPEAKERS

George Winder, Gill Phillips

Gill Phillips  00:11
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 Wildcard, and want to help give a voice to others, talking about their experiences and ideas. I love chatting with people from all sorts of different perspectives, walking in their shoes. If you are interested in the future of healthcare, and like to hear what other people think, or perhaps even contribute at some point, Wildcard Whose Shoes? is for you.

So in this episode I’m picking up the conversation that I had in episode 58 with Dr George Winder because I enjoyed it so much and you may remember that he told the story about V and how for the cost of a pair of shoes and some gloves. She was able to effectively come off medication that she’d been taking long term for mental health get involved in a walking group and basically transform her life by becoming a local leader and then moving on and doing a university course and having a trip to China. So picking up the story there. This is how our conversation went …

Gill Phillips  01:30
And it just made me think of it when you were talking in passing, really about V and the walking group. And I remember when I went up to Alvanley in Stockport, I actually joined the walking group, yeah, from the GP surgery that happened to go about a mile and up a hill and stopped off at a cafe, and we had some couple of retired people playing the guitar to us, and we had a few songs and that, and the fact that I'm talking about it years later, these things are enjoyable. And whether you talk in terms of mental health or wellbeing, they're good for people, aren't they, all of us.

George Winder  2:06
100% and if you look at the International Studies of what make people live longest, there are some obvious things, like vaccination, stop smoking, stop drinking, but social interaction and having meaningful social contacts are huge. There's some really interesting studies, particularly around the Mediterranean, where there's longevity and social contact. It's one of the most important things. We recognize that loneliness is a huge problem in in all communities. And anything we can do to reduce reduce loneliness, and I think lots of the things that we do... so we have chair-based yoga, yeah, we have Pilates. One of our GPs does Pilates. She comes to do Pilates because she sees the impact that that makes. We've got two, what we call 'move to music' groups. They're over subscribed, we've got 20 people, it overflows. And, and you talk to people about why they do that, because for lots of people going to the gym, which is only two new jars, to having their local council gyms, they don't feel that that's an environment that they are welcome or or feel comfortable to go and use. And some people go on from there, we always wanted it to be a stepping stone. Start doing this, and then get the confidence again. Feel the endorphins, feel how much good it makes you do and, I've no doubt we don't track it well, but I've no doubt that we've, helped lots of people, but also we, the walking group, come back for coffee morning. We've got fast walkers, slow walkers. They meet separately. Now, not just at the surgery, and they're friendship groups, they're people who look out for each other, people who will help each other if they're struggling, emotionally or physically or need something to do in the house, or even social networks that they've built. It's unbelievable.

Gill Phillips  3:42
Yeah, I think that was exactly what I was going to say. You know, the more subtle things that might not be measurable, but the friendships and so on that come from it. I mean, you mentioned Pilates, and I'll tell you a little personal story, because it's relevant. So I had a breast cancer experience last year, and as part of that, I was offered peer support, and I would have run a mile. There's absolutely no way that I'd go along to something called a peer support group. But actually they set up a Pilates group, and a group of us went along because Pilates is good for you, and we did a bit of stretching, and we got to know each other, and we made friends. And then after the Pilates group, we have coffee together. And obviously that forms a proper peer support, you naturally pair up with the people that you've actually got a bit of a shared story with, or that you get on better with or laugh with. And, you know, I can see that running through all of your work, George and you know, I suppose that's why I'm so passionate about sharing these stories. I think the story of V is a little kind of, what would you call it?

 George Winder  4:45
It's not a microcosm, but it's a snippet of a larger pie.

 Gill Phillips  4:49
But it's a great story, and there are so many of them out there.

George Winder  4:53
Yeah, and other places do do this. It's just, how do we scale it up? And I guess that's the point about scaling up that, social subscribing, you know, I worry about some things are good at scale, some things aren't good at scale. And yeah, part of this, and part of working with communities, is that they feel part of their community. And as soon as you take it out with a community, and soon as it's not for their community, but that reciprocity, that sense of, you know, I'm doing, I'm volunteering, I'm giving,  because I'm part of this community, and that, I think you have to do that. And there's real risk, moving out of communities at that level. These are the things that are best done at relationship level, people level.

 Gill Phillips  5:31
This is the dilemma, really, isn't it? And this is so like my Whose Shoes? work, that people might see the effect of it and they all we want a bit of that, but unless you actually understand the relationships and the valuing people, and the way you invite people along to an event, and the kind of love and care that goes into it and that local ownership, we encourage people to put their own stamp on it and come up with their own sort of introductory activities. Or we have a little pledge card, and rather than having just a standard one, you know, you get different creative people enjoy developing one for that service, and that's what brings the kind of human element in, rather than just a package that works.

George Winder  6:11
100% and we found where the greatest success has always come from, people's own... we want to talk to the ones that were a young woman toddler group, because one of the volunteer's daughters had had post natal depression and didn't have access to support in the community. So we used to have, we ran the Baby Clinic. It was just a place where people didn't have to go and have posh coffee and cake, but they could just drop in with slice of cake and other things. And that was hugely successful. And then we had a retired teacher who was interested in supporting families where English wasn't their first language, and by the end - it hasn't got going again for lots of really sad reasons, because, largely because the pandemic - we had, we had to buy more chairs. We got, 30 plus chairs? Because there were so many kids coming to these reading groups. And then we had students coming and doing supported reading. So we had medical, medical students want to come and work at GP practices to get experience to get into medical school. And we said, well, you can't do that, but you can come and work in our reading group, and English isn't great, so that was amazing.

 Gill Phillips  7:14
Meet some real people.  

George Winder  7:15
And meet some real people! And that teacher in the pandemic continued those reading things. And I remember looking out into the car park with her stood under a boot over the top of her in the pouring rain, handing out tablets and books and reading books to the kids in our community during a pandemic. Yeah, through some tragedy that hasn't got going again, because that was her passion. But her passion proves that you know, this is what i'm saying, you can't, that's got to be driven by people where they recognize that they see that commitment, they have a passion. It really wouldn't work if I just said, can somebody come and run this group? 

Gill Phillips  7:49
No, not at all. And I think you touched on it a little bit. I mean, I think I'm very interested as well with those kind of informal things, the stuff that gets in the way. So I remember we did an exciting, like mini project that I think you'd have enjoyed, called Cough Mind The Gap, my local town, amazing voluntary organizations. They're, in particular, Grapevine I worked with, and we did a quick sort of Whose Shoes? session around Cough Mind The Gap, was the gap in Coventry between the services that were available and what people need. So it throw up all sorts of things very similar to what we're talking about today. But I remember, particularly in talking about these reading groups and different things. And there was a guy there, and he got a bit sad, and he said, 'Oh, we used to run a football group, but it just became so difficult, because suddenly we needed different qualifications or different checks, or all the kids are going to be taken in the right size car seats, and parents can't share in the same way'. And you just felt this kind of layer of stuff falling down upon community activities that have been going you know, they weren't a problem when my children were young, but some things that are obviously meant to help, and health and safety and so on just kind of get in the way a bit, sometimes. 

George Winder  9:06
Absolutely, and it's a real it's a real challenge that because for some of those things, you can see absolutely, to understand why. But again, people are coming to harm because we're not doing stuff. And you've got to look at both, both sides. That, I think, people look at risk unilaterally. You talked about different perspectives, and there are different perspectives on risk, and sometimes risk aversion creates harm because things don't happen. And that's a real balance. I know, I see it from both sides. 

 Gill Phillips  9:29
Yeah, it is a balance. But you did come up with a quote, which I wrote down, 'inactivity can be as dangerous as activity'. And it's that, isn't it? 

George Winder  9:44
Yeah, it is!

Gill Phillips  9:45
That you knock out the things that might be dangerous or that might be, you know, not proper, or whatever, whatever, and what do you actually end up with? And if you make people disillusion in the process and things that they were passionate about or volunteering to help with, they become it's all too much trouble, then you lose, you lose the people who are the leaders, don't you.

George Winder  10:09
Can I share... working with communities partners, and one of the things we recognize where working with public health in Seacroft and surrounding areas where I work, more people have strokes. Right? Incidence of strokes is more. But the number of people diagnosed with high blood pressure is about the Leeds average, okay? And what that suggests to us is there are people without a diagnosis in hypertension, so high blood pressure - because high blood pressure leads to strokes, if you reduce blood pressure, you reduce the number of strokes. So there's a presumption, but a fairly reasonable one, that we're missing quite a number of people living with high blood pressure who they may later go on to have a stroke, right? And so we're doing some work to see how we can do something about that, and that's based with our third sector partners. It's with our PCN team, we call a proactive team, and their aim is, as the name suggests, to be as proactive as possible for groups who need exceptional care. And one of these groups is largely people who've been invited to the GP practice for NHS health check schemes and other things, who, for whatever reason, aren't coming for you know, might be because they work, might be because of transport reasons,  might be inertia for whatever reason. But we're, we're keen to do something because we diagnose blood pressure, reduce blood pressure, will reduce strokes. And one of the things that we can, I remember, we're doing this is, the amazing opportunity we we can by accessing people in different environments. So for example, again, looking at people who might attend food pantries, people who are attending other community spaces where they're not also accessing GP practices and other things. And we've seen very much in the early days of this, where we've rung up from GP practices: 'please come and get your blood pressure checked', very little. We're going out, and our third sector partners are working with the community, when we have a few already people with undiagnosed blood pressure at high level, that we are likely to reduce their chance of having a stroke by 20 or 30%, very quickly. 

Gill Phillips  12:16
Brilliant. 

 George Winder  12:17
And what's been really interesting is about people's fear of taking a blood pressure. So, blood pressure machines now,  10 or 15 quid, we buy them at bulk, much cheaper than that, give them out, press the button, pretty safe. But people are so worried about taking someone's blood pressure or do something, that they're then not doing it. And okay, so we could just come in and get it done. It's okay. We can manage with what it is, but there's a real fear of finding something that can then not know what to do with it. Again, I understand that, but it's really interesting about stopping, it's stopping things being done, because everyone's like, 'Ah, no, but if it's raised, what do we do?' And I'm like, 'it was raised five minutes ago. You haven't raised it. It was just raised'. And now we can help people go and confirm whether that is and I understand why people are worried about it. And also we need to be careful of not medicalising other people's normal community spaces. 

 Gill Phillips  13:09
Yeah, yeah. 

 George Winder  13:10
And that , but it was really interesting about, but now we know, and I keep thinking, that's great, yeah, isn't that brilliant? We're not caused and just, we've just found it. And so what that work has widened lots of people's perspectives, what's also really crazy. We've got two, two staff members who we found because, these are people you'd think would be turning up for health checks and stuff, but they've got busy lives, got families, they've got other things, just like me. And, yeah, yeah, you know, a bit disorganized. And so it's been really impactful. We went to a community event held by one of our key third sector partners the other, and we took 67 people blood pressure who haven't had blood pressure done the last five years, who should have had it done, just at one morning with some of our coordinators just going around with the machine. 

Gill Phillips  13:55
Fantastic, yeah, rather than 67 10 minute appointments that someone's got to sign up for and come along and see somebody.

George Winder  14:02
Yep, and the other thing, I guess, is the wider engagement with third sector partners has led to high level of trust, the soft conversations around saying, there are different ways we can do that, and it's changed our approach to supporting communities who traditionally can't access and to go to that question, is the NHS accessible to all? No, and there are organizational, institutional barriers to that, the movement towards everything via a smart phone, everything via online access to GP surgeries. Can I? I'm going to tell them story, if that's alright?

 Gill Phillips  14:40
Yeah do, I like your stories. Yeah.

 George Winder  14:43
I'm lucky enough to be what's called a Poverty and Truth Commission in Leeds. So we're, we're working collectively as a set of what we call civic and business commissioners. So civic commissioners are people who are affected by poverty or live within poverty, and a group of people from organizations within the city. And one of the things that we try to do is listen and understand how poverty is affecting people in lots of different ways. Again, it's been an incredibly eye opening experience. One of those things is about the institutional way that the NHS works against people who have accessibility needs or other things. And I recently filed a letter from a NHS organization where it's somebody had been sent for an endoscopy, a camera to look into their stomach to make sure they didn't have an ulcer, or worse, a stomach cancer or bowel cancer, because they were very anemic. When I filed this letter, I recognized the name because I'd referred them, and I thought, oh, it's locked down, and this person, they are schizophrenic and they've got a learning disability, and that person hadn't responded to whatever invite was sent out to them from hospital, so they get an automatic discharge. That's it. 

Gill Phillips  16:01
Well.

George Winder  16:02
And you think, what have we done to ensure that that person has, their needs are met, their needs are understood. Do they have a phone? Do they have access to the internet? We have lots of services now, where, what we hear from the Poverty and Truth Commission is lots of people struggle or don't get those messages of opting into appointments. So people are discharged if they don't opt into an appointment, but that opt-in system is difficult for them to navigate, either through language problems, literacy problems, access to technology problems. And so I think we've got a growing commitment in Leeds to look at that and to actually understand and say, actually the people who are missing these appointments, why are they missing these appointments? Not 'what can we do to discharge them quicker?' You know, that's person on a, on a cancer pathway. We've just said to let in, and so we have systems to try and reduce that. But really, again, if we were really honest with ourselves, how much time and effort do we put into managing what is probably a group of people who need more help, bulk systems that the people who've got support, access, family and structures, all those things, internet access, whatever it is, will be able to take on those services more easily than the people who are economically disadvantaged, affected by poverty, learning disabilities, all those things.

Gill Phillips  17:28
It's fascinating, isn't it? And then you might get a really great project somewhere looking in detail about people who are discharged or people who didn't come to appointments, and really putting some resource into that. But it's about resources, isn't it, to find out the stories that sit behind the 'did not attend', or for children, they weren't brought well that they didn't have the choice to come. 

George Winder  17:52
So we, Leeds teaching hospitals are doing work around that, and there is a commitment to looking about, reminding people and signing people up. But again, it's how much of our resource and energy.

Gill Phillips  18:02
How much resource, yeah.

George Winder  18:04
I think there is much more we could do. So we code every, every letter from a child that doesn't attend an appointment at our GP surgery. We put it on a hat to say does not being brought. But if we, to follow that number up, it's hugely sometimes it's indicative of something else going on in our home that we would want to help and support about. But again, if we really resource that properly, i'm sure we'd identify some real unmet need, and whether that's just about them being able to communicate back with us but say, don't need to come anymore, or whether that's about them saying, it's really hard for me to get my child to an appointment, or there are other things going on in my life, like domestic abuse.

Gill Phillips  18:41
Yeah, yeah. 

George Winder  18:42
And we know about it, I don't think we resource it well enough. 

Gill Phillips  18:46
No, I love the work that you're doing, George, digging behind the obvious or the data or the presentation of whatever it is, to find out why. And that's, I guess, a combination of resource and passion and just imagination to do things differently and it's not so easy, is it,  as just doing the set,  the set piece perhaps. 

George Winder  19:10
It's not, but I said I am passionate about that. 

Gill Phillips  19:13
Yeah, and that comes through.  

George Winder  19:15
I've also been fortunate. For example, Becky ran a postgraduate diploma in coproduction. I was enabled. You start looking at the systemic,ow can the system do this. We were supported to attend that postgraduate diploma. But I met Becky. That's where I met her.  

Gill Phillips  19:31
Well, that's great, yeah. 

George Winder  19:33
And that has stayed with me. It has led us to be, I think, better leaders, better enabled, better tools, because of the perspective that it gained, yeah, and that was enabled by people at the time, in senior leadership positions, who said, I will invest in, I'll invest in these people. And so I think there has to be, like everything, there are levels at which you have to enable and catalyze and give energy to at lots of different places. And that doesn't come without everybody contributing to that, and I think in Leeds, we've been blessed by that, throughout lots of different organizations, third sector support for giving everybody an equal voice at the table. My fear is that in really constrained economic environments, that that gets less focus, less resource, because we're focusing all the resource on managing acute illness or whatever it is. Yeah, it's that rationalizing at the wrong end. We'll rationalize weight management services which don't exist in Leeds particularly, but we'll continue to prescribe drugs because NICE deem we have to and if we don't, we're legally challenged, but nobody legally challenges if we don't provide a weight management service.  

Gill Phillips  20:47
Right yeah, I remember Becky mentioned that, the cost of the obesity drug and the issues around that, compared with helping people have perhaps, healthier food or things that might be more preventive. 

George Winder  21:07
Yeah, we prescribe some very expensive cholesterol drugs, which is great because it reduces people's chance of having a heart attack and stroke disease to some degree. But we don't provide enough services that support stopping smoking and alcohol, and we could spend more and more and more on that, those types of services. But we, we have to - not blaming anybody nationally - provide a medication that is fiendishly expensive for very few people, and we struggle to be honest with people about this. Maybe we spent years in austerity where we said we're in austerity, but you can have what you want from the NHS. And therefore stuff that we don't have to do has got stopped, despite that being stuff that will help people in the long run.  

Gill Phillips  21:56
That honesty thing is the elephant in the room, in a way, isn't it that more and more things are developed that are possible, more drugs, more tests, more scans, and we all want, inevitably, the things that might help us and the resources. It is that honest conversation, isn't it about how to balance the money and how to spend it on the things that really make a difference?

George Winder  22:19
And I genuinely don't think that happens anywhere that I see it. I think people talk in hush whispers around that, but nobody talks openly in the media, politicians, amongst the national language about saying, absolutely we need to, probably, are going to say, stop doing some stuff. And the stop doing stuff is likely to be things that, if it was your family member needing that expensive drug, you would fight tooth and nail... 

Gill Phillips  22:35
Absolutely. 

George Winder  22:45
...to get them that drug. And I understand that, but funding that drug stops us funding a lot of other stuff. And how do you balance that? I don't think anybody's got, it's such an ideologically difficult question. 

George Winder  22:55
Absolutely 

Gill Phillips  22:06
But I think it's also very, kind of, paternalistic. I mean, I've found through my workshops that we have some really difficult topics come up and difficult conversations, and if people actually start to learn about these different issues and the different perspectives and listen to other people, then they become very good at finding a solution together. 

Gill Phillips  23:06
Whereas if you're just told, you know, this is how things are, and other things are swept under the carpet because they're too difficult for you to hear. It's very patronising, really. 

George Winder  23:39
Absolutely, absolutely. And I would really welcome that. And you're right. My, My experience is when you do talk to people and you listen as well, and people like, oh, yeah, I get that. That's fine. 

Gill Phillips  23:56
And people love being listened to. They really do. It takes an awful lot of that anger and defensiveness out of conversations just to feel properly, properly listened to. 

George Winder  24:02
Properly listened to. 

Gill Phillips  24:03
Yeah. So you were talking about the postgraduate diploma that you did on coproduction, and I couldn't help but mention that the thing that's actually brought us together, really, for this conversation, is my favorite piece of work that I've been doing for about the last 12 years is to use whose shoes in a annual coproduction module with each cohort of Darzi fellows, thanks to Becky Malby. And I love it because I love the session, I love the kind of people who want to learn about coproduction and sometimes how out of their normal experience, or perhaps formal medical training, it is. But I also love how it really sticks with people forever. It really is transformational. The kind of thinking, and I love to stay in touch with the people who've gone through that program, because they're special. You know, a lot of them are, like, really pushing the boundaries in so many different areas of healthcare, in that rather special way of listening to people and working with them. 

George Winder  25:03
And it's interesting. I don't know where the right input that is, but it's done in a postgraduate place where there are people interested and maybe do that, and maybe the undergraduate curriculum isn't quite the right place. I don't know, but I do think every doctor should spend a bit time in general practice and understand perspective. And I think the thing about coproduction is that listening and understanding people's perspectives, isn't it, giving time to that, being really thoughtful around that, but also having some skills to enable that. 

Gill Phillips  25:33
Yes, yeah, and not being frightened of it, I think. 

George Winder  25:35
The work we do with a Poverty and Truth Commission in Leeds is very much that. It is coproduction, but lots of the early stages of that are relationship building so that people can be honest with each other. We can hear the truth, so that we're put on an even grounding where people can be absolutely honest and we have genuine emotional connections to people, so that you're able to, by empathize and, and to, yeah, do better, to better than the than previous. And I think, as you said, people who undergo those, those programs are generally, their lives are transformed and they transform other people's lives because they their eyes are open, I guess. 

Gill Phillips  26:18
They potentially take it into every conversation, in a way, which is an enormous impact, isn't it?  

George Winder  26:25
Yeah, yeah.  

Gill Phillips  26:31
So George, before we finish, I don't think you've told us yet about your approach to multi-disciplinary work, which I absolutely love and wanted you to talk about. 

George Winder  26:37
Well, thank you. So yeah, I'm glad you said multi-disciplinary work, because it should be that, and it is around a multi-disciplinary team. And I think sometimes we talk too much about the meetings being a multi-disciplinary team, but we are fortunate in Seacroft to have a collective of people, a multi-disciplinary team, who largely work around a frailer population, broadly, but are absolutely focused on helping patients in the most proactive way they can, and stepping into problems and not saying 'that's somebody else's thing to sort out'. And we often think about what's what's good about it, what's good about it is anybody can turn up, and nobody's expected to turn up. So we hold space, eight till nine, every Wednesday morning, and we have done for quite a few years. And because of that, people know where we are, and you can just turn up. It's on Teams. There is an invite, but anybody can come. And we have a very fluid conversation. We invite people to present cases and to ask a question about what they want collectively from it. But you know, you don't have to email in a week before and get permission and do those things. We quickly go through and say, 'Who do we need to talk about today? How can we help people?'. And we have a range of people going from a consultant geriatrician from a teaching hospital, some GPs, some of our care coordinators,  who are... we've got proactive care coordinators and ACP, so advanced clinical practitioners from the community sector. We've got a dementia care worker from from a mental health trust. We've got some some third sector, we have a social worker. So I hope that i've named everyone, going to get in trouble! Pharmacists! Pharmacists! I get in trouble for not talking about people! But we have a wealth, and a broad view, and everybody's welcome to supporting the families and the people we discuss there. And you know, our geriatrician can't get there till quarter past eight. We know that, so we don't talk about, you know, we might talk about something else, first. Our - hope she won't mind, But our our person from the Mental Health Trust has her daughter sat on her knee. She brushes her hair on her way. She's got lovely long hair and she has to brush her hair because she's getting ready for school. Do that. We've got the district nurses already out, getting insulin to people on the morning insulin already, and they run in, give someone's insulin, run back, and they've got their phone stacked on the car steering wheel, talking from their mobile phone, and it's ... what we want, is no barriers to entry. So no barriers to patients, no barriers to people. We don't do referrals. So we have a system in which, if people think they can help that person or family or carer, we saw that problem between us, and I think for me, that's multi-disciplinary work, where there is no organizational barrier. People come because it makes them, and we've done some work, some little bits and brief surveys about, why do you come? 'Well, I feel like I'm actually making difference'. 'Feel like I'm helping patients'.  

Gill Phillips  29:37
Yes, yeah.  

George Winder  29:38
Really like sharing. Really like talking to people. So sometimes it's just, I just want to share this thing, you know, and that's it. 'What am I asking? I'm asking, am I doing... is this okay?'. And everyone's like, all right, it's good. So I am excited by that. I know that it doesn't work well everywhere, there has been years of trying to get teams to work collaboratively across across sectors, and I like how it works for us, but that might not work for everyone. 

Gill Phillips  30:08
But I think what might work for everybody is the principles. And what I'm hearing is you've created something that's flexible, that fits into people's lives, that's welcoming, that they get something from. You know, they feel that they can dip in and, you know, the fact that you can't make the whole 60 minutes every week doesn't mean that you're a nuisance or, or difficult, and it really reminds me, George, and I think you'd absolutely love this, and I'd love to invite you I take part in a monthly kindness conversation organized by Dr Bob Klaber, who was one of my earlier podcast guests who I've met through the kindness conversation. And it's just the most amazing network. It draws in people from literally across the world. And we regularly, every single month, get Cath Crock joins from Melbourne, and Nicki Macklin joins from New Zealand. And by definition, I mean, it's six o'clock in the evening, it's an anti-social time for them, big time. And, and other people you know from America, and they, and Bob, did something recently, and it was very similar to what you're saying, like, what is it? Why do people keep coming? And it was just those, those same points, really about how you contribute and get something from it, and you build those relationships, and it's very, it's very rewarding, and it's more than rewarding. It's life enhancing in a way.  

George Winder  31:37
Yeah, well, I don't want to overstep: people get, if they get value from it, they'll keep coming. And so people get value from it for whatever reason, there's almost a, it is almost a team hug. 

Gill Phillips  31:42
Yeah, yeah.  

George Winder  31:48
I'm not gonna say... bit cringy, bit cringy.  

Gill Phillips  31:52
And the fact that that can happen virtually is crazy, really, yeah, obviously. And in our case, I mean in your case, it's people who probably know each other more. And in our case, most of us don't, you know. And then when you do meet people, as I got the chance to meet Cath Crock from Melbourne recently. And, you know, we're meeting like old friends. It's really, she's been on the podcast series as well. You can feel this network kind of growing. 

George Winder  32:15
Cyber, yeah, yeah. I would love to come.

Gill Phillips  32:18
So yeah, a couple of introductions then, I love it when these different threads spark each other and build the networks.

George Winder  32:25
Absolutely, absolutely. And I think that's, the greatest strength comes in networks, don't we? It's no single, single person, is it? You know, networks, social networks, community networks, work networks, all those things, and the stronger they are, the the more you can do and, and it's, again, one of our strap lines. You know, you can only move as fast as the trust allows, and you build trust in networks and relationships. 

Gill Phillips  32:48
You do. 

George Winder  32:49
And people trust you. You go and do, you know, the reciprocity, somebody will come and say, 'I've got this problem' and I'm like, 'I can go and sort out for you. That's okay. You know, you don't need to do that', or 'that's great. I know a person who can do that'. And so the trust comes with real things, you know, doing things for people, or just being kind. When they're saying this is really difficult, and you're like, yeah, this is cool, and it's okay. 

Gill Phillips  33:12
Yeah, the conversations we've had around kindness in, in healthcare just been extraordinary. I'm sure you'd instantly get what I mean, and I say each month we're talking about different aspects, or perhaps have a different presenter, or somebody just, you know, challenging us to think a bit differently. Very, very powerful. 

George Winder  33:31
I like that. It is, but that's, equally it's simple stuff, isn't it? Human traits.

Gill Phillips  33:37
Very simple, not overthinking it. Just, yeah, make things happen for people. And that's what you're doing, George. And you know when I said 'team' at the beginning, I use 'team' in the sense of all of that network, collaboration, you know, the people that need to be involved are being involved, and that's special. 

George Winder  33:56
Absolutely. 

Gill Phillips  33:58
Well, thank you so much, George. It's been such a pleasure talking to you and finding out just, I'm sure, a tiny, tiny sample of what you're getting up to. I just hope it inspires people to think that, they can't copy you because they're not you, but they can be inspired to take ideas and follow some of the principles, I think, of just, just go for it, rather than be too worried about everything. 

George Winder  34:23
Yeah, I think you just got to start sometimes, haven't you? And I'd just like to say, I work with some amazing people who, over the years, have given me freedom, but also support. And now I hope that we continue to that collaborative process with our teams, and I hope that I now try and share some of those freedoms with them to do better stuff. 

Gill Phillips  34:44
Yeah, I'm sure you do and you will, yeah, well, thank you George, and it's another contribution to our series. 

George Winder  34:51
All right, thank you so much. Gill. It's been lovely to talk, hopefully we'll continue talking.  

Gill Phillips  34:55
Yeah, okay, thanks! Bye then. 

Gill Phillips  34:59
Thank you so much for listening. If you enjoyed this episode, it would be fantastic if you would leave a review and a rating, as well as recommending the Wildcard Whose Shoes? podcast series to anyone who you think might find it interesting, and please subscribe that way you get to hear when new episodes are available. I have lots more wonderful podcast guests in the pipeline, and don't forget to explore and share previous episodes: so many conversations with amazing people who are courageously sharing their stories and experiences across a very wide range of topics. 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. See you next time.