73. Create the conditions - then let the magic happen. In conversation with Ruth Germaine

🎙️ This episode was recorded jointly with the So, Who Cares Anyway? podcast, hosted by Ruth Germaine.

In this warm, wide-ranging episode, I’m chatting to fellow podcaster and Darzi alumna Ruth Germaine to explore what it really takes to tackle healthcare’s “wicked problems” through coproduction.

A powerful invitation to think differently.

Drawing on our shared roots in the Darzi Fellowship network, we reflect on why lived experience, curiosity and relationship-building matter far more than tick-boxes and tidy solutions.

I share my journey from social care and local government, through cancer, to creating Whose Shoes?® - a deceptively simple, colourful board-game approach that opens up honest conversations between people, professionals and those in positions of power. Along the way, we explore the power of poetry, the beach-ball metaphor, and why Whose Shoes scenarios are so open-ended – the discussion will be the one YOU need to have.

Our conversation ranges from maternity services in Buckinghamshire to SEND roadshows and a neonatal unit in Liverpool, illustrating how ‘planting seeds’ can lead to outcomes no one could predict at the start.

We also reflect on the challenge of evidencing impact, the limits of KPIs, and a Whose Shoes hallmark: the pledge - small or bold actions, taken from the heart. #NoHierarchyJustPeople

This is an episode about creativity, courage, and the quiet magic that happens when people feel truly heard.

🍋💡 🍋 Lemon Lightbulbs

1. Co-production isn’t a method - it’s a mindset
   If people don’t genuinely feel valued and listened to, no tool will save you.
2. The answers are in the room
   Real change starts with free-flowing conversations, not a prescriptive agenda
3. You can promise something will happen - just not what
   That uncertainty isn’t a flaw; it’s the essence of true co-production
4. People see through tick-box listening instantly
   You can’t fake curiosity or shortcut trust
5. Creativity creates capacity - even when time is tight
   Fun, colour and poetry don’t distract from serious work; they unlock it
6. Ripples to ... IMPACT!
   A conversation can lead — unexpectedly — to things as big as a new neonatal unit
7. Just because it's countable, doesn't mean it's what matters most
   What matters most (trust, insight, confidence, connection) rarely fits a KPI
8. The best change work draws people in
   When it’s real, people text friends: “Get down here — this is different.”
9. Pledges work because they’re personal
   Small actions “from the heart” beat grand strategies
10. Learning happens with people, not to them
    Networks for learning together generally beat programmes and courses

LINKS

So, Who Cares Anyway? Podcast by Ruth Germaine

It takes a Village - Buckinghamshire maternity Whose Shoes? event

Whose Shoes? comes to Nottingham

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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.

Chapters

• 0:00 Welcome & context - Wild Card – Whose Shoes? meets Who Cares Anyway? A joint recording and shared love of inspirational conversations and healthcare improvement
• 3:44 Darzi Fellows, wicked problems & co-production Why the Darzi network matters - and what makes it such fertile ground for creativity and lived experience.
• 6:07 Planting seeds & serendipity - How opportunities appear years later - and why working independently means trusting the long game
• 8:55 Two podcasts, shared curiosity Different styles, same intent: inspiring conversations that help people think differently
• 9:53 Gill’s journey: social care, cancer & finding purpose - From systems to stories - when life feels too short to waste ⭐
• 13:40 Personalisation - Why “personalised care” needs shared understanding, not buzzwords
• 15:20 The birth of Whose Shoes?® Beach balls, perspectives and poems - and why a board game became the answer
• 18:21 Social media, Twitter & building a movement - How connection, not marketing, helped Whose Shoes to grow
• 20:00 What Whose Shoes actually looks like The board, the colours, the crocs - and how the game works in practice
• 23:40 It takes a village: Aylesbury maternity workshop - What happens when teams go all-in on creativity and relationship-building.
• 28:15 Scenarios to spark your own solutions - 'Whose Shoes' is non-prescriptive to enable true co-production
• 31:30 Sensitive topics & being truly heard - Baby loss, race equity, and the Nottingham workshop that overflowed with people
• 34:09 Evidence, impact & measuring the wrong things Why KPIs struggle to capture what really matters
• 37:35 Golden people & taking risks - The champions who say “let’s do it” - and why leadership courage matters
• 39:45 Children, young people & SEND - #CYPWhoseShoes - Developing new Whose Shoes resources through deep co-production.
• 42:30 Celebration as evidence - Ball of wool storytelling, shared ownership, and capturing impact differently
• 44:40 Innovation means not knowing the outcome - Why you can’t demand proof before you try something new
• 46:00 An extraordinary outcome: a new neonatal unit = How Whose Shoes conversations helped lead to a major service redesign in Liverpool
• 48:59 Visual capture, post-its & collective sense-making ... to create ownership of ideas and energy
• 51:38 Learning with people Networks for learning together - not programmes, not courses
• 53:20 What can I do to make a difference? Pledges, small actions, shared energy - and why you shouldn’t do it alone
• 56:57 Final reflections & thanks - Plant seeds. Find your people. Do something - and see what grows

Transcript

Gill Phillips  0:00  

My name is Gill Phillips, and I'm the creator of whose shoes, a popular approach to coproduction. I was named as an HSJ100 wild card, 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 health care, and like to hear what other people think, or perhaps even contribute at some point, wild card whose shoes is for you. 
 
 So, a little bit of a change for this, my first podcast of 2026 and I hope the year so far is going really well for everyone listening. So the tables are turned. Instead of being the podcast host, I am the guest. So how did that happen? I recently had the privilege of appearing as a guest on Ruth Germaine's podcast. So who cares anyway, where she talks to people who inspire her around health care improvement, so a massive overlap with my own wild card, who shoes podcast. It was fun being a podcast guest. We both enjoyed the conversation, so thought we would share it here as well to reach a different audience and cross fertilize between the two podcasts. I'll put a link to Ruth's podcast in the show notes, Ruth invited me to talk about the impact of the whose shoes approach in fostering genuine CO production and personalization across health and care. Whose shoes has been used in all sorts of different settings, including Dementia Care, maternity services and with children and families, but the common approach is always the same, to create the conditions for people from all sorts of different perspectives to have conversations as equals, and then for us to listen, really listen. It is quite a simple formula, really. So jump in. Here we are Ruth Germaine and myself, Gill Phillips in conversation.

Ruth Germaine  2:28  

Hi, it's Ruth here, and I just want to ask, What if a board game could change healthcare? To find out, listening to this episode where I'm joined by Gill Phillips, the creator of an amazing game called whose shoes, colorful, poetic, radical tool for CO production, where people can really think about what it's like to see in somebody else's shoes. We talk about creativity, courage and what happens when people feel truly heard. So this one's full of goose bumps. I think it's amazing. I hope you enjoy, and I'm really delighted today. I always am. But yeah, especially delighted today to have Gill Phillips join me. So the first time I met Gill. Gill came along when I was a Darzi fellow, to introduce us to a game that Gill created called whose shoes that we use for CO production. So yeah, I'd really delighted to have you on Gill CO production is one of those things I think is just so important, not always understood. And I think your game is just such a creative way of approaching it. So I'm going to pass over to you, because I know that's a really short introduction, and just asked you to introduce yourself, please.

Gill Phillips  3:35  

So thank you. Ruth, it makes a change, doesn't it, to be a guest on somebody else's podcast.

Ruth Germaine  3:40  

Yes, I didn't say that today, that you have your own podcast. I do. Yeah.

Gill Phillips  3:44  

So my podcast is wild card whose shoes, which has been an extension from the WHO shoes work that I do, which is about looking at things from different perspectives. So as Ruth said, I'm the creator of this rather Maverick tour, and I absolutely love it. And one of my favourite pieces of work ever has been working regularly with each cohort of Darzi fellows. So I've stayed in touch, obviously, with Ruth, and I'm proud to say, with many other Darzi fellows. And I just think they're a special breed of people that somehow during that Darzi program, people really seem to get CO production, the importance of listening to people lived experience, collaborating, thinking differently, to solve what Tom holiday likes to call and Becky Malby likes to call wicked problems, and I've just found it the most amazing network. So Ruth and I came together again in person recently when, sadly, it's the end of the Darzi fellowship program as we know it, and we had really quite an amazing get together and celebration. I was surprised at how many people I knew, like from across all the different cohorts, and it was just really lovely to reconnect with so many of them. 

Ruth Germaine  5:01  

it was a great event, wasn't it? I mean, it was sad because the Darzi program was ending, and as you say, it's been so important, but it was also just great to see everybody there and the passion and everything in the room. And yeah, Rebecca Malby, she's agreed to be on the podcast. At some point she's been on mine. Yes, yes. And I think we've had a few podcast guests that are the same, haven't Yeah, Angela Catley definitely being one of them, whose absolutely fantastic with when I

Gill Phillips  5:28  

get old, and I think inevitably, when we both cover quite similar areas, don't we? We're both looking to basically chat to inspirational people, people who inspire us, and we hope will inspire others around some kind of Healthcare Improvement, that's the common ground, isn't it?

Ruth Germaine  5:44  

I think it is. Yes, I always say, if I find it inspiring, and if I've enjoyed the conversation and found it interesting, then hopefully other people will too inspiring, challenging, thinking differently. And I think being creative is such an important thing, which certainly your game really helped with me to think about it. Actually, we don't just have to do set things. We can think about it in different ways.

Gill Phillips  6:07  

So and serendipity and like, as one door closes, another one opens. It's obviously a big cliche, but it's also true. And literally, when I was on the train going down to the Darzi event, quite sad that it was all finishing. I got a very exciting invitation to go and run whose shoes sessions for the current NHS GMTs trainees, so the NHS Graduate Management trainees, and that was last week. So it's funny, isn't it, and I'm sure you're going to find the same Ruth with working for yourself and doing your own thing. You plant seeds. This was a seed going back to, I think, march 2022, and you've planted a seed. I did a session for them, then a virtual session, and then suddenly, what was it like? Three and a half years later, you know, quite a big opportunity comes along, and I absolutely loved it. It was really good fun. And I was on the panel as well.

Unknown Speaker  7:03  

Ruth, you were on the panel. So what did that evolve? Well, it involved.

Gill Phillips  7:08  

So our workshop, I took my friend and colleague, Lise Edwards, that I've been working with at Midlands partnership Foundation Trust, doing a new who shoes project around children and families. So that's another story will perhaps come on to so we've gone together. We've been invited to run these two whose shoes workshops. And then they said to me, well, Bing, as you're coming anyway, will you be on the panel? So I found myself now again, I think, in terms of knowing what to expect, I was thinking we'd be probably sitting behind some kind of table, and then there'd be an opportunity to write notes, because if they're asking a question, they had somebody asking a question to three of us on the panel, and the other two were brilliant. One of them was Dr Siva, who, again, I'm looking at that so hands off. Ruth, I'm thinking she might be a podcast guest at some point. And Gill rook from NHS England, and basically asking us questions in turn. But if you're my age, and also the third person being asked the question, you perhaps kind of want to make a note of what what's been said, or what you might say. And it was just like it felt quite exposed in a way. And it was great. It was more like a kind of fireside chat, if you know what I mean, where we were just sitting and answering questions. And I really enjoyed it. And I thought to bring my experience, perhaps some less conventional approach and storytelling approach, I think was hopefully what I could perhaps bring to the panel. So we had an hour, I think, with someone, introduced it and set out the key aspects of the 10 year plan, and then put various questions to each of us. And then there was a question and answer session at the end. So, yeah, life's interesting.

Ruth Germaine  8:55  

Yes, yes, sounds it. And I like that bit of planting seeds and seeing what happens, you know, and they come up when you least expect them to. Then, from your point of view of hands off the podcast, I think what's interesting is, actually, I've listened to some of your podcasts, and I know you've listened to some of mine, they're probably quite different. And I think we probably draw out different things for people, because I think so often these people that come on, I mean, we've spoken already about how long we do our podcast for both of us have said sort of just over an hour maximum. But actually, when they come on, I'm sure that these people, I could talk to them for ages. Yeah, so I don't think it really matters, because there's so much more that these people have got to say absolutely. But what I'd like to know, Gill, I'd like to know a bit more about you, okay, and what led you to whose shoes, sort of that drive, that passion, which I feel every time I'm around you. You know, where did that come from? And why did it push you in that direction? And then we can go on to what whose shoes is later on, maybe.

Gill Phillips  9:53  

Okay, thanks, Ruth. And obviously that's the key question, in a way, so a sort of potted version. My background was in social care, and I worked for 30 years in local government, so quite an unexpected background, probably in a way, and I'm surprised that now looking back, that I sort of stuck with it for that long, but I was pretty happy I was bringing up my three young children, and and I was given a lot of scope, if you like, to be myself, you know, certainly in in the context of that time ago, and to bring my creativity to work for most of the time. And then, as I think it happens with a lot of people's stories. Different people come along, different management. Things change. You get closed down, you're perhaps a bit too creative. And while this kind of transitional period was happening, and also, I'd been off work for 16 months with cancer, and I think that very much for me, made me stop, and I think I already didn't want to be wasting time, and was quite a positive person, but I really wanted to, like, make the most of what I could do and what I could bring. And I became the story, really was I became very passionate about personalization, which was what was happening in social care at the time. So this was sort of building for two or three years I was part of a really exciting project with Coventry University. I was well regarded. My ideas were being listened to, and we found ways of storytelling with people who'd got very complex learning disabilities, to listen to their stories authentically through all sorts of different media and storytelling. And I loved it. And we were one of, I think it was 13 pilot sites around individual budgets, and it was new at the time in terms of wanting to develop more personalized approaches for people, they'd be given a budget and able to buy the support that they needed, rather than the council just providing a service for them. And honestly, I became excited about this because I thought it was real in terms of services starting to fit around the person, rather than people going from pillar to post, getting what was available or not, and nobody talking to each other, which fast forward to the NHS 10 year plan now is quite an interesting concept. And what happened for me was I realized I was working at the time in a sort of performance context. I was sort of quality improvement, and I was being asked to deliver on outcomes and personalization, and basically, I became very convinced that nobody knew what it was, and we needed to kind of go back a step to really discover what these words meant, so that they didn't just become a good idea, but a buzzword. So I started to do some thinking around, say, a care home setting, and you want to deliver everybody wants to deliver personalized care. So I've always got the assumption that people come to work because, you know, they're good people, and they want to do their best. So in a care home context, if you want to deliver personalized care. What does that mean, and what does it mean for the people who live there? What does it mean for their families? What does it mean for the care staff? What does it mean for the manager? What does it mean for the catering staff? What does it mean, perhaps, for people who come in and provide activities, volunteers? What does it even mean for the people who designed the place in the first place. So the environment and it was absolutely fascinating, and I'd read Community Care in particular, was the journal at the time about this emerging agenda of personalization and the idea of kind of looking at things from different perspectives. And fast forward to now. We're using the analogy of a beach ball. If you look at a multi color beach ball and you only see the red stripe or the blue stripe, we're encouraging people to turn that beach ball around and see the other perspectives. So if that makes sense, that's where whose shoes was born, in a way, developing a board game that genuinely had scenarios from different people's perspectives, real people, all of them have always been 100% somebody's real experience put into a little scenario card. And then, right from the beginning, we've used poems, and we've always found that poems kind of reach people in a way that perhaps other approaches don't. A poem from the heart is difficult to ignore. So that's been the basic whose shoes concept. From the beginning, I got the idea of developing a board game, and I didn't, I mean, I had all this time working for a local author. Authority. I wasn't equipped in any way, really, to know what to do or how to do it, but I think passion can carry you a long way and reaching out to other people. So as I think I mentioned, I got support from Coventry University, who were amazing. They're a very entrepreneurial university, and the techno center in Coventry basically helped me with business mentoring, design of the board game from the design hub that was next door. And it was literally it was crazy, like doors opening all over the place, and there was a Health Design Institute over the road. It was just as I needed the various different bits. I was finding the people to help me with it. Even manufacturing the board games originally were printed in Estonia. The little Croc shoes come from China. The dice were locally made in England. The cards were printed up the road. It was, you know, I was way, way, way out of my comfort zone, but it was incredibly exciting. And I started off and I was selling this board game, and at the beginning I did sell it as a board game, as a tool, but not in the way that it's sort of evolved since, in terms of a licensed, facilitated package, it's become more sophisticated and bigger, really. But in the early days, it was just sold as a board game. And I had this business mentor who said to me, Gill, who are you going to sell this board game to? And I said, Well, other, other social services departments, obviously. And he said, how many of those are there? And I said, I think we're about 150 and he said, How many of them are going to buy it? How many are you going to sell it to? And I said, Well, all of them, because they need it. And then who else are you going to sell it to? And I couldn't think of anybody. So it was that level of naivety, in a way. And actually, my second customer was Ali Gardner, who was a senior lecturer at Manchester Metropolitan University. So the journey was so different from what I expected. But I think, you know, I just wanted it to happen, and really went with the flow in terms of taking opportunities and trying to network with people and just reach out, really. And then the recession hit. So I said I set up in 2008 wasn't the best time to be setting up a business, really? No. And I had, you know, looking back, I had a really successful first year, you know, considering and certainly got the money back that I put into the business, I'm, like, giving up my job, and I hadn't been made redundant or anything. So my salary just stopped, and I say, obviously putting some of your own money into developing anything really, I think I had more help at the time than you'd get now. You know, there was more help with, say, Business Link and one or two services that were available. But then it felt as if everybody I built contact with lost their job or got redeployed or didn't know what they were doing. And that was before social media, really. And then Twitter kicked off. And honestly, I used Twitter to build the whole thing and build the relationships and keep in touch with people when they move from one place to another. It was, it was really transformative.

Ruth Germaine  18:21  

I think all that social media and Twitter was just so useful, wasn't it? I think we spoke about Twitter and what it is now. So I know some people still use it, and I completely understand, but for me, I don't so much now, but I think listening to your story there, I mean, there's a few things I'm just going to pick up on that I really, really like. I mean, one was about bringing my creativity to work, and I think that is something that, you know, we struggle with, because actually, so often we go to work and it's just so busy. And listening to people now, I think it's busier than it's ever been. Yeah, so there isn't room for creativity either in the minds of the people in the organization, because you talked about people allowing you that, but also in the minds of the individual, because we're just going to work, we've got so much to do at home, at work, is almost that get that job done. So even if you've got those creative ideas, are you allowed to do them? And then the other bit was about passion can carry you a long way. So actually, trying to tune in from that creativity into that passion is obviously something that that you use to drive you, and I think is just so important. I mean, you've said lots of things there. Gill, I wonder if at this point it's worth asking you to describe whose shoes, and certainly we can put a link in the chat so people can perhaps see it in action. I know you've created some brilliant videos and things so we can put those links in. But for people listening now, it'd be nice to have a little bit of a picture about what it is, what it does. I mean, I've seen the board. It's great. It's colorful. It's red and yellow and blue and green. I think if I remember my head, it's back in 2019 as you say. There's the little crocs that you move around. There's the cards. But perhaps you can just give us a little bit more of a picture. I'm getting excited now.

Gill Phillips  20:04  

No, you remember it very well, and that's nice. I mean, it is, it is colorful and memorable, and it's really, really simple. I mean in terms of describing it to people when they're playing the game, if you like, or using the tool to use a bit more management speak. And that's been an interesting story in itself, you know, Gill, you'll never get anywhere. This was the early days. If you call it a board game, you need to call it a learning and development management, facilitation, quality improvement methodology, and many more words, you know. And for me, the joy of it really is it's simple. It really you can play it in different ways. It's a flexible tool, but the look of the board is you've got four packs of cards, and like you say, with their blue, which represents and means that the scenarios in that pack of cards are sourced by the people, so you might call them, depending on what the context is that you're using the tool in patience. It could be, I've done a lot of work in maternity, women and families. It could be informal networks. It could be your sister, your extended family, but they're like your gang, and that applies pretty much across the board. And then you've got yellow scenarios, which another pack of cards, so you've got four brightly colored packs of cards on the board. Yellow scenarios are frontline staff, so they're in some kind of paid capacity to look after people. So in maternity, that could be the midwives, the obstetricians, the GPS people who are in a paid capacity, community midwife, all sorts of people. And then you've got the red card. Now probably, if you wanted to make a really significant change, money is involved, and these are the people you perhaps need to influence. So it could be the chief exec, it could be a policy maker, it could be a commissioner, but they're kind of people in power. Really the red pack of cards and then the green pack of cards is basically anybody else who, depending on what the subject area is, is or should be involved in the topic. And it's trying to get people to realize that perhaps being a finance officer in an NHS Trust, it's still all about the patients, whatever job you've got, it's still all about the patients. That's who you're serving. It could be someone who's developed an app. It could be somebody from the community. It could be a volunteer. But it doesn't really matter too much about that from the point of view anybody using the game, because what they do is they come along and they throw a dice, and they've got these brightly colored little cock shoes as counters, and they've got footsteps on the board as spaces, and they throw the dice, and they land on a footstep of a certain color, and they pick up the card that corresponds to that color, and they read it together as a group, and then they talk about it, yeah. So who comes to the events? Anybody and everybody says, very, very inclusive. And even the sessions that I did for the Darzi fellows, the Darzi sessions were great because we had citizens came along, yes, whereas the GMTs session that I did last week for the graduate trainees, it was just for them, and I warned them that it was like a different type of experience of who shoes, because unless you're sitting around the table with a really mixed group and listening to each other every which way. So people think whose shoes is about listening more to the patients, which it is, but equally for me and it really is, equally the staff need to be listened to. Say, take the example of maternity services. If you want a good birth, it's not all about the woman and the baby, because unless the staff looking after her have got capacity and get recruited into that profession in the first place and want to stay there and want to get out of bed in the morning and do a good job, then you know, if they're burnt out. And so it's trying to bring all these issues to the fore. So when you mentioned earlier that people are too busy and that in the current climate in the NHS, it's really hard to make room for creativity, and you're right, Ruth, but my goodness, it's exciting when they do so last week, I want to give a shout out to the maternity team in Aylesbury, so in Buckinghamshire, and they'd been planning a whose shoes maternity workshop for months, and that's what it takes sometimes, because originally they wanted to do it quite. Quickly. And I said, No, it'd be too quick. It won't be good enough. You've got to use that planning time to build relationships, to get the right people in the room, to think of a theme that's really going to work and be special to you. Anyway, fast forward to last Wednesday's. The room is packed. It's over subscribed. I've made the mistake of telling them, You can invite more people than you've got seats around the table, because some people won't come. But I think they pretty much all came, which, you know, it's like a nice problem to have the energy in that room. So that their theme, which I absolutely love, was it takes a village. Yeah. Oh, nice. So around someone having a successful experience of pregnancy, birth, postnatal care, going home, etc, etc. It takes a village. But what I loved about it because I'd given them a challenge. The best workshops will be something that the local team have really got behind. Done something special themselves, done something creative. I'd given them examples of music and all sorts of different creative approaches that people have brought. And when we had we've had various planning meetings, and they said, Oh, we've come up with our theme. It takes a village but honestly, Ruth, they made it like a village fete. So this is the NHS at the moment, and the tables were named after local villages, and they got little pictures on them. And they got the whose shoes bunting around the room, so very colourful, but they put their own bunting up as well. All the little name badges had got houses on them. And during one of the planning calls with them, Nick, who was the I think that, like the PA to the director of Midwifery, suddenly popped up really excited. And while we'd been on the call, she'd sourced these large post its in the shape of houses. Oh, wonderful. So when we came to do our pledges at the end of the workshop, because whose shoes is all about, what can you do individually to make a difference? We can perhaps talk about that a little bit more, but she sourced these large pledge cards in the shape of houses that then they could collect up and make it look like a village with all these different pledges. So it was just extraordinary. And someone came up to me at the end, and she was going to join the maternity and neonatal voices partnership. She was buzzing with it. She was wanting to use her quite difficult experience to help others. And she hadn't expected, I think, to come along with that outcome. But I think if you just, I think my message would be, if you just create the conditions for people to feel that they're honestly valued and listened to their magic can happen, but you can't just do it by saying, we want to do that CO production, that whose shoes thingy, because it seems to be working somewhere else. It absolutely doesn't work like that. It's the opposite of a tick box. And you, you've got to genuinely set out to listen to people. And I think people can see straight through you if you don't,

Ruth Germaine  28:15  

yes, yeah, I can completely get that. And it's not the easiest thing to do. But Gill, you've obviously been doing it for a long time, and what you've not only managed to do is to create that yourself, but you've managed to create the conditions listening to that, where the people that are actually going to be doing this work that you're working with, that they've learned how to create that as well. I just want to go back one bit, because you talked about the blue, the red, yellow, the green, those different things and all those different people. Because I'm just trying to remember, when we were doing this at the Darzi event, are they pre-set stories and poems so that when you're playing that game, there's something there and then that person on the table starts to share that? Just remind me,

Gill Phillips  28:58  

yes, the cards themselves that I've described are like mini scenarios, and they're almost always a statement rather than a question. So I think that's what people need to kind of take a moment sometimes, to get their head around. You know, I think so many tools will say, this is the problem. What's the solution? It kind of like, narrows things down for me, whereas the WHO shoes scenarios have got, it's a bit like, definitely Twitter helped me a lot in the early development. If you, if you think of Twitter, and somebody just says something, a statement, and other people agree, disagree, say all that happened to me, or this is what we did, or whatever. So who shoes is very similar in that you've got a statement genuinely by somebody. I mean, for example, one of the maternity scenarios that that's been really quite impactful, but two that come come to mind, you know, know what? I'm like, my mind goes off everywhere but and. Midwife, for example, saying, Well, this is all very well, but I don't even get a chance to go to the loo or to have a break. And Murray from Darzi, so Murray Anderson Wallace, who I think is brilliant. Murray used to say that whose shoes was like an inanimate actor. So the fact that that scenario came, you can imagine someone sitting there bottling something up and thinking, This isn't real. You know, this person, this game, has no idea what my life's like. And the scenarios are really deliberately quite provocative, so that just the thing that someone's thinking about comes out as the next scenario. And you can almost see this sort of sigh of relief that, yeah, people are listening. You know, this is the real deal. We're actually talking about real things, not sanitized. Yes, you know, management kind of things. And I think the the pinnacle for me, really, if that's the right word, was a workshop we did in Nottingham whose shoes has grown into more and more sensitive topics. And, you know, I've got nervous sometimes, like, ultimately, I'm advocating fun and humanity and a board game, and the game itself varies according to what topic you're discussing. So for example, we've had a whole set of cards about dementia care, dementia friendly communities, maternity care, more recently, children and families. So it's always about crowd sourcing real perspectives from real people, and as I say, over time, it's become more and more sensitive topics. So for example, we've done workshops around baby loss. We've done workshops around the experience of people from black and ethnic minority communities in maternity care, where it's known that the outcomes can be a lot worse. Yes, so I was starting to say that the pinnacle for me was a workshop in Nottingham, where we were using a specific set of cards around the experience of people from black and ethnic minority communities, which actually Ruth I'd first develop with Rosie Murphy. Oh, okay, a Darzi fellow, yeah. So this is where all the connections and all the links come in. So Rosie Murphy, absolutely lovely, a very insightful midwife who was working Croydon at the time as part of her Darzi fellowship, and in terms of ripples, so Rosie was there at the beginning, and then I was doing this work up in Nottingham. And the thing that really, really stayed with me that several of the women were texting their friends during the day saying, Get on down here. This is the real deal. This is, you know, these issues, somebody's listening, and it caused a problem, because you've got so many, you know, it's a board game, and you've got tables and you've got chairs, and you start to get extra women turning up who weren't on the table plan, yes, hadn't signed up for the event, and bringing their babies and their buggies. And it wasn't a very big room. It's a problem. But, my goodness, was it an exciting problem to have. It was just brilliant. Wow, wow. And taking that particular event, I mean, one of the most difficult things for me with whose shoes, really, has been, how do you measure the impact? You know, there's a lot of ripples, what I call lemon light bulbs, where people understand things in a different way. But that Nottingham maternity event, the maternity team were doing in close collaboration with Nottingham University, and they were doing it as a bit of a research exercise. So it was everything was written up, analyzed, reported on, in a way that was exciting in terms of evidence, because everybody's looking for evidence.

Ruth Germaine  34:09  

Yes, yes, that's always the hardest thing, isn't it? And I, I totally agree with you, when you're doing something like this, it's a bit different, bit creative, trying to get that evidence of impact at the end. And I think I don't know so much for social care, because it's not my background, but I think it is the same, but certainly in the AHS, it's always key performance indicators, those KPIs. And sometimes you just feel like we're actually we're measuring the wrong thing. So trying to evidence the outcomes and the impact that actually matters to people is so hard because then, as you said, you talked earlier on about all those sort of people that you're trying to influence, and they want to know about pounds and pence, maybe, or they want to know about numbers. But actually a lot of this is qualitative data. It's it's what people have said, it's what people feel, it's what what happens. So it doesn't always give you those numbers in the same way that. Of perhaps being looked for.

Gill Phillips  35:01  

Yeah, I think that's been one of my bug bears, really, and my sort of long term, kind of slight run in with, say, NHS England, that they like to count things that you can count, which by definition, as you've just said, Is not this kind of softer ripples, change of behavior, it's hard to measure. So something I'd like to mention is in terms of my journey and how it's evolved, and the different topics and so on, I have what's called My golden people, and they're just the people that come along and believe in you or give you an opportunity. So say, for example, in the early days of whose shoes. I don't know if you ever seen the cartoon whereby someone's getting really excited about something that's innovative, but then obviously you can't do it because it's never been done before. Yeah, yes, yeah. And that, that's exactly my journey, that people really like the idea, but to actually find the people who are prepared to invest in it a bit, to take a risk a bit, it can be a bit of a can of worms. Whose shoes, because you don't know, it's genuine CO production. You don't know what's going to come out from those conversations. And it's deliberately aiming to do that so that, you know, we invite people to go off piece from the scenario, whatever conversation they're having is the one that needs to be had. So in the early days, someone called Kath Evans was a fantastic facilitator. She's She was, at the time, the patient experience lead for maternity and Children's Services at NHS England, and she's now Chief Nurse, or chief children's nurse, I'm not quite sure, at BARTs in London, but Cath. So again, with Twitter, you get I've been big on hashtags. I've got fab OBS flow, who is my big maternity pal, and I called her can do Cath. So can do Cath was working at the time in a position of influence, and basically said, Let's do it. I've seen this in action. It works. Let's give it a chance. And we developed through a whole project across five hospitals in London, the original maternity scenarios and those whose shoes maternity scenarios are now being used in 100 NHS Trusts. Wow. So it's been an amazing kind of journey. So anyway, coming back to because I'm sort of aware that I'm going off on one a bit.

Unknown Speaker  37:32  

No, it's all interesting. It's fine. Joan, hopefully, okay, but we

Gill Phillips  37:35  

were talking about evidence of impact, weren't we? Yes, yes. Now and then I was talking about Golden people and Lisa Edwards at Midlands partnership Foundation Trust has been amazing to work with. So I've worked with Lise and with that trust over the last four, almost five years, and we met in a breakout room for a liberating structures session. Liberating structures is just all sorts of creative ways of making meetings and events more engaging, more exciting, more relevant, more impact. So we met there because we're both interested in creativity, and we've now been doing a properly funded, long term project developing new whose shoes resources around children and families. So I'm hoping it's going to have the same kind of scope and the same kind of impact as the maternity work. And it's, it's had everything that it needed to have in terms of, you know, I've just said it's taken that four or five years to develop. It is not a quick fix. It's taken that long because we've gone out and met with real people and found out what the issues are, and developed, CO produced the scenarios, the poems. We've got 45 new poems, and it's it's been very, very exciting. We've done work around joining things up for children and families. I've learned so much mental health care, experienced children and young people and special educational needs, disability and neurodiversity. So it has been huge. And it got to this summer, and we were sort of finishing the formal project and finalizing the resources. And can you believe we had something called a celebration event? Yes, yeah, wow. Like, again, like, I say it was, you know, like the maternity team I mentioned, and it takes a village, you know, I think that's courageous, you know, to call it a celebration event, not a evidence sharing it. You know what I mean, you can take, yeah, knock all the you know, the fun out of it was a celebration event, and it felt like a celebration. And part of the challenge was, how do we share the impact, how do we share the story, and how do we share the impact of what we've been doing? So we've actually got a whose shoes YouTube channel. And My poor husband, so the long suffering, Mr. Whose shoes, comes along to these events. He loves filmmaking and but he also loves on a sunny day, first of July, going wandering around the grounds and, you know, listening to the birds or whatever. And I said, we need to film this event and everything about it, because it's like a unique opportunity to come up with evidence. And the three things that stood out for me from that event were we wanted to tell the story of what we've been doing, and instead of somebody standing at the front and telling the story, a ball of wool got passed around the room with the people in the room grabbing it when it got to their part of the story. So, you know, all we've got to the mental health events. All that was the mental health participation team. That was all that was you Tori, that was you Marie, that was you Cherose. So they were taking the ball of wool and standing up and telling their part of the story, and then passing it on to the people. So that brought you in, didn't you? That's how we got into and the project naturally evolved and brought more and more people in it. And we had these planning meetings whereby, in a more conventional way, I think the people who'd finished their module might be glad to leave. And, you know, get back to their day job. We couldn't get rid of them. I mean, like in the nicest possible way, they all wanted to stay involved. You know, it's been this massive snowball project of energy. So at the celebration event, we had the ball of wool to tell the whole story. And we've actually produced two videos, and we're working on the third one from this event, because, as say, it was just so rich and so lovely in terms of people coming up and sharing their joint experience, rather than one person standing at the front and, you know, telling us what happened. So the other main part of it was because the last topic, send special educational needs and so on was so complex, and the needs of the people involved in it were so different. Instead of having one workshop, we'd had a road show. Oh, wow. So we'd had, yeah, the send road show, and all the people in our project group took it upon themselves, this maverick, growing project group, yeah, took it upon themselves to say, well, I'll take it, I'll take the whose shoes resources out to a school. I'll take it to a secondary school. I'll take it to a special school. I'll take it to a parents forum. I'll take it to a professional forum. So we'd had all these different people going out and basically testing out the new resources, not in one big workshop to bring everybody together, because that would have been too big, too overwhelming. You know, we were aware of the needs of the people we were serving. Yvonne Newbold, whose been an amazing part of the project, I could talk all day about Yvonne, she and I ran a virtual session for some of the parents who by definition, wouldn't be able to come to a face to face event because of their caring responsibilities. So we basically try all sorts of different methods to reach the people who perhaps aren't normally heard, and it's exciting.

Ruth Germaine  43:23  

It sounds really exciting, to be honest, and even if people haven't quite visualized, right? I think what's coming through Gill is a, your passion, but B, I think enough that people can pick up and start that imagination, that creativity and and start to think. And as we said, you know, people can definitely click on the links, but there's enough there, I think, for people to really understand. What I'd like to ask you now, Gill is just go back to the bit that you spoke about, that people like to count the things that you can count rather than what matters. And that innovation, and people are told, Well, go off and be innovative, be creative, and then show me the evidence that it's going to work. And by that very fact. And Adam Leanne, who was on my second podcast, who was talking about do with he said exactly the same thing. If you're doing something that's innovative and creative, it probably you haven't got any evidence that it will work. Sometimes we just have to be allowed to go rogue and give it a go, and I can't tell you what it is I'm going to count at the end, because I don't quite know what's going to happen. Yes, what we're doing at the moment isn't working, yes, so actually, we just need to try something else out. So I was just wanted to come back to that, because I thought it's a really important point that you brought out there, and I really like that.

Gill Phillips  44:40  

I think that's exactly right Ruth, and I think we say to people, if they if they put the the work into the preparation, you know, it doesn't just happen if they put the work into building the relationships, getting the right people in the room, making it feel. Fun, creative, making people feel that they really are not just being told we want to hear your voice, but they're valued. They're listened to. They're part of following it through afterwards. If they want to be with the pledges, they can make their own pledges to what they want to do. If all those things happen, then the magic will happen. I can promise you something will happen. Something really good will come from this. But I can't tell you what it's going to be, and people have to believe that the example that I absolutely love to quote, and you'll see why, and in terms of perhaps silencing the naysayers in Liverpool, a new neonatal surgical unit is being built at the moment as a direct result of whose shoes co-production conversations. Wow. So it doesn't, it doesn't get any bigger than that. It can't do and what happened there? Ruth, you'll love this, because that outcome was never on the radar at the beginning, not at all, not but the conversation. So we, I think we have four different workshops, and there was a mum called Helen Calvert, whose baby had heart surgery. She made it happen. So in terms of co-production, Helen Calvert absolutely amazing. Insisted that whose shoes came to Alder, hey, Children's Hospital. Yes, Joanne Minford, brilliant paediatrician there. Transformation lead got hold of it. I mean, we literally went, Helen and I went to meet Jo at Alder, hey, hospital. This is years ago. Jo ran around the hospital with a copy of whose shoes board game under her arm, getting out on the table with whoever happened to be around. Look at this. Look at this. So we got by him from the hospital to have the workshops. The chief executive, Louise Shepherd, was very supportive. That makes a difference. And they had a series, I think it was about four different workshops. And what happened was that throughout the workshops, people kept saying, Oh, well, obviously we can't do anything about that. Obviously we can't do anything about that. And what the thing was that they couldn't do anything about which is true is that Liverpool Women's Hospital and Alder Hey, Children's Hospital are four miles apart, but vulnerable babies were being transported between the two hospitals, and families were finding like a new dad. Well, do I be with the Mum at Liverpool Women's Hospital? Do I be at with the baby at Alder Hey, what do I do? So perhaps we can do something about that. Perhaps, if there's a new neonatal unit at all the hay, they wouldn't need to go backwards and forwards between the two. So that's what I mean by like true co-production. So then people got excited, and Jo and her team put in a business case. And obviously a new unit like that costs millions, and they were successful. So it's being built at the moment, and I think opening quite soon, and I'm hoping to go up, you know, and see, wow, yes. And we had the we have the graphic artists. So again, in terms of visualizing what we do, a big part of it is, how do you capture what people are saying? So you have the conversations on the table. And what can be frustrating sometimes is people are so deep in these incredible conversations that they're forgetting to write anything down, and it will get lost. So we have post it notes. And instead of having a table facilitator who records everything, we have post it notes everywhere, so that if you have a quick thought or you've said something, you can take control, and you can write your own post it note. And then we have a visual artist who records all the conversations, and then that can become an action plan, or used in a business case, or whatever it might be, very, very powerful. 

Ruth Germaine  48:59  

And of course, the visual art you know that happens like that, anybody who's seen it just just looks incredible, doesn't it? So that, in itself, is inspiring. And you actually answered my next question. So I'm pleased I went back to that. Okay, my next question was, can you tell me about an incredible outcome that's come out of you shoes? Now you probably go from any more incredible than playing a game where you've got some nice little crocs going round on a ball, some footsteps and some colourful cards that to go in with lots of people passion and a new hospital. I mean, that's a massive impact, isn't it, and the impact of that hospital, just from what you've said already, you know, Dad's not having to think whereabouts am I? Where I need to be this hospital or that hospital, and babies not having to be transferred when they're vulnerable. And I'm sure so much more as well about that hospital that's probably come out. I don't know if there's anything else you want to share. Beck Gill, well,

Gill Phillips  49:55  

I was just, I had a Goosebumps moment for a minute there. And I mean, as you can probably do. And I'm not a big fan of counting and league tables and KPIs and so on. So no, I take it all with a pinch of salt. I understand that, yeah. But coincidentally, I think Alder Hey, have come out at the top of one of these recent league tables, and Midlands partnership Foundation Trust have come out at the top of their Leake table, or number one or number two kind of thing. And, you know, perhaps it's, it's something to do with because, I mean, whose shoes, and the ability to open the doors and having an unknown kind of thing, you know, like whose shoes, that's going to genuinely find out what people will think, rather than try and over manage that. Perhaps that's part of a mentality in a trust like that, whereby they're open to learning. And what I've found with the whole who shoes journey, and certainly in the early days, it was very, very telling that possibly the whether it was local authorities or whatever it was who desperately, in my view, needed whose shoes in terms of perhaps thinking a bit more creatively and just opening the doors to conversation. They weren't the ones going for whose shoes. It was the ones who were already pretty excellent and who just want to make sure we're doing the like thing, find out what we can do to improve. And that applied whether it was care homes or whether it was all sorts of different teams that we've worked with, housing associations. I'm going back to the earlier sort of community based, sort of social care aspects that people perhaps don't know so much about.

Ruth Germaine  51:38  

Yes, yeah, and what you what you've really said there as well, that I really liked, is that open to learning, and I think that we so often when we talk about learning, developing, improving, people think it's a course, it's a module, it's a program, it's an online delivery. But actually learning is just constantly learning with and from people. Yeah, those networks for learning together, as I've I've called them since my Darzi work. It was one of the things that came out of my work was that you need networks for learning together, and people, they sort of get that bit and think, oh, so what do I need to go and learn? No, you just need to learn with people, with them, from people all the time. Listen, be curious. That's brilliant. Yeah, I love that. To me. That's what that's about, you know? So, and I think that's what you're doing, to be fair, Gill, you're creating, if you said to people, I'm creating a learning environment, they might think, Well, what's that? But actually, that's what you're doing. You're creating an environment where people learn and question and do all the things they need to learn. So we're coming towards the end of our time, Gill, now, and I'm really conscious, so I could talk to you, you know, just carry on listening, because it's been fascinating. And as I said, I was quite excited to to have you on. When I met you up at the Darzi event, I was like, oh, Rachael, I'm gonna have to ask jury's to be on my podcast. He was a fellow podcaster. But also, just because of everything that that you do, that's really nice. So you said earlier on, he said, we might come on to that, but I'm going to ask it of you. Okay, what can you do? Well, what can I do to make a difference? So I'm asking you, but you might do it for, you know, the people listening, whether that be just people in our community, our public or whether that be a somebody on the front line, or whoever that might be, yeah, people do to make a difference.

Gill Phillips  53:20  

Okay, well, I can answer that really well, I think in that thank you, that links with our pledge. Okay, yes. So what we do in a whose shoes workshop is we don't just throw it at people at the end that we're asking them to make a pledge. We kind of sow a seed right the way through everything that individual people can make a difference. There's always something they can do, so we invite them to think about what they're going to do to make a difference. And again, it's a bit kind of reverse psychology sometimes, in that if you can't think of anything, then please don't make a pledge. You might think of something later, but don't write something down just for the sake of it, or because you see the person sitting next to you writing something, it's not that. It's something from the heart that you really want to do. And honestly, Ruth, it can be the tiniest thing it can be. I'm going to speak to so and so about such and such that's fine, and small things add up, or it can be a big thing, and one I can think of quite recently, I'm going to set up a community bus and take it all around the community, and we're going to offer these different services, and we're going to see what other services are needed that could be on the bus. I mean, whether it's taking blood pressure or whatever it is, and then when it's live in the room, I kind of invite people. Okay, so do you need any help to do that? Probably setting up a community bus. You do? You know, is there anybody else in the room that can help you? So we get an energy going. And obviously, with my kind of social media connections, I can normally link. Them to somebody who's already doing something similar, yes. So I think coming directly back to your question, you know, what can someone do? I think find what you're passionate about, rather than saying they should do so. And so, you know, this needs to change. Think about what small action you can do to make a difference and then do it, and it really simplifies it, and then, okay, you might well do another action, another one. And I think the other message would be, it's lonely to do it on your own. So linking with other people, find people with that shared passion and do it together or learn from them. So, for example, during the pandemic, we did some virtual whose shoes workshops. And I think it was really difficult and really demanding, because we were trying to bring a creative approach online, and we were working with some very challenging kind of topics to try and keep things going for them during the pandemic. So we did a whole day workshop with Shrewsbury and Telford maternity team, and then separately, we did an equivalent workshop with East Kent who were both in a similar position under the media spotlight. Really good people trying to do their best. But if you said, Do two organizations work together? What does that mean? You know, does it mean the chief execs work together, know each other, go for a drink together? Whatever? Does it mean that perhaps the bereavement midwife in one Trust has got a mate and another trust in a similar position, really difficult job. They know each other, they talk to each other, they learn from each other. So the kind of community of practice idea, which I think you've mentioned really strongly, Jeff, I think is a really key message.

Ruth Germaine  56:57  

Thank you, Gill, it's been absolutely fascinating. I think those key messages, you've said them really well, so I don't need to repeat them. Thank you. I will certainly be thinking about planting my seeds and following my passion and thinking about those actions I can take those small actions and linking. Who can I link in with to take those actions? Brilliant. So thank you so much for joining me today. I really appreciate it. It's been absolute pleasure.

Gill Phillips  57:23  

Thank you, Ruth, I've loved it. Thank you. 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 wild card who 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 you.