78. Samira Ben Omar - Training doctors to walk in people’s shoes

In this episode of Wild Card – Whose Shoes?, Gill Phillips is joined by Samira Ben Omar, newly appointed Professor of Inclusive Practice at St Mary’s School of Medicine.

Samira is helping to shape something genuinely exciting: a brand-new, socially accountable school of medicine, built around communities, inclusion, humility, curiosity and trust. 

Rather than starting with programmes or project plans, Samira talks about starting with conversations — coffee mornings, community spaces, lived experience and the real messiness of people’s lives.

Together, Gill and Samira explore what it means to train future doctors and healthcare leaders who are more than “book smart”; people who can sit with discomfort, listen deeply, understand power, and recognise the huge resource that already exists in communities.

There are powerful stories in this conversation: parents navigating SEND systems, GPs learning from mining communities, the importance of faith and community spaces, the role of music therapy, and the challenge of measuring what people actually value.

A conversation full of goosebumps, lemon lightbulbs and a very big “watch this space”.

For anyone interested in the future of healthcare, co-production, community power, medical education and human-centred care - this one is not to be missed

Lemon lightbulbs from this episode  🍋💡🍋

💡 Communities are not an “extra” - they are the lifeblood of local action.
Samira makes the powerful point that community and faith spaces are where so much real support, trust, advocacy and practical action already happens.

💡 Future doctors need to be more than “book smart”.
Clinical excellence matters, but so do curiosity, humility, listening deeply, understanding communities, and being able to sit with messiness and discomfort.

💡 Trust takes time - but trustworthiness can start now.
Do what you say you will do, be known as a person, and honour reciprocal relationships.

💡 “I am your red book. I am your integrated neighbourhood team.”
Fatuma’s story is incredibly powerful: the parent as the holder of the whole memory, navigating everything for her child in a fragmented system.

💡 "People do more when they decide for themselves."
A beautifully simple line with huge implications for healthcare, co-production, leadership and communities.

💡 The system often responds to complexity with more complexity.
Samira reminds us that “simple is very difficult to do”.
Huge synergy here with Whose Shoes! The answer is not always another framework, strategy or project plan.

💡 Relationships require you to move beyond your role.
If Samira needs to make coffee at the Roehampton coffee morning because they’re short of volunteers, that matters. It says: I’m here as a human being, not just as a title.

💡 Communities can sustain clinicians too.
A really interesting twist: communities are not just people to be “helped”. They can be allies, advocates, bridges and sources of nourishment for doctors working in difficult systems.

💡 Human-centred care goes beyond person-centred care.
Person-centred care can sit within a clinical interaction. Human-centred care asks how we design whole systems around people, families, communities and real lives.

💡 Measure what people value - not just what the system asks for.
Samira’s commitment to co-designing an outcomes framework feels huge. Not just measuring activity, but working with communities to understand what really matters.

💡 Power needs to be noticed, not ignored.
This conversation keeps coming back to power: professional power, institutional power, community power, lived experience power - and the need to design spaces where those dynamics are acknowledged.

💡 The future doctor who  learned from going down the mine, before the consulting room.
The story of the GP in Wales being sent down the mines on day one is unforgettable. You cannot treat people well if you have no feel for the lives they are living.

SO. Watch this space.
This is not just a set of nice ideas. St Mary’s School of Medicine is trying to build something different from the start - with communities, inclusion and social accountability as the golden thread. 

SUCH an exciting conversation. Thank you and good luck, Samira!

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Transcript

My name is Gill Phillips, and I'm the creator of Whose Shoes, a popular approach to co-production. I was named as an HSJ 100 Wild Card, and want to help give a voice to others talking about their 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, Wild Card Whose Shoes is for you. Welcome back to another episode of Wild Card Whose Shoes, and I have a very special guest today. I'm joined by Samira Ben Omar, someone who has spent years working alongside communities, really listening to what matters to people, especially those whose voices are too often overlooked. And now she's stepping into a new role as Professor of Communities and Inclusion at St. Mary's School of Medicine, helping to shape how future doctors are trained with communities right at the heart. How exciting is that? I first met Samira several years ago through work we were both doing with Professor Becky Malby and the Darzi fellows, although we only ever seemed to meet like passing ships. Samira's morning session finishing just as I was setting up a Who Shoes co-production session in the afternoon, more recently our paths crossed again, and we realized just how much we have in common, lots of goosebumps moments, and a few lemon light bulbs as we talked about our current work and some favorite people. I suspect a few ears might be burning during this conversation, so Samira, it's so lovely to have you on the podcast.

Samira Ben Omar  2:05  

Oh, what a joy to be here at long last. As you say, we have crossed paths so many times, but I genuinely believe in the right time and the right moment, and I think this is the right moment to have that conversation and to have a proper conversation with you. So, thank you for being so generous in inviting me on the podcast. It's a genuine honor and a privilege to sit with you and talk to you, and for a whole hour. Incredible. Thank you.

Gill Phillips  2:40  

Well, likewise, Samira, and I've referred just very briefly in my introduction to your new role, and I think since we had a little conversation a few weeks ago, just sort of preparing for today, you've actually started, is that right?

Samira Ben Omar  2:53  

I have this is week three to say week three in my formal role as a professor of Inclusive Practice, I would say I've been working on the program for the past few months as an independent consultant, but the formal role really working on what is the challenge in creating and co-designing a socially accountable school of medicine. So it's an honor to be asked to join as a professor at the school. It's a brand new school, physically an actual brand new school, so not just in terms of the school of medicine that's been developed, but being built, and how exciting is it to be involved in something where you are starting from scratch? How unique is that, and how exciting is that? So, tell us more. What excited you to say yes? I suppose I have known and worked alongside Sonia Kumar, who's the professor and founding dean of the school of medicine, where we were both in Northwest London. She was at Imperial at the School of Medicine there, and I suppose there's something about the way we work and the way we connect differently with people in communities, and that's really about understanding deeply what impacts on health happens outside of healthcare settings. So, 80 to 90% of what impact on health happens outside of healthcare settings, and Sonia absolutely gets that, understands that, and is deeply committed to that way of working and connect. Second is the reality that actually people are messy, people are complex, and we work in complex and messy organizations as well, yet somehow sometimes we pretend that we're working in nice neat structures, and that that's the real challenge. So we both understood that, we both were working on that. So when the opportunity came up, I really couldn't say no, to be honest. How exciting, how exciting it is to actually kind of really think we're not going to start with a program, we're not going to start with a project plan. We're going to start with conversations in community settings. So, my very first conversation was coffee morning on the Roehampton Estate in Wandsworth, sitting with a group of people, and we were just talking about what matters to them.

Gill Phillips  5:38  

Yeah,

Samira Ben Omar  5:39  

yeah,

Gill Phillips  5:40  

and this is super exciting for me. I've already recorded a podcast, you know how I love connecting people, so I don't know whether you're already connected to Dr. Guddi Singh, because she's one of my absolute favourites.

Samira Ben Omar  5:52  

Yeah,

Gill Phillips  5:52  

and I recorded a podcast with Goody, and it was around re-imagining healthcare, so it's so aligned to this, and Goody is very much on my mind at the moment, as, as we're recording this this time next week, I'm going to be presenting a workshop at the World College of Paediatrics and Child Health with Goody Crud, called Whose Power, and Goody has just today posted on LinkedIn about how looking at the sessions for that conference feels different to previous years, because some of these issues that might have been regarded as fringe are becoming more centre stage, and for me to hear that you're setting up a course for medics to start right at the beginning, choosing the right people and shaping around compassionate care rather than purely medical. Tell us more.

Samira Ben Omar  6:46  

Oh, without that, I think I probably said enough times in enough public settings that these sometimes, having worked in the NHS in community and occupied the spaces in between, these can be lonely places. Yes, but they're becoming less and less lonely, and I think that's because the power of people who are connected together around the shared purpose, a shared way of thinking, that's focused more on understanding, understanding community power, and second, understanding how the system views power and where power sits and the type of power. I think there's something about understanding that there's something about designing for that and really truly connecting the reality of people's lives around how we design, how we can make in and how we deliver, so to me the mainstream, which we design services, information, and deliver is quite, it's quite narrow, it's quite narrow, and it deals with the assumption that we know within the system, we know and understand what the issues are, and some of the answers, so I think, for me, the power of actually kind of having people with lived experience sitting with you, thinking with you, and actually learning from them, and being a participant rather than the person who dictates the agenda is so critical. So for me that's really exciting, and it's also a little bit unnerving, because I'm mindful that actually all my own power, in all humility of my own power, and the power that maybe my new title takes, or my experience actually brings into the space. So for me, How do we do something different? How do we mobilize differently, but also, how do we sit in spaces that are occupied by both institutions and communities? How do we design those spaces where we are mindful of the different types of powers that exist?

Gill Phillips  9:01  

Is extraordinary. extraordinary, isn't it? And there's so many different angles to look at these things from them, and I know the work that I've done around children and families, so we're just very exciting time for Whose Shoes at the moment. We're just launching our new children and young people's module, really for children and families, which is sort of on a par to what we've done with maternity, but obviously a much, much earlier stage, we've been developing these resources with Midlands Partnership Foundation Trust and also Staffordshire County Council, and we've got in June our first workshops coming up outside of Staffordshire, in Northamptonshire, so very exciting time, but working with different people. I mean, Yvonne Newbold has been phenomenal in supporting me to develop the resources, and for her, in terms of power, you know, the lived experience to have a son, as she has Toby with. Very complex needs, so he can't advocate for himself. So then the power or not of the family to be able to advocate, and the fight that is involved in children services in actually working through systems, even if you know them really well, even if you're a professional within the system, but you're suddenly on the other side of the fence, and then sort of jumping to working with Goody as a paediatrician, and seeing families come that the medics want to help, but actually the problems that they're seeing aren't really medical problems, or the medical problems are caused by poor housing, or whatever it is, so that's sort of all in my head from millions of perspectives at the moment, and sometimes it's a bit overwhelming, really, as to what you can actually do.

Samira Ben Omar  10:50  

It's incredible, and I think just reflecting while you're talking, one of the one of the people who opened the session at our round table discussion last week on launching a socially accountable school of medicine was Fatuma. Fatuma is a social worker and also a parent of a child with additional needs, and her story is quite powerful because this is somebody who works in the system and understands as a system and should be able to navigate the system, but she talks about the complexity of actually kind of trying to advocate for her, for her child, in terms of their needs, in terms of what she needs, and what she said was so powerful, in terms of saying, I want you, as a clinician, as a doctor, I want you to train future doctors to understand that they know what they know, but I also know what I know, because I'm the carer, I'm the person who has to be there all the time, but what she also mentioned was the fact that actually I know that I'm the only person, I am your red book, I am the integrated program. I am your integrated neighbourhood team. I am the person, I am the mother, and I am all of those things, and I need you to understand that I hold the whole memory. Yes, and it's so powerful. And we had very similar, so we did run a conversation with the called Wandsworth and Richmond SEND Parents and Carers as an amazing group of people who were actually carers and parents of children with SEND needs, as they described them. The issue and the challenge is, what does it feel like to be in that space, knowing and understanding that actually there are some spaces, even in GP practices or hospital, they're not fit for purpose for actually having a child in those spaces. What it feels like to be able to navigate an extremely complex system. What does it feel like to be known and understand that there's certain issues and challenges, and your child needs sort of support, yet not to be heard, not to be listened to, not to be acknowledged. So, it's quite powerful. So, then, for me, the challenge, and for our school of medicine, is how then do we create a future workforce, and especially not just future doctors, but future doctors and healthcare leaders, these are not just going to end up being doctors, they're going to also end up being healthcare leaders. How do we create and train them and develop the capacity so they have the empathy, the deep understanding, the humility to sit with people in communities, so that they can learn from them, but also they can navigate a system that's actually not designed for everyone, it's designed for those who have privilege, who are able to navigate the system. So, so I completely understand that, and completely get that. And I think we will have a short video of the event. You can see the Fatuma’s story, it's phenomenal, extremely powerful, and also both the lens of the system, but also through the lens of the parent and carer of a child with additional needs.

Gill Phillips  14:11  

There's so much to I know. Another podcast I recorded, which comes to mind, was with a friend of Yvonne Newbod, who I actually met sitting next to her at Yvonne Newbod's wedding last year, so people were teasing me that I even network at weddings. So Benedicte Symcox, her name is, talks on the podcast about tugboats navigation that she runs, and she helps parents navigate the Send system, which I've got on the one hand, it's phenomenal, and what she does, and the way she does it, and the person she is, absolutely phenomenal, but the sadness that you actually need that in the system, that it's so complex, and there's so much, as you say, advantage if you can know the system and navigate it very well. Compare with just a parent wanting the best of their child, but not really knowing where to start. So, with your course, Samira, with your school of medicine, who are we going to get in the door in the first place? Who are the people you're looking for? And I remember you using this lovely phrase that they're more than book smart? What do you mean by that?

Samira Ben Omar  15:23  

Oh, yeah, absolutely. We don't just ... we want incredibly book-smart kids to join us, but we also want future students, our students, to have a strong and wide sense of understanding of community and social justice. So, one of the key things that we're doing in the assessments, not just in assessing for school grades, we're also assessing for actually kind of the ability to be able to have either an experience or a sense of working with communities, being of those communities, and also connecting to the different groups and the networks, the community action for us, it's really important because it just gives us a sense of what type of doctor do we want to train and develop. The second thing is just in the first year the students will be taking part in music therapy. Wow, that's core module. That's in our core module. So we're not saying that we're going to do things differently. We are doing things that we're committing to doing things differently, and you can see it throughout the whole team. You know, we've got an incredible team of people who are committed to a more what we call a bio psycho social model of health, so this isn't about underestimating the power of community, but also link it to the to the wider social issues that people live through, so we want people to be able to deeply understand and empathize with the way people live their lives, but we also want them to be curious. We're recruiting future students to be curious, to ask deeper questions, to be connected to their neighbourhoods, to know I want to know about you, and I want to know about your situation, I want to know about your family, your community, and your neighbourhood, because that helps me do my job a bit better. What we've created through this process, it's a golden thread. What we're saying is, whatever we do, we have to do it through this lens. We call it the golden thread, but for us, they're an outcome in themselves. So, how do we create future doctors who have the humility and the ability to listen deeply, to unlearn, to listen, to learn, and understand. How do we create future doctors and healthcare leaders who actually are comfortable working with emergence, able to sit with discomfort, they're not always going to have the answers, and that's okay. The idea is, how do you sit with people? How do we create a system where future doctors will train them to be able to put a really critical emphasis on trust, not just about building relationships, but actually the outcome is trust in itself. Yes, yes, and pride. You know, we want them to be proud that they belong to St. Mary's School of Medicine. They're proud to be part of a socially accountable school of medicine, and also they need to understand that actually pride also sits in communities, so you may go to communities where it may, on the face of it, look like there's huge issues, there's huge challenges, but no one understands communities and people in those neighbourhoods have a deep sense of connections and networks and pride, and you need to respect that. And the final one is just a curious, see, be curious, be curious about the school, be curious about the community, be curious about the neighbourhood.

Gill Phillips  19:16  

What an incredible and very simple set of values, and you know, as you were speaking, Samira, I can see the whole way that we connected through the Darzi fellows community, and you know, I learned so, so much over I was working with them for about 15 years, I think, and all of what you're saying about being able to sit with discomfort and messiness of people's lives, and what they taught me about wicked problems in systems, and so on, that it's just all about people and listening and trust, and if you can build that trust, it's phenomenal, and we find this through our workshops, and they say that trust takes a long time to build, and you know this kind of thing that worries me. It actually happened a little bit with the work I did with one of the phenomenal Darzi fellows, Rosie Murphy, was we worked with a project in Croydon, the maternity project, and Rosie pulled it off brilliantly because she really worked with the local community and reached out to them and found out what was important to them, and so on, but I was aware that in terms of the kind of thing I worry about with Whose Shoes is it doesn't happen against a timescale, and obviously if you've got someone with a student with a one year fellowship or course, and so on, that can be a tension, because if you're building trust with communities, they need to believe that that's genuine and long term and real, rather than to tick a box somewhere for a project, and I think it's these kind of tensions that that can sit behind things, isn't that

Samira Ben Omar  20:58  

so? There's, I think, there's two things, one is simple, is very difficult to do.

Gill Phillips  21:03  

Yes,

Samira Ben Omar  21:03  

yeah. So I think, because we work within complicated systems, not complex systems, and both, I would say both complex and complicated systems. So simply very difficult, because the default position is to respond to a complex and complicated thing with another set of complex and complicated things. Yes, so I think for me that that's the challenge. So for me to keep this story of what we're trying to do simple and connect it's the connection to different people in communities. How does it connect with the individual? How does it connect to the frontline stuff? How does it connect to the healthcare leader? I think for me the simple story has to connect to everyone, and that's really important. I mean, one of the stories it was during the conversation we had at the round table, one GP, I mean, she was phenomenal, and she said, you know, in Wales, she was telling the story of, of a GP in Wales, and this was quite a long time ago. And she said the first day at the GP surgery, their first job, they were told that they need to go down the mines and spend the day in the mines, that was the first thing. And she said the GP was a bit frustrated, you know, trained as a doctor. Then, what is he going to do down the null minds? And why is he going down the mines?

Gill Phillips  22:26  

He's going to learn exactly, so he's

Samira Ben Omar  22:28  

going to understand and deeply immerse himself in the reality of people. You cannot be treating people who spend their days, their lives down in the mines without knowing and understanding what that's like, and so that, that was the energy in the room around just something as simple. When we started talking during the roundtable discussion, and he had an amazing set of clinicians, healthcare leaders, we had somebody from leisure, we had psychotherapists, we had community members, and the energy in the room was actually kind of quite incredible. So, for me, there was something about actually the simplicity of what we're trying to do, and the stories through which we're trying to articulate this trust takes a long time, but trustworthiness can happen. I'm going to say and do what I commit to saying and doing. Yes, I commit. So, in going out and talking to the groups and communities, people know me, and therefore they build a relationship with me. So, as somebody now working at St. Mary's School of Medicine, I have to step in beyond my role, I have to go down there if they need me to go down there and actually help out with something. I have to respond to that, so the trust is not about, you know, I do my job and relationship requires you to move beyond your role, yes, beyond your organizational boundaries, in the same way that Sonia, who's our founding dean, you know, she'll be going out there and actually kind of saying, okay, what is it that we need to do, and how can we support you? So it has to be equal and reciprocal, you know, I'm here to support you, but you need to be here to support me. So I think for me trust is not something about actually trying to build something that's transactional. This is something that the person that I commit to is the individual, so they know me, they know Samara, and they'll pick up the phone and say, "Samira, can you help out with this? They're not going to pick up the phone to school at St. Mary's School of Medicine.

Gill Phillips  24:36  

No,

Samira Ben Omar  24:36  

we have to be mindful of that. We have to be aware of that, and we have to honour that, so trust is about honouring the equal and reciprocal relationships. So, if I need to go to the Royal Hampton coffee morning and sit down and actually make coffee because they run out of volunteers and I'm there doing something, then I have to do that.

Gill Phillips  24:56  

Yes,

Samira Ben Omar  24:57  

so I think for me those are really quite equal. Call and reciprocal, and actually kind of, that's where going back to our earlier conversation about the power, you know, is where the power lies, and what are the power dynamics, and do they feel they're able to do that, and actually kind of talk to you through that. So, for me, the challenge in saying all of that and doing in that is we can't just say we want to train future doctors to do that, we also want to train the current staff to behave like that, to be in that space, to be able to deal with emergence, to be deal with the discomfort, to actually kind of go out to the groups. I'm one person doing two days a week, so the idea is then, how do we actually kind of do that to mobilize people and to connect people together? I always see it as a kind of.. I was explaining to somebody this morning, it's like knitting, you know, you've got your yarn ... if you like your base yarn, the colour, and then you need to build on it. So, the idea is, if you want to get the mosaic, then you need to actually kind of introduce them and web them into the whatever jumper or whatever you end up with, you have to actually kind of do it in a conscious, in a mindful way, otherwise you're not going to end up with whatever you wanted to. So, for me, my job and doing this is about knitting and knitting and networking and bringing things together,

Gill Phillips  26:22  

it's a lovely analogy,

Samira Ben Omar  26:23  

it is, and I think that's what we need to do, and creating spaces where people come together beyond their organizational boundaries, beyond the community boundaries, to actually make sense of things,

Gill Phillips  26:36  

so, so many goosebump moments. Can I tell you what's been going through my mind with just a few random bits as you've been talking, so lovely Tom Holliday, who we know through the Darzi fellowship.

Samira Ben Omar  26:50  

Yes,

Gill Phillips  26:51  

I had a lovely experience with the Darzis when he was a Darzi fellow himself, and Tom, as you know, has gone on to be the associate professor running the Darzi program, but when Tom was a Darzi himself, we went up to a community cafe, I think it was in Stockport, and all the Darzis were lovely, and we ended up on a community walk, and at one point we went to a pre-planned session in a cafe, where there were a couple of older guys with guitars singing, it was all of that community involvement. They had song sheets, now quite a lot of them, perhaps the majority stood round together, and they had the song sheets, and they sang. I picked out Tom at the time as one who I'm not saying the only one, but who went and sat with the people in the cafe, chatted to them, sang with them, and you know it was in his DNA, really. And then to go on the podcast that I had the privilege of recording with Tom, which has been a really successful one. Exactly what you're saying, that he now, through the way he works, can pick up the phone to a named school nurse that he knows, rather than, you know, from the doctor's point of view, it, I think, used the word lonelier earlier, you know, it can't be that this hospital calls this GP practice or this school, it's about those relationships that build that help everybody, don't they?

Samira Ben Omar  28:19  

Yeah, and without a doubt, and I mean the lovely Tom, I think it's in his DNA, as you say, to actually kind of step into that space, and I think I have not had a single conversation, probably throughout my career, not just the last 30 years, where people said that actually their purpose is to develop plans and strategies, and actually, kind of, they want to build relationships. What they want to do has purpose. They want to make things better for the people and communities that they serve, whether it's during a clinical interaction, and I think there's something within the system that actually kind of sucks that out of us. Yeah, so for me, it's how do we reintroduce that and actually give people permission to say that, that, that's important, that's critical, and we need that, you need that to actually give you the, the energy to kind of carry on, you know, you need that strong sense of purpose, and, and the other thing, it's just about actually kind of connecting deeply to people around a shared agenda, there is a shared agenda. I mean, we talk a lot about one community and another community. When I did the community champions program in Northwest London, it was talking a lot about community cohesion, and you know, a Somali woman is not going to come with a, you know, an Irish woman, and you know they're all very different, and I tell you, they're not going to come together around, actually, and sit somewhere and have coffee, but I'll tell you what they'll come around, and they did was around the child oral health, they came together around that, and they came together because they were both, both communities were completely frustrated at the fact that. The kids were missing out the days in school because they had to go and get their teeth fixed, and there were huge issues around the access to the services they got together around that, and that's the thing,

Gill Phillips  30:15  

and they would do, wouldn't they, as parents worried about their children, that's what they've got in common immediately,

Samira Ben Omar  30:21  

exactly, so people do come together, and there is that's the sense of community cohesion, is not some sort of an idea somewhere, it's a reality, so what we call it and what we frame it is up to us, but I think it's how it manifests itself on the ground is the critical thing, it's how do I make something relatable to the people who are at the receiving things, and I can't do that unless I deeply know and understand those people in communities, and unless I sit with them, unless I give them the respect

Gill Phillips  30:54  

and care for them, isn't it

Samira Ben Omar  30:57  

exactly? And care for them,

Gill Phillips  30:59  

really? Care, yeah,

Samira Ben Omar  31:02  

exactly, so, and I think we all have it, we all have it in us, and we just have to remind ourselves with that.

Gill Phillips  31:12  

So, I love the examples you gave, I love you were talking about really an immersive experience, and starting the GP in Wales, and having to go down the mine, and when you spoke about that, and I wish I can remember that the detail, but there's a place up in the little peninsula near Anglesey where I went quite recently, like a couple of years ago, and there's a museum there about the mining community and how it faded as other things happened, and the way they've done it is just brilliant in terms of telling you what the story was, and again in a kind of immersive way, and the thing that really made me remember that was that there's a GP surgery there set up as it was at the time, and I can picture it now, and I think anything that teaches people in a way that's more than just, you know, read about it, you hear the voices, or you go and walk into the GP surgery, and I took photos of the rather old-fashioned couch, and you know, you just can imagine people in this very remote place waiting for the doctor, and how important the GP was, but I bet he got immersed in their lives, and you know he wasn't just someone who got flown in to prescribe something, you know,

Samira Ben Omar  32:31  

but that's the nature of how we connect together, how we relate to each other. One of the conversations I remember was just with one particular woman who was, and we were talking, and she said, I trust you when you trust me, I listen to you when you listen to me. So, if I go into a GP practice and actually kind of the first thing that you say is you know eye contact and actually you've already made assumptions about who I am and what I do. Then, automatically, whatever you do, I am not going to listen to you, and therefore, when you listen to me, I listen to you. And it's so powerful. Somehow, we kind of miss the point of the listening, you know, the scene, you know we focus on what we say, but then there's so much of body language, what I'm telling you when I'm looking at you, when I hear in your body language is saying, so all of those things are really quite important, so and it's how can you be present when you're talking to somebody, that's the first one. The second is we always talk in the system, we always talk about working with people in communities as an extra right. One of the things about my anxieties and the challenges is if we create a socially accountable future doctor who is gonna work in a system that's very clinically led and hierarchical? What is the level of almost kind of moral injury that we create in doing that? So, what we want to do is also be able to not to just challenge that, is how do you navigate that, and where do you get the support and your energy from the community? So, your community becomes your asset. Yes, they become your allies, they're your advocates, they're your supporters, they're the ones who are going to help you do that. And that's the thing, is how do we then change, reframe the way we look at communities to say that actually we are mindful, you're going to be going out and working in the system that's still quite medical, that are quite hierarchical. So, where are you going to get your energy? Where you're going to get your, your food, if you like the food that you just, just the nourishment that you need to sustain you while working in that, and for me, that's the community, the community. Are going to be your bridge, they're going to be your advocates, they're going to be your allies, they're going to be supporting you, so that they free you up to do the bit that you're really good at, and they'll actually release you for all the other bits, because they're going to be there talking to you, supporting you, supporting the carers, the faith groups, and all of them. So, for me, I'm mindful that this isn't about going down and saying we've got these lovely golden threads, and we're going to, you know, create doctors with humility, with curiosity, and empathy, and all of that. We want to do all of those. We want to create incredibly competent, clinically excellent doctors, but we also want them to work in a system where they understand and are able to navigate a system that could be hierarchical and medical, and for me that's the exciting bit. It

Gill Phillips  35:48  

is really exciting times, isn't it? Because you know, I've just had a bit of a lemon light bulb there, if you like, in terms of the theory, and you know, if you produce the very best doctor that you could, but then how they work in the real world, and perhaps at the most difficult end of the real world, if they're unlucky and get into a culture that's difficult. How to sustain people and avoid burnout, or just people walking away from the profession after far too short a time, isn't it? Because they, they can't deliver things in the way that they, they wanted to, and in this case we're trained to. So, I think the fact that you're thinking of all of that, and the community supporting people, yeah, it just.. it really is exciting. Samira,

Samira Ben Omar  36:34  

it's.. it's not only in that, and this is for me personally, and this is credit to Sonia and the School of Medicine Professor Sonia Kumar, and the School of Medicine in actually creating a role and a position as Professor of Inclusive Practice, and this is.. I don't have a PhD, my background is in the work that's done, and it's something that was her vision in actually saying we're going to give parity of esteem to the practice and the depth of experience around what community is, and we want to award it a senior executive role, not something that we're just going to, because it could have been just kind of ahead of inclusive practice, we've got a part-time role, and you can tick that box. This is quite a, this is quite a senior role, and it's quite ana professorial role within a school of medicine that's community-centered and really kind of brings together that social accountabilities. So, I think for me to do that and to actually kind of do something like that, it's quite pioneering in a way, and I mean, in all humility, I'm doing it, but it is figuring it out. I'm actually kind of doing it, and testing and learning while doing it.

Gill Phillips  37:53  

Well, I'll be so interested in following what happens. I really will, and I hope we stay in much closer contact. Absolutely, because I talked to so many different people, but this, this is so exciting, in terms of basically all the things that I learned through Whose Shoes, all the problems, if you like, from the from the parents, from the communities, from the healthcare professionals, burnout, psychological safety, it's all there, obviously, and you've got new people starting right at the beginning of their careers. I know we've had early Whose Shoes scenarios over the years about healthcare professionals who've had communication included in their first year at university, rather than just the anatomy of the body, and so on, and you've got music therapy.

Samira Ben Omar  38:45  

Yes,

Gill Phillips  38:46  

can we come back to that a minute? I mean, why I got so excited about that was it's incredibly topical for me, because I'm a massive fan of music therapy, and I've got some friends at Chelsea and Westminster Hospital who I think are the absolute leaders in music therapy, and I'm due to catch up with my friend Claire Flower shortly. She'll probably be on the podcast, I'm sure, at some point. But I was on a session, so there's a really amazing group of paediatricians called Colab, chaired by another good friend of mine who's been on the podcast, Mary Salama. She's a senior paediatrician, and Mary's now the chair of Colab, and I'm just so privileged, really, that I get invited along to bits and pieces. I've done the odd session with them, and this one was only a week or so ago, and it was about play therapy, and again, just the same sort of values. I mean, isn't it obvious that children need to play, but how it can almost become an extra in a hospital environment rather than central to the fact that it's a young child, and not only do they need to play, but how much it can help and distract. Act, and you know, make the whole experience so much better. So, anyway, I was on this session and started to say, and music therapy, and then it turned out there was a music therapist from Chelsea and Westminster on the call, so she was made up. I given a shout out to them, and you know, is these things that are around, well, they're just human, aren't they? Rather than the fact that someone is ill or has got a condition or a disease, it's how you fit those needs into your whole holistic needs as a human being, whether you're a child with play or an adult with all the things that are going on in your life, and make healthcare that big picture, rather than just going to see the doctor and getting given some pills.

Samira Ben Omar  40:49  

I couldn't agree more. I think there's something that you touched on in terms of kind of the human element, and I always say there's there's two things, and I'm a fan of person-centred care, but for me it's more that it's beyond that, it's human-cantered care, because person-centred care is during that clinical interaction, but human-centred care really looks at how we design whole healthcare systems through the lens of the person in their families, in their communities, and how they make sense of things, so for me it's really quite important and quite critical, and if we're going to move away from a medical model to a more kind of biopsychosocial model of health, we'll really need to think about how we do that and the way we do that in a meaningful way, so for me it's kind of a new way, and I almost needs to come with this disclaimer. Yeah, we're going to get things wrong, and it's going to be messy, and it emergence, and we're going to go back and forth, but what's the alternative? Our helping equality is a wide name, the frontline stuff are burnt out, and we have this huge resource in communities that we're not tapping into, and we really need to rethink the way we train future doctors to manage the complexity of what is happening now, not what we assume happened in a small room, in our small consultation room,

Gill Phillips  42:24  

and to learn from the pandemic, and we saw how communities just jumped in and solve problems, and you know all of Becky's work around, don't let Becky Melby, you know, don't let the old system bite back, and you know, optimists like me thought, wow, this is really transformational, but the system is very good at sort of closing things down and coming up with more formal ways of doing things, and more checks and guidance, and you know, things that are obviously important, but take away the just power of people to find solutions,

Samira Ben Omar  43:00  

without a doubt, and I think there is something about, I mean, it's probably for a different conversation. There is something about what happened during Covid, and if you talk to a lot of communities, I mean, racialized and minoritized communities, in terms of disproportionate impact, but also there's something about the system and those in positions of power and influence, there is something about when it hurts me, I can mobilize, when it hurts on you, then it becomes there's a detachment, yes, that's why it's so important to have lived experience and to have people of those communities in those communities in those decision making rooms actually kind of making sense of things, so I think that for me there's real learning, not just in terms of to me it wasn't hugely surprising that we revert back to Thai, because the urgency of the now meant that actually I am affected, and therefore it's almost that primal thing, if it affects me, then you go into survival mode, and then you're going to do whatever you need, and I think we're not in survival mode anymore yet. Our primal kind of thing steps back in and says, I want to protect me and my family, and that's the sad thing, but it is one of those something to think about in terms of if we're gonna not revert to type, is what is it that we're pushing forward, and how do we keep pushing it forward? Yeah,

Gill Phillips  44:27  

wow, some deep stuff here. Samara,

Samira Ben Omar  44:31  

yes,

Gill Phillips  44:32  

really deep and really exciting, and the potential is huge. I mean, I love the words like emergent and discomfort and messiness, and because that feels like people's lives, doesn't it?

Samira Ben Omar  44:47  

Yeah, people, you know, we are messy and we are complex, and we say one thing and do something else, and, and, and we have to design for that, we have to design for that, and we have to train for that. You have to navigate that, and if we do that, then actually, then this is the bit from the golden thread around humility. It gives us a sense of actually we are part of something rather than we have the answers to everything.

Gill Phillips  45:18  

So, Samira, looking ahead, let's be a few years ahead now. First doctors and healthcare leaders are coming through, and they've been trained really well to be socially accountable and to think beyond just the traditional medicine, but they'll have gone through their course and they'll get into their practices, or wherever they're working, what would be the absolutely highest level messages that you want them to take forward with them?

Samira Ben Omar  45:49  

So, I think the four things from my perspective are as a doctor, no one understands that communities do more when they decide for themselves, and that goes equally for people and patients, so people do more when they decide for the for themselves. Our job is to create the spaces for them to be able to articulate what they want. Second, actually, the community and faith spaces are the lifeblood of local action, so as a future doctor, you want to use that, you want to capitalize on that, you want to immerse yourself in that, because that's where you're going to get your, your strength, your support, your advocacy from. The third one is understand that actually discrimination, and in particular racism, has a negative impact on health, so where there is discrimination and racism, then there will be an impact on the health of people and communities, so be mindful of that, and the final one is that actually we know and understand you're going to have lots of activities that you need to measure, you need to respond to the system, measure also what people value and work with people in communities to measure what they value most,

Gill Phillips  47:12  

and that's a whole new area, that is, isn't it? Around measurement and what we measure. Well, one

Samira Ben Omar  47:17  

of the things we're doing at St. Mary's, the next stage now is to co-design an outcomes framework. Wow, so we've got all these golden threads. So now the idea is, how do we work with local, maybe health innovation networks, but also with people to co-design an outcomes framework? I don't know what it's going to look like, because we haven't actually had the conversation, but that's part of the next stage, and we've committed publicly to it, and it's on record, and with Sonia standing there saying this is what we're going to do, and this is how we're going to do it, so we publicly making a commitment.

Gill Phillips  47:54  

So I think I think that's actually a good place to end. I think there's a massive watch this space, isn't there. Yeah, so it's all brand new. It's not brand new in terms of any concepts or ideas. It's brand new in terms of actually making it happen, and with students, the right people being selected, they're doing their music therapy and their immersion, and they're learning in these new ways. And how exciting when the first cohort gets released into the world. So, watch this space, and I'm just so excited about what you're doing. Thank you so much for talking to me.

Samira Ben Omar  48:31  

Thank you so much for inviting me to do this. I genuinely enjoyed talking to you. I learned a lot just from listening to you, just even this podcast, it's always equal learning. So, thank you for that.

Gill Phillips  48:45  

Thank you, Sameera. And we'll watch this space.

Samira Ben Omar  48:48  

Perfect. Great. Take care.

Gill Phillips  48:52  

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.