Speaker1: [00:00:00] The NHS is the most diverse employer in Europe. Because health is not their focus. If leaders don't know, it is their job to go and find out. What would you propose that we do? You're almost halving the life expectancy of people. It's going to be much more difficult to get it right with our patients... Was for us to have a conversation around race, around belonging and around inclusion. We're not just responding to people's health needs today. We're actually also building for the future. 

Speaker2: [00:00:30] Voices of Care, the healthcare podcast.

Speaker3: [00:00:33] Jenni, welcome to Voices of Care. Thanks for making the trip from, I'm not saying it's going to be sunny Dorset, but from Dorset.

Speaker1: [00:00:39] Well, I actually live in Winchester. But another wet day today. But really pleased to be here.

Speaker3: [00:00:45] No, it's a pleasure to have you here. I wanted to kick off by looking at the national picture now. I know that you're an avid cricket fan, and you advise Hampshire Cricket Board on their board. But to use a cricketing analogy at the moment, if you listen to Sir Stephen Powis, he's talking about a quademic with flu, etc. the pressures on the NHS, they really have got a bit of a tough wicket at the moment, haven't we?

Speaker1: [00:01:10] It's been really significant actually. So if I think about us in Dorset, when we were planning for winter last year, so last calendar year, we devised the best winter plan that we had. And so we thought it would foresee anything that came at us. But you'll probably know that there's been an increase of 7% in urgent emergency care, year-on-year comparison. And Dorset has not been safe from that either. So we've seen an increase to the extent that the plan worked, but it still wasn't enough to get us out of winter. So when you're talking about things like norovirus and RSV.

Speaker3: [00:01:56] And Covid.

Speaker1: [00:01:57] Flu, Covid. All of those things. And what we saw in Dorset actually, was that we had to get into escalation beds. And probably even more challenging for us was the ambulance waits category two, because we are the lead commissioner for the South West Ambulance Service across the South West. And so I know because of that because we constantly look at ambulances. Dorset generally does not have a problem with ambulance waits. We tend to, you know, have people off the ambulances as soon as they arrive at our hospitals. But this winter it wasn't the case. So yeah, it's been a kind of perfect storm, if you like.

Speaker3: [00:02:39] Now, as you say, the national picture. And thanks for letting us know about Dorset. The national picture. I think the stats show that it's significantly higher.

Speaker1: [00:02:46] It is.

Speaker3: [00:02:46] The number of beds being occupied with flu. So, absolutely support everyone fighting that battle. The other big picture that struck me in early January, we, of course, had the Prime Minister announcing the new national plan for elective care recovery. Now 40,000 appointments, the constitutional standard is going to come back at 92% by the end of the parliament, with some interim measures. I think at beginning of Jan it stood at 59. What's that going to mean in practice? Because that's going to require a lot of extra work and a hell of a lot of planning to get that right. 

Speaker1: [00:03:21] Yeah. So we are in the planning at the moment. So you will know as part of that, that there's an expectation that every organisation increases by 5% in relation to the emergency. So in Dorset we are at 60%. So we will get to the 65%. That's the expectation by March 26. So it's going to involve a lot of planning. I guess one of the considerations for me and for those of us that lead ICBs, is that the NHS ten-year plan and I'm sure you'll come to that a bit later, requires a strategic shift. And you know, I won't repeat the details now, but it requires a strategic shift, which is great, and I don't think anybody would argue against that. But for every minute that we focus on the operational, it then becomes much harder to plan that strategic shift. So I think that's going to be one of the real challenges for us in Dorset. But I would say nationally also, how do we make sure that we give the head space and the capacity and the thinking to do that longer-term shift when there's a real requirement on us to improve on and quite rightly so, on people waiting for, you know, their elective surgeries.

Speaker3: [00:04:43] No, absolutely. That's an operational piece together. An alchemy of time is going to be needed to some extent. Talking of the ten-year plan, you mentioned it. Of course, national listening exercise. Darzi. We don't have time to go through all of the things that that's going to cover. You've talked about the three shifts. I think the particular one for me that came out strongly. I mean, they're all do, but is the prevention agenda. And I wanted to really get your view on the promise and the role that integrated care boards are going to play in this, because it's been, what, two and a half years since the statutory setting up of the boards. You've been in post since that time. It's a great opportunity, but a tremendous challenge, isn't it?

Speaker1: [00:05:30] It is a challenge. And the prevention agenda. So the NHS ten-year plan and that shift from hospitals to prevention. Sorry, from hospitals to community, from treatment to prevention and from analogue to digital is exactly what our five-year plan was based on in Dorset. So we wholeheartedly support it. The forward plan that we've got. So we think it's the right the right thing to do. So we will be doing that. And the prevention piece is a really big piece for us. We constantly discuss how do we make sure that we stay in that prevention space. So we have lots of things that we do in Dorset. And I can tell you a bit more around our community diagnostic centres that we have, because they include a really big focus on prevention. Particularly in terms of wellbeing and mental health issues. But additional to that, we had our integrated care partnership meeting last week. And of course, because every single agency is in the process of actually planning their finances and creating their plans for 25/26, the prevention agenda was one of the things we talked about at the ICP. And we kind of gave a commitment to ourselves there that we would all think about increasing our spend and focus on prevention as part of the planning round that we're doing at the moment. So we kind of said it needs to be at least 1%, but, you know, it can be more than that. But what we agreed outside of that when I went back to my ICB, is that we need to make sure that we're all talking the same thing when we say prevention, because I think prevention for us in health might mean something totally different for public health, for local government, etc.. So we need to get that clarity. But it's absolutely the thing to be doing.

Speaker3: [00:07:26] And just touching on that briefly, because obviously at the ICP, by definition, you're working with a very broad range of stakeholders, as it should be. I wanted to just get your view because I know you're very passionate around this subject. To bring in all stakeholders. We've had a suggestion now, not a suggestion, a commitment for a commission on social care. Because whatever happens in the NHS, it's going to be predicated on social care also getting its proper due, I think.

Speaker1: [00:07:53] Yes. And you know this is not a party political thing. We know that social care has not had any investment for the last decade or so. And the answer for prevention, the answer for bed numbers and the number of people going into hospital, and the number of people in hospitals that don't actually have a physical requirement to be there, but they can't get out because they can't get care packages. All of those things lead back to social care. So, it's important for us as an ICB in Dorset to work with our local government colleagues to solve those issues. And we are looking at no criteria to reside as an example of that. So that's for people that are in hospital that don't have a physical medical need to be there. And we have been working collectively with local government around that. And we've got some innovation that we're doing at the moment around the no criteria to reside. But in addition to that, it is about making sure that across the board we can understand, you know, where the meeting points are for all organisations.

Speaker1: [00:09:10] And so in addition to the local government being part of our integrated care board, they are also key partner for the Integrated Care Partnership. And we agreed at the meeting last week, actually, because we were the only ICP in the country to have an independent chair. You probably know that most of the others are co-chaired or chaired by local government leaders or councillors. So we were the only one in the country that had an independent chair. Sussex then joined us in round about October last year. But we agreed last week that we would move from the independent chair process to both leaders of our councils jointly chairing the ICP moving forward. And I think that's a good thing because it does mean... 

Speaker3: [00:09:56] True collaboration.

Speaker1: [00:09:57] Absolutely. And that focus, because health is not their focus but the focus around integration, prevention, wellbeing, housing, education, employment, all the things that sit outside of health. I think they will help us to really think about how we can tackle those things. 

Speaker3: [00:10:15] No, absolutely. And I should congratulate I think NHS England conducted its annual assessment of ICBs not too long ago in January, and the report, I think, commended, Dorset's commitment to operational leadership and wider things. So it sounds like an interesting time. I wanted to talk about a topic now because all of these changes that you're talking about, whether it's the ten-year plan, whether these operational plans, forward plans are going to require the workforce to be honoured. Now, within that, it's a subset. I know equality, diversity, and inclusion is very, very close to your heart. It's of course, everybody's commitment, but I think that was one of the reasons. It should be, but it was one of the reasons, I believe, that attracted you to enter into a leadership position in the NHS about a decade ago.

Speaker1: [00:11:07] It was. That's exactly right. So when I applied to be a non-executive with University Hospital Southampton, the head-hunters came to me and said, you know, they're interested in somebody that's got an understanding of EDI. Would you be interested in applying? And I said, yes, but are they also interested in somebody that lives EDI? 

Speaker3: [00:11:32] Yes.

Speaker1: [00:11:32] Because, you know, I am likely to be different to what they have on the board at the moment. They went away and spoke to the hospital, came back, and said, yes, they are interested in that too. So, that was my interest. I thought if we've got an organisation that's saying they want to get this right, let's do that. And I still remember my stakeholder event with people very senior in the organisation asking me around things like positive discrimination, you know, what would you propose that we do? And I had to explain positive discrimination is illegal in this country, so we can't do that and we don't have quotas. But it said to me, actually, that there is a real commitment to get the agenda right, and they knew they needed to do something different. So that's what took me in in the first place. And it is. EDI has been in my bones for every single job that I've done. 

Speaker3: [00:12:26] Going back to the home office. I don't want to remind you, 25 years.

Speaker1: [00:12:28] Going back to being a probation officer.

Speaker3: [00:12:29] Probation officer.

Speaker1: [00:12:31] So my very first job as a probation officer, in fact, before that, my very first job was with the Department for Health and Social Security, as it was called then.

Speaker3: [00:12:41] I remember.

Speaker1: [00:12:41] And the union decided to set up an equalities officer. So they asked for people to volunteer to put their hands forward. I did, I was elected and I wrote a letter out to all the members saying, first equalities officer. I don't know what the issues are that we need to look at. So I'm coming out to all of you to help me set the agenda. You know, from my perspective, we're probably looking at sexuality, sexual orientation, gender, race, ethnicity.

Speaker3: [00:13:13] Way before the Equalities Act.

Speaker1: [00:13:14] Disability, way before the Equalities Act. And about four years ago, I happened to get some stuff out of my mum's loft that I had put up there when we moved to Türkiye, only to find that note that I had written all those years ago, that email too. It was still there and my daughters were shocked. They said, oh my gosh, those are the same issues we're talking about today. And I said, yes, but there has been change.

Speaker3: [00:13:40] There has been change. And we laugh about it. But on a serious note, we've got the NHS staff survey results coming out in the not too distant future. But if we just go back to the last set back in March 24, the instances of staff in the NHS facing discrimination was at the highest level since 2019, and people from minorities facing discrimination from their co-workers, their managers. I mean, how important is it to get this right if we've got any hope of the ten-year plan working? 

Speaker1: [00:14:14] Yeah, well, it's absolutely essential. You know, the NHS is the most diverse employer in Europe. So if we don't get it right, nobody's going to get it right. We owe it not just to our staff because of the diversity that we have, but also to our patients. So if you look at any review that has been done on health outcomes, across the NHS for the last few decades, you will find that the outcomes for black and people of colour are poorer than the outcomes for others. So whether that's maternity, cancer...

Speaker3: [00:14:56] Mental health referrals.

Speaker1: [00:14:57] Absolutely. Whatever you look at, you will see that the outcomes are poorer. And so unless we actually take those issues to our core and really start to think about what we need to do to make that change, we are just going to be replicating and perpetuating those inequalities and health inequalities for the rest of time. So it's critical that we get it right.

Speaker3: [00:15:22] Now you can also speak from a voice of profound authority, not through just lived experience and roles. You are, of course, head of equality and inclusion at NHS England. I just wanted to get your take because the debate around diversity, equality and inclusion has taken a certain development. I mean, there was some startling things that happened in England in 2024, in the summer, if we look on the global picture, public programs promoting DEI are being rolled back. How worried are you about actually the policy commitment to this?

Speaker1: [00:15:56] I think we can just get caught up in policy commitments. But for me it is about real outcomes and it is about real experience, and it is about what it feels, how it feels to work in certain organisations. So when I was the director for Equality and Inclusion within NHS England, my brief to my team would be how does it feel to be a worker there, particularly if you're somebody for example, of black ethnicity or if you've got disability. What does it look and feel like? And it is the question that I ask my organisations also. And if leaders don't know, it is their job to go and find out because likely that the experience is different and we see that from the NHS staff survey. Of course, we also see from the WRES, the Workforce Race Equality survey. We see it from the DES, the Workforce Disability Equality Survey and I could go on. So leaders need to understand what it looks like and feels like for their staff to be working there, and then do things with staff to make sure that that experience becomes better.

Speaker3: [00:17:11] Absolutely. And there's one comment I remember looking at your leadership role there. You were very, very strident, which I expected. And you said, you know, I think you absolutely enjoined everybody don't hide behind the data. What did you mean by that? 

Speaker1: [00:17:26] Because I think so. I'll give a real example to this. One of the things that I think we often hear in the NHS is that the workforce and the leadership needs to reflect the communities that we serve. It is not something that I hold to. You might think that's really odd.

Speaker3: [00:17:47] I'm listening very attentively to this

Speaker1: [00:17:49] But the reason I say that is if that was the case, somebody that looks like me should only then aspire to become a leader in somewhere in a metropolis.

Speaker3: [00:18:00] Yes.

Speaker1: [00:18:00] And when I walked into Dorset in 2020.

Speaker3: [00:18:03] A very different demographic.

Speaker1: [00:18:04] Absolutely. In terms of ethnicity, it's a really low population. But 50% of the chief execs in Dorset were black.

Speaker3: [00:18:15] Of course.

Speaker1: [00:18:15] So if and that was nothing to do with me because I arrived and they were already there. So if we could only aspire to be in areas that reflect the population, then that wouldn't have been the case in Dorset. So my feeling is that whoever we are in the NHS, we should aspire to work where we want to and we should be leaders where we want to and we should be able to be there and be welcomed and be embraced and not have people crossing out our faces on the board in the corridors, because they don't like the fact that there's a black face on there. So that's partly what I mean about the data.

Speaker3: [00:18:57] Interesting. 

Speaker1: [00:18:59] Because we know what the data says, we don't have to keep looking for more data for it to tell us. We know what it says. 

Speaker3: [00:19:05] You need to do something about it.

Speaker1: [00:19:06] Just do something about it. 

Speaker3: [00:19:07] Okay. That's a clarion call for anyone watching. Just do something about it. I'm going to stay with the theme because one of your guiding principles as a leader I know is collaboration. But the other one is inclusion. And we've talked about that from a staff perspective. But inclusion in its widest sense, of course, must mean not just a statutory duty, but tackling health inequalities and unacceptable variations in outcomes, etc.. Now this has been quite important, very important for Dorset in terms of the forward plan. Can you tell us a little bit about the work that you're doing? Because there are pockets and significant pockets of the population that fall within Dorset into that core 20% of the most deprived in the country.

Speaker1: [00:19:51] Yeah. So, I think if you look generally at Dorset, what you will see is that the life expectancy for people living in Dorset is relatively high. So it's around 83% for women. And it's around, I don't know, 79% for men. So it's relatively high.

Speaker3: [00:20:12] It's fallen nationally of course, as you know.

Speaker1: [00:20:15] Yeah. And we also have the oldest population over 65 in the country in Dorset. So, if you look on the surface, it looks really quite healthy. If you then break that down into West Highcliffe as an example, that age difference goes down by about 15 years. And also if you start, you know, Dorset has some quintessentially beautiful villages, coastal areas, etc. if you walk in you would think, oh, I want to be here, I want to live here. You scratch beneath the surface that you start to realise that actually there is inequality there. There is deprivation. And so for rural communities, if you, you know, lots of seasonal labour, people that don't have access to their own vehicles to get around. Transport infrastructure is almost non-existent in those places. Once you start adding all of those things together, what you find is that we have pockets. So West Boscombe as a contrast to West Highcliffe, the variation goes right down. And then if you add to that something like being homeless, you're almost halving the life expectancy of people in Dorset. 

Speaker3: [00:21:41] So the health gap does exist.

Speaker1: [00:21:43] It really does exist.

Speaker3: [00:21:44] I think I read in your Health equalities report, I think. Poole. Bournemouth. Christchurch. You can see that gap.

Speaker1: [00:21:50] You can.

Speaker3: [00:21:50] And that's a big priority I think over the next few years to drop that gap.

Speaker1: [00:21:54] It is, it is. And that's where we focus. So when we talk about healthy life years for children, when we talk about mental health, it's all of those things that get exacerbated if you're living in the 20 most deprived populations. And so it's an area where we want to focus. So dentistry is an area where we want to focus. We want to go beyond the core 20 plus five. Because the core 20 plus five focus on dentistry in children is about increasing the rate of tooth extraction. We think it should be around prevention. So we don't want children having tooth extracted. We want to prevent that in the first place. So we have had a programme whereby we are taking dental packs out to nurseries and to schools so the children can be taught how to brush their teeth. And we're trying to do some work to get some dental training, not necessarily a dental school, but dental training within Dorset because we don't have anything. We want to encourage dentists to come in and work for the NHS so that we can actually really focus on that prevention agenda. So health inequalities is a really core piece for us in Dorset.

Speaker3: [00:23:10] Yeah. And it's also interesting to see that obviously within that there's groups that are late. I think men in particular to take up some services. There's some groups that don't want to go, don't feel comfortable going to the hospital. And there are also some groups that are actually reluctant to take preventative measures like vaccines etc. So I guess there's an education piece in all of this.

Speaker1: [00:23:31] There is. So in 2020 when we started our health inequalities work and we got the health inequalities group together, we looked at our data. So you probably know we've got the Dorset Insight into Integration service, which provides us data right down to postcodes. And we looked. 

Speaker3: [00:23:52] That's one of your pillars as well. The data is really important.

Speaker1: [00:23:56] Absolutely important. So we looked at our data to see what it was telling us and what we found, because we wanted to decide where we should focus. And what we found was that, when it came to the flu vaccinations, if you were somebody living in a fairly affluent area with very few or no health issues, you are more likely to take up your flu vaccination than if you were somebody that were living in a deprived area with multiple health issues.

Speaker3: [00:24:26] Where actually the imperative was even stronger to take.

Speaker1: [00:24:28] Absolutely. Those should be the ones that were taking it. So we looked at that data, and then we decided that we would work with GPs to ask the GPs to work with their communities to try and change that. One of the reasons we did that was because we thought actually that if we don't get this sorted when and if a COVID vaccination comes around, it will be the same communities that will not be taking the COVID vaccine. And they're more susceptible to the poorer outcomes of Covid. So that was the reason we did that. That DIIS data that we have then enabled NHS England to see what was coming, you know, because we were kind of like a week, two weeks ahead of the national data.

Speaker3: [00:25:16] Oh, right, okay. 

Speaker1: [00:25:16] And so some of the national stuff could be modelled on what we're doing. So we do use data. And so when I say don't hide behind the data, it's not that data isn't important. It's really important. But it's making sure that it's used and used in an effective way. And so we use it around our health inequalities agenda. 

Speaker3: [00:25:35] Great. One final point on health inequalities. This is of course a national imperative under the statutory obligations of the Integrated Care Board. But I think it's also one of your five pillars if I've got this correct, is that really driving the role of the NHS as an anchor institution amongst the bigger social determinants. Tell us something about that, because I think you've had quite a few initiatives that are making a difference.

Speaker1: [00:25:59] Yes. So anchor institutions is a really big pillar for us of the health inequalities agenda. Partly it's because health in most settings. I don't know any setting where it isn't, but if I say it's every setting, someone's going to come and say it's not in ours. But in most settings, health is the largest employer. And so that enables us to be an anchor organisation because we have a cohort of the community and, you know, lots of places. It will be local people working for the local hospitals. So, we have an opportunity to raise people out of poverty to give them access to health and wellbeing, things that they may not get access to, but also for them to become pillars and role models within their own community, around things to think about, whether that be exercise, eating, health, and wellbeing, etc. but also the reach that we have then across other organisations is also significant. And so we work with local government as anchor institutions because we feel that we also have an opportunity to give back. And then as part of the Integrated Care Partnership, we have been exploring how we can roll that anchor organisations work out to commercial sector because we do have some large commercial employees also employers. Sorry. Also endorse it. So, I guess the reason we call ourselves an anchor institution is because we can use it to leverage other things. 

Speaker3: [00:27:44] No, absolutely. Final point I wanted to touch upon is to look at one of the other guiding principles that you've been on record as saying that supports your leadership style. And that's the vision piece. But I wanted to focus on Dorset in particular. Services are transforming. One of the missions, of course, is to go from analogue to digital. And I think it's been a year where innovation with is it, National West?

Speaker1: [00:28:11] Wessex Health Partners. 

Speaker3: [00:28:11] Yeah. Can you tell us a bit about that? Because that's, that's both in primary care and prevent heart disease and also technology enabled care. 

Speaker1: [00:28:20] That's right. So I guess, some of the kind of influence around that came from our community diagnostic centres. So the first one that we set up was in Beales, the shopping centre in Bournemouth. And people can turn up to you know have their diagnostics done around orthopaedics was one of the things that was in there. We continued to roll that out. And so working with the Wessex Health Partnership, which includes all of the provider organisations across Dorset, health provider organisations across Dorset and across the Wessex area. So that will also take in Southampton and Winchester, Portsmouth University, Bournemouth University, Southampton, University of Southampton, and Solent University to look at not just the data research but the things that we could be doing with technology to try and aid that. So, you and I, we've probably both got wearables on our hands, on our wrists, and we know that, you know, there are things that can be done to help people to manage their own health. It's not just about turning up at the door of the doctor or the hospital. Our communities say to us that they want to stay well and they want to live well, and they don't want us telling them what to do. So it's really about working with people to identify what they need to enable them to have information on themselves and then to be able to use that data and information to help themselves to stay well. 

Speaker3: [00:30:05] And I think that whole role of innovation and research has also been quite prominent in terms of your role at University Hospitals of Southampton?

Speaker1: [00:30:12] It is and so I mentioned earlier that it was the EDI agenda that was one of the drivers for me to apply.

Speaker3: [00:30:19] Back in 2016.

Speaker1: [00:30:19] When I applied in 2016, but it was also because it was a university teaching hospital. And key on research. I had, you know, a real interest in research. And I think that's what university hospitals are there to do. And I regularly do the staff induction on a Monday morning. Because you can imagine every single Monday we have new people starting at UHS. We've got almost 14,000 staff there. So, it is a big organization. And that is one of the things I talk about innovation and research and I say to staff, you know, hopefully that's why you're here. But if it's not, there's so many opportunities for you here to get engaged in that because we're not just responding to people's health needs today. We're actually also building for the future. And that's what innovation and research enables us to do. 

Speaker3: [00:31:15] Absolutely. Now, looking at the future, you mentioned the word, just the short-term future. There's a lot of change, for you personally, I believe it seems it must have gone by in a flash. Dorset, you've been there for a couple of years in this role. But tell us about that. You've got, you're taking on not less, but more responsibility.

Speaker1: [00:31:34] I am, and I'm actually going to be sad to leave Dorset because it's been a fabulous place to work. We've got individuals, you know, like the Dyson stuff. There's so many things that we are doing that are at the forefront in a relatively small population area. And I've got a wonderful board and some great partners that we've been working with. But yes, I stand down from that role at the end of March of this year because I've been asked to take on chairing the hospital in Portsmouth and also the hospital in the Isle of Wight. The two of them came together in April last year as a group model. And I'm going to be doing that alongside the University of Hospital Southampton. So I will be chairing three of the four hospitals in the Hampshire and Isle of Wight, uh, footprint throughout the four acute hospitals. So, it's a big job. It's a job I'm looking forward to. I think there's, you know, some great opportunities for us to work collaboratively and think together around our patient pathways. But it also takes me back to, I guess, what has become my home since 2009, when I came back from living in Türkiye, which was Hampshire on the Isle of Wight. And so, you know, I covered the Hampshire and the Isle of Wight in policing. So I have an interest across that whole patch. And so, yes, I'm looking forward to that.

Speaker3: [00:33:03] Just one final question, if I may, Jenni, just looking ahead. We've got the ten-year plan coming up. It was the Nobel Prize-winning economist Elinor Ostrom in her acceptance speech in 2009. Thank you, Professor Chris Ham, for referring to that in your recent article. And she said that all research shows that a core priority for public policy should facilitate the development of institutions that help us to bring out the best of what it means to be human. And I think the NHS, quintessentially is a human endeavour for all the technology that's coming, just with your perspective for that part of the world, all these roles that you've had, what would you like to see in the ten-year plan that's really close to your heart?

Speaker1: [00:33:43] So one of the things, I want to go to a Nobel Prize winner as well to start my answer, and that's Muhammad Yunus. And it was... 

Speaker3: [00:33:52] From Bangladesh.

Speaker1: [00:33:53] From Bangladesh. And, it was during the start of COVID. I remember he did an article which was talking about our world economies and the fact that they, you know, create unequal societies. And there was an opportunity out of COVID for us to start thinking and doing something different. And he was putting a challenge out to world leaders to say, think about having a different economic model. And one of the things he said as part of that was that he wanted every child globally to have a day each year in their school life when teachers will say to them, go out and design the new world economy because they are the future. And so if we handed the mantle over to them, they would come up with something probably more equitable than we've got now.

Speaker3: [00:34:46] Interesting.

Speaker1: [00:34:47] And so I just thought it was a fascinating piece of knowledge and insight that we got from him. And it was one of the things that I then focused on when I was in NHS England because my feeling was that I didn't have charge for economics, but certainly in terms of human capital, there was an opportunity for all of us in the NHS to actually do the same thing, to tap into our human potential. And so one of the things I wanted to do was for us to have a conversation around race, around belonging and around inclusion and to give that responsibility to each organisation to say if my organisation is going to be at the top around belonging and inclusion.

Speaker1: [00:35:35] What do I need to do? And they work with their staff to do that. So that's what I would like us to do as an NHS with human capital. We are human people working with humans. And if we don't get it right with our own staff, it's going to be much more difficult to get it right with our patients. And then I guess the final thing that I'd want to say on that is that a real recognition that the NHS long-term plan, which we're waiting for, but the consultations going on at the moment. We know that government is talking about the three left shifts, as we mentioned earlier. And so I guess my second request is that we all give ourselves the headspace and the thinking space. You know, 20% of the time that we're working each week to make sure that we are thinking about the future and that we are thinking about what we need to do. How do we contribute to the prevention agenda? How do we work with our communities to make sure that we can help them to live well and be well? And so that we are not doing things to our communities, but we are working with our communities.

Speaker3: [00:36:52] On that very inspiring, unifying note. Jenni, thank you very much for your time and your wisdom. 

Speaker1: [00:36:57] Thank you very much, and it's been a pleasure to be here.

Speaker3: [00:37:00] Likewise, pleasure is ours. If you've enjoyed this episode of Voices of Care, please like, follow, or subscribe wherever you receive your podcasts. And if you want to find out more about what we're doing to turn the dial on the health and social care debate, please visit newcrosshealthcare.com/voicesofcare. In the meantime, I'm Suhail Mirza. Thank you very much for joining us, and I look forward to seeing you on the next episode. 

Speaker2: [00:37:21] Voices of Care, the healthcare podcast.