School is back!

Welcome to Episode 1, Season 3 of Agents Assemble ⁠⁠The School for Change Agents⁠⁠  podcast.

This year, The School for Change Agents is brought to you in partnership with NHS England’s Health Inequalities Improvement team. We’re bringing you stories of incredible people across the country who are on a mission to narrow the gap and make healthcare equal, equitable and accessible for all!

In this episode, host Kerry McGinty is joined by Mary Hill, Head of Policy for the Healthcare Inequalities Improvement programme, Abdul Hamied, Deputy Director Strategic Partnerships for the National Healthcare Inequalities Improvement Programme and Sara Javid, Policy Delivery Lead for the National Healthcare Inequalities Improvement Programme.

We discuss why tackling Health inequalities is everyone’s business as well as how each member started they journey of change.

Grab a cuppa, maybe a biscuit or two and enjoy the listen!

This transcript was provided by sonix:

Kerry McGinty: [00:00:08] Hello and welcome to series three, episode one of Agents Assemble, the podcast brought to you by horizons. This is the podcast where we expand and explore the teachings of the school for change agents, and we seek out improvers and change agents to share their stories and so we can learn and get inspired together. I’m your host, Kerry McGinty, and I’m a production manager at horizons. And today, you know, it’s episode one of a new series. We need to start it with a bang. So I’m really, really thrilled to be joined by the members of the National Healthcare Inequalities Improvement Programme team, Mary Abdul and Sarah. Hello everybody. How are we doing today?

Sara Javid : [00:00:51] Hi, Kerry. Hi. Thank you.

Abdul Hamied: [00:00:53] Morning, Kerry.

Kerry McGinty: [00:00:55] I’m loving it. Everybody’s looking gorgeous and ready for a good old chinwag today. So before we get started in the nitty gritty, this is the team that’s helping improve health inequalities across the country. And I’m dying to ask so many questions and so thrilled that we’ve got together to have this conversation. But before we get started, I’ll do my best Cilla Black impression, everybody, what’s your name? Where do you come from and what what do you do?

Abdul Hamied: [00:01:23] I’m happy to go first. I’m Abdul Hamied. I’m one of the deputy directors within the National Health Care Inequalities team and have a portfolio of strategic partnerships. That’s wonderful, because it means I can go and collaborate with anybody that’s got an interest or potential role to play. I’ll say a little bit more about what I do within that role, but hope that is a good starter.

Kerry McGinty: [00:01:44] That. That’s lovely. This was very blind date. Abdul, you did it very well. Mary, do you want to go next?

Mary Hill: [00:01:51] So. Hi, I’m Mary hill. I’m head of policy in the national healthcare inequalities improvement team. So in our policy team we look at national policy drivers for action. And we look at how we can influence national policy and levers. But then also look at how we can influence systems and people for change around health inequalities to.

Kerry McGinty: [00:02:17] Fantastic. And last but not least, the glamorous Sarah. What’s your name? Where do you come from? What do you do?

Sara Javid : [00:02:23] Hi, everyone. I’m Sara Javid, I’m a policy delivery lead working in Healthcare inequalities improvement team alongside Mary and Abdul, and I sit in the policy function to support the work that Mary’s just described. But also Abdul burrows me some time so I get to do exciting projects like this with him.

Kerry McGinty: [00:02:40] It’s fantastic. Yes, we should probably say that the reason we’re coming together today is excitingly on the 13th of November, the school for change agents, the next run is launching. And with that, we’ve got this amazing partnership with yourselves, the Health Inequalities Improvement Team, to really showcase some amazing work that people across the country are doing to narrow the gap and improve healthcare for everybody. And I’m really excited to get into that. But for those people that might be listening, you know, health inequalities think it’s everywhere. It’s in the news. It impacts every single person on the planet. And what I don’t want to do is assume everybody’s like so up to date with it. We’ve got the experts here. So it would be really great. Like if you could explain a little bit about, you know, what is the true reality of health inequality, specifically where we are in the UK now, and what is the impact of health inequalities for people who are trying to get the right health and care?

Abdul Hamied: [00:03:46] So Kerry mean, obviously, I mean, if I start and then and then Mary and Sarah will come in, as you rightly said, healthcare and quality is is everyone’s business. At this moment in time, however, it’s become much more high profile. And in particular, that’s obviously as a result of the pandemic we saw during the pandemic how, you know, on a daily basis, on a weekly basis in the media, in the papers and of course, in the political conversations, how the pandemic was rolling out and how it was impacting on different communities, different ages, different genders in different ways. And that data that was becoming very clearly visible began to really provide a spotlight on what had been around for a long, long time. We know healthcare inequalities have not suddenly just been created as a result of the pandemic, but the pandemic has provided a spotlight where we were beginning to see, for example, from a workforce perspective, we were seeing people from ethnic minority communities. More prone to being infected. More likely to be ending up in hospital. And obviously some of the deaths that we’ve seen in the workforce, in health and social care have been overrepresented in terms of those groups. We also saw from our populations and our communities, again, we were seeing those vulnerable communities, those homeless, those Gypsy Roma travellers, people from ethnic minorities, people over a certain age and people living in certain parts of the country were again at greater risk of infection, hospitalisation and of course, sadly, the loss of life.

Abdul Hamied: [00:05:20] So I think what that pandemic has done is provide that magnifying glass for all of us in a very short time space where everybody was seeing that being played out in front of our eyes. And I think that’s what’s made more and more people really aware and conscious that these equalities exist. And more importantly, we can do something about it. You know, we began to do something about it as part of the pandemic in the way that we were targeting the cohorts, the way that we were engaging communities, local authorities, our partners in terms of community, voluntary sector to reach those groups that normally have poor access, poor experience or poor outcomes. And I think that’s what’s probably helped us galvanise the programme that we are leading on. And we were established in 2000, January 2021. So, right, slap bang in the middle of the pandemic. And that’s actually giving us a greater impetus in and greater opportunity to collaborate with people when it comes to tackling the healthcare inequalities. I’ll hand over to Mary because she’ll have a little bit more detail, but I think hope that gives you a sense of why it’s now much more prominent in in, in in the public space.

Kerry McGinty: [00:06:28] Definitely. And I think just reflecting what you said there, the work that you’re doing, and obviously people have been working to try and improve things for years, but the fact that the team was formed, as you say, you know, only a few years ago, the pandemic kind of really did shoot it into the stratosphere of, we don’t want to stand for this anymore. Everybody deserves the right and equal access to health care. So, Mary, it’d be great to get your insights. And, you know, tell us a little bit about some of the work that you’re doing to kind of, you know, push this on.

Mary Hill: [00:07:00] Yeah of course. So I think that’s Abdul’s described health inequalities have kind of become come to the forefront of people’s consciousness throughout the pandemic. But we also know that actually inequalities, life expectancy have been rising since way before the pandemic actually. So there’s lots of evidence out there around what health inequalities are, the impact, the impact on health outcomes and some of the barriers that people face in access to our services and their experiences of our services as well. So I think what our programme is aiming to do is kind of bring more of a focus on, okay, so what are the practical things that we can be doing, particularly in the health service, to address inequalities? And I think now’s a really opportune time as well. We’ve had the establishment of integrated care partnerships, integrated care boards, which has come into kind of statute in the last year or so as well. So there’s that opportunity for particularly in local areas, for lots of partner organisations to work more collaboratively, better together, to really join forces, to kind of really impact and work with their with their people and communities. So what we’re intending to do is a programme is really kind of set out some strategic priorities where we think the most action is required, but also where we can have an impact. So we’re particularly interested in ensuring an inclusive recovery as we’re restoring our services and kind of looking at particularly access and waiting times for different groups of people.

Mary Hill: [00:08:44] We’re looking at our data because, as I’ve just described, that’s so important in being able to understand where some of the inequalities lie. We’re looking at digital access as well digital inclusion, digital exclusion. We’re looking at preventative programs and opportunities in prevention. But we’re also looking at leadership. And leadership is incredibly important around kind of setting the direction of travel culture and really kind of ensuring that health and equalities is embedded in all the work that we do, so that we really understand the impact on people and what opportunities there are for us to make a difference in the health service, particularly kind of in delivery there as well. And just before we move on to Sarah as well, I was just going to mention kind of a few more statistics really, that puts this in a bit more context. So we’ve got our core 20 plus five approach where we’re looking at specific population groups, and we’re also looking at specific clinical interventions as well, where we think that we can have the biggest impact on premature mortality in particularly in particular. So we’re looking at disparities in maternity outcomes for black and Asian mothers and babies. There’s huge disparities in outcomes there. But then also looking at other areas as well. So premature mortality amongst people with severe mental illness for example as well. So there’s a number of areas that we could explore further. But I’ll stop there because there’s a lot of information. No.

Kerry McGinty: [00:10:19] Yeah. Just a few areas. And actually what really strikes me about it is this there, it’s so in there’s so many different threads and there’s so many different projects that are all live and all as equally as important as each other. And, and it’s just it’s a big, big problem. But you’re making so many waves already. I mean, I think on Twitter and just from this journey, working with you guys on the school for change agents, the core 20 plus five and graphic even mean it’s all over my Twitter. It’s everywhere that I look. So people are really invested in this, and it seems to be that people really want to make this change and are willing to support you and Sarah just come to you like working in this and all these different projects. What are kind of some of the because there are so many projects. But from your insight from working in the team, what are some of the response has been like for people to know, know we are working on this, we’re going to tackle this problem and we want to make it better for you. Share some of your insight and some of your experience.

Sara Javid : [00:11:31] I think connecting with partner programs and other partners outside of England to other bodies as well. There’s so much passion and interest and people to make a difference. I think people can see inequalities wherever they are, wherever they’re based. And as Abdul described, some of the populations, a lot of the populations sometimes are unseen, but we’re aware of them. So I think there’s so much desire to try and create some justice and fairness and equality. And I think that drives a lot of goodwill and a need to sort of collaborate, work. Together, despite any sort of formal organisation or commissions between partners. And there’s you know, Mary’s described some of the work that we’re doing at strategic level. We’re also working on enablers. So we’ve got programs such as the clinical Ambassador program that’s record 20 plus ambassadors. People are voluntarily signing up to a program where they want to roll out the code 20 plus five or various elements of that within their role. So that’s over and above their day job. And that’s just fantastic. Amazing that people want to do that, provide, you know, extra support for this agenda, do their bit champion or actually deliver some innovation where they think this isn’t working for this population group.

Sara Javid : [00:12:36] I want to do a bit more to support sort of that more professional level. So these are people working in either settings, local authority settings, third sector. So a whole range of people at various levels. And underneath that we’ve got sort of a grassroots movement. So we’ve got people who are being sort of trained, empowered upskilled as community connectors. And they’re working within their communities and advocating, championing and providing insight both to the community around what they can gain. You know, would they want to engage in an intervention? Would they go for cancer screening and also providing that insight back to health services? So we’ve got this multifaceted approach at strategic level and sort of ground up, bottom up level to support everyone. And there’s so much engagement, so much desire to create change within the system, which is why I’m excited about this call for change agents, because I think it’s another enabler, an exciting way to engage people, to empower them to create that change that everyone’s looking for.

Kerry McGinty: [00:13:30] I mean, the excitement. I could see the grin, but also from working with Sarah, it’s been amazing. All of the ambassadors and connectors and, you know, sneak, sneak bit of info for school. We interviewed one of the ambassadors, May, who works in Coventry, and she just finished a long shift. But there she was, chatting in the actual energy and passion for people to make these improvements. Her and she told me the story of her learning disability and practices, like the badges that they can give to people to make the experience of people with learning disabilities, and that much better when they go to their GP practice, which means more people want to book an appointment. More people attend their annual health checks. But she was already buzzing with ideas and positivity, and I think that’s what is encapsulated here with this little merry band of followers. Don’t know why I said it like that, as if we were like Robin Hood in the green tights, man. But um, mind you, maybe a shared outfit for the launch of school? That might be nice, but one thing that strikes me is all the is the passion that comes out of everyone. And I think I’d love to hear how. Why did you decide that? Oh, I want to work on this. This is my job. As you mentioned, people are volunteering. It is a social movement which really fits in with school. It’s all about galvanising people. Like, here’s our shared purpose and vision. Let’s go make it happen. But what made you or was there a moment? Or is there a story that made you think, I want to do this? I want to improve health inequalities full time. And that’s how I’ve come to be here today, talking to this very nasal girl from Coventry. Big question. So whoever. Very big. How did you get in there?

Abdul Hamied: [00:15:15] A very.

Abdul Hamied: [00:15:15] Big question. And to be honest, there will be some people who will have a very clear career path. And maybe, you know, health inequalities will be one of their first jobs or roles. But for me, on a personal level, you know, I, you know, listen, I look like someone or some groups that have poor access. I actually have some of the statistics that Mary was describing, you know, people from certain communities, you know, ethnic minority communities, homeless communities, Gypsy Roma communities, people living in deprived areas, and all people with various disabilities tend to get ill earlier, you know, and therefore we live a life longer with health conditions and multiple conditions. And then obviously, ultimately, unfortunately, some of us die earlier. So we have a shorter life. And I’m, you know, I’m still fairly young. And I became diabetic, you know, when I was 40, you know, type two diabetes. And I’m living with that. And obviously, you know, that’s having a huge impact and other things will follow. So I think there’s a little bit of a personal lived experience. You know, in that sense, however, my my own career journey, I worked in the voluntary sector at the beginning after graduation. I’m an engineer. I wonder why? I’m not sure why, but I did engineering. But I’ve worked in the voluntary sector tackling kind of doing community development and tackling those root issues around economic opportunities.

Abdul Hamied: [00:16:38] Because of the decline in textile at that time, I worked in local government across Liverpool, Blackburn, Rochdale, so I live in the North West area and that was very much about tackling the social determinants of health, education, housing, employment, enterprise, etcetera, etcetera. And then found my way into the NHS not as a health inequalities lead, but doing various change and transformation programmes. It was only actually during the pandemic where I was lucky enough to be working as a deputy director for Vaccine Equalities, I really began to bring all my experience, my lived experience, my work experience to the fore and obviously then the passion, you know, the fire within got lit and and then I’ve been lucky to have then been able to be successful in securing a job in this team where I feel even much more at home because I live, I breathe. And I am committed and passionate, but can see the most important thing is we can. We have the data and with data. If we use that data properly, we can make a difference. We did that in the vaccine. We knew which postcodes didn’t have vaccine. We do targeting it on the street level. So the power of data is really important.

Abdul Hamied: [00:17:49] And one of our key strands is about data and how we improve the quality of data. The other one was about co-designing with key players. So we worked on the vaccine programme with partnerships with faith organisations, local government, community organisations, people lived experience and that helped us get the message developed properly. And you’ll hear a lot of this about the messenger is equally as important as the message. We always try to get the message right but then delivered it through the wrong channel. We tried to learn on that and of course. Quality improvement. You know, this is why this connection, this partnership is really more important. We know we can learn from best practice. You know, as a team, we we are our enabler is about appreciative approach. We we don’t do much work out on the ground. We help other people do the work. We help capture it and then amplify the great work that people do so that we can share and spread. So I think it actually, for me, feel at home and feel committed. And I’ve been lucky to have been surrounded by a family of people who may not have the same experience that I have. However, you know, we’ve all got the same values, ethos, and more importantly, we are passionate about what we do.

Kerry McGinty: [00:18:58] Amazing. Mary. Sarah, what what led you to this point?

Mary Hill: [00:19:05] Oh, well, it’s.

Mary Hill: [00:19:06] A big question, isn’t it? So, um, do you know, I’ve like Abdul, I’ve had the opportunity to work in the voluntary sector and also with local government before I moved across to the NHS. So I feel like I’ve kind of, um, from a career perspective, seen kind of lots of different angles around different social issues actually. So I’ve looked at kind of youth homelessness before, but also child poverty. And quite a long time ago I was working on child poverty action plans when I was working in local government, and also worked with the London Child Poverty Commission a long time ago. But kind of during the years I’ve kind of experienced various different roles in the NHS now as well. And I think, as Abdul has described, I feel like I’ve kind of found a home here because I’ve got kind of various different experiences from from working with different groups of people and hearing different people’s stories and experiences. So I feel that I’ve got a lot to kind of offer now in this national role, and kind of one of the things that really drives me as well is that when the place that I was growing up in was a very rural community, and when you kind of live in a rural community, you can often, often feel quite isolated from, um, opportunities from services. It’s quite, um, quite, uh, yeah. Challenging actually, and often overlooked, um, kind of some of the experiences of rural communities.

Mary Hill: [00:20:33] So I’ve still got lots of friends there who I grew up with, but you can kind of see some of the challenges that they face in accessing not only health services, but education. So I feel that I’ve got kind of that opportunity to kind of have a voice around policy making and the role of kind of rural communities, as well as kind of one thing that I’m interested in, one area of work that I’m interested in. But I think what what really drives me as well at the moment is, as I’ve described this kind of focus on action. So I feel that there’s a real opportunity now and a momentum around taking action. And I think it’s really important for everybody to realise as well that, um, change isn’t always other people’s responsibility. It’s all of our responsibility. So I think everybody within their own roles, whatever it might be, don’t think you need to be working in the National Health Inequalities team to be having an impact on, on people’s experiences and health outcomes. So we’ve all got our own spheres of influence, haven’t we? So I think anybody listening has got that kind of opportunity, even if you’re not in the health inequalities team, to be really taking action and kind of championing what we can all be doing to, to address inequalities as well. So yeah, that’s my perspective.

Kerry McGinty: [00:21:49] I think you’re so right. And I think that’s one of the key things of the school for change agents. You know, we’re not saying only clinical staff can join only people. It’s everybody. If you’ve got an idea, if you’ve got that passion and drive, which all of you feel like, I’ve taken a baraka just speaking to you all because it is like it’s exciting in the energy and the passion is there, but everybody can make a change. And if everybody made a tiny change, what impact would that have? It a massive one, and Sarah really would love to hear your story of how you kind of ended up here with your amazing outfits, funky earrings, and amazing energy to make change happen.

Sara Javid : [00:22:28] Really pleased this is a video because we’d be disappointing everybody, wouldn’t we? So don’t believe everything.

Kerry McGinty: [00:22:33] Kerry Sarah answers. Sarah may have been working on this school for change agents, and she’s been showing me up with her amazing style and glamour and grace. So I have to up my game every now and again. But anyway, back to the matter in hand. Sarah, how did you become this change?

Sara Javid : [00:22:48] Really interesting is the entire team bring different perspectives, and the entire team at all levels are extremely passionate about inequalities and making a change. And you can see that in the work that everyone does and delivers over and above. There’s a real drive and energy within the team as well. And you know the entire perspective from the rural inequalities that Mary mentioned, ethnic inequalities that Abdul mentioned, which are focussed in our plus groups within the core 20 plus five approach. I think for me, it’s a blend of both personal experience and lived experience that Abdul described. The area I grew up in was a tier three area throughout Covid, and we’d get the WhatsApp messages daily about people passing away who had grown up with and rounders and growing up. It was definitely a one of the 20% most deprived areas, so it still is. It was an old textile town. Industry declined and there aren’t many opportunities around here, so it’s really nice to be able to focus and influence policy, to try and make that change for people. And inequalities are extremely nuanced and complex. When I worked in, the local authority could influence things around housing and the very small social aspects and social determinants.

Sara Javid : [00:23:56] And now being in NHS is quite nice to be able to have a real practical approach to what the can do to change those inequalities. So I think I’ve had my background. Public health and health improvement. So the threat of inequalities has been there throughout my career. All the way through, I’ve worked in public participation to try and empower people to use their voice and to make that space for them within the health service, so that they know they have a right to health care and in a way that they want it. And what’s nice about the program as well is we don’t just focus on access, we also focus on experience and outcomes as well. We want to see that change. We want to see that improvement in people’s lives, in their health care, in their in their trajectories around their health as well and their well-being. So it’s quite nice I think. So, yeah. To answer your question, it’s been a both personal and professional journey to here.

Kerry McGinty: [00:24:42] Yeah. And I think the important thing that I picked up from everyone is it’s that lived experience we all have our own, but also utilising other people’s stories. We learn from other people’s stories. We improve from other people’s stories, which and you know, the school for change agents is all about. Yes, it is a course that’s got all the theories of change for you to learn, but we haven’t got the demon headmaster lecturing you about it. We’ve got real people who are sharing what they’ve done, their experience, and also sometimes their failures. You know, change is not a straight line, as we all know. It might take a few wines and a few turns, but and I’m conscious we are coming to the end of the podcast, which does make me sad because I could talk all day, but, um, we partnered together for the school for change agents this year. People are going to see real change agents get inspired by people who are making real impact on the ground. Why is it so important to hear stories of change through this health inequalities lens?

Abdul Hamied: [00:25:43] So I think from my perspective, Kerry is health inequalities. Improvement is not rocket science. It’s simple. It’s common sense. It’s something that we would all want to do because we want to have the best possible access, the best possible experience, and live as long as we can, as healthy and as active as we can. So it’s so easy in trying to understand the importance of why the connection with all this great work is to just to demonstrate to people it can be done, how it’s been done, and how you can simply take the approach, the concept and apply it locally, or at least get that confidence that actually if they can do it in Birmingham, they can do it in Rochdale. They can do it in Manchester. They can do it in London, where we are today. So it’s just to make sure that people can make that connection with personal passion if we improve it. For myself, I can improve it for the area that I live in and the populations that are accessing the particular service. And then here are some examples of other people who’ve done it. So therefore we don’t have to really reinvent the wheel.

Kerry McGinty: [00:26:49] Amazing. Perfect. Mary, what? What would you say? What would be? You know, some of the reasons that you’d give for people to sign up to the school for change agents and hear these stories of change agents making a real impact.

Mary Hill: [00:27:03] So I think it’s really important because we think there’s been we’ve been talking about health inequalities for years. And I think there’s there’s potentially a view that it’s something really big, really nebulous that you can’t have an impact on. But actually there are kind of shorter term immediate things, immediate actions that you can take. So hearing those stories will provide you with that kind of insight into what those kind of practical things are that people can do. So it’s moving away from having a bit of a tick box, late stage consideration of health inequalities of, oh, that’s something over there to saying, actually, let’s be proactive. I’m starting a project, I’m starting a piece of work or I’m kind of delivering a service. So here are those health inequalities, considerations and some kind of practical steps that I can take. And that can be kind of really kind of minor tweaks. But it’s actually considering the issue and engaging with people to to do something about it and working with others and listening to people. So it kind of will give that hopefully that inspiration and incentive to kind of go away and think about your own role and what you can do in your, in your area.

Kerry McGinty: [00:28:17] Fantastic. And Sarah.

Sara Javid : [00:28:20] I’m going to slightly disagree with Abdul and say sometimes it feels like an impossible task because it feels like it’s outside of your power, your remit. It is too nebulous. You don’t know where to start, you don’t know how to start. And I think even if you see a case study or a story of somebody who is doing something completely different to you, it might actually just inspire you to think, I’m actually going to try something. I’m going to raise my voice. I’m going to use it in a meeting, I’m going to make a change to my service. So I think it can have, you know, exponential impact on somebody who watches it in various different ways. So I think it’s great to share, for inspiration, for motivation, to galvanise people. And I think we all want to leave the world a better place. And actually this way we can actually make the health service a better place for everybody.

Kerry McGinty: [00:29:01] I don’t know how to top that last sentence there, sir. Honestly, I’m watching her. She didn’t write that down. It’s not rehearsed. That was beautiful. I think you’re so right. And I just want to say a massive thank you to all of you for joining us on the podcast. And, you know, the school for change agent starts on the 13th of November. We are all working very hard to make it the best one yet. And to showcase these examples of change agents. And, you know, the School of Change agents is people have taken part across 140 countries, although Abdul was still after Antarctica, aren’t we? So if anyone’s listening in on an expedition to Antarctica with the penguins and wants to log on to do this school for change agents, we would be very grateful. Eternally. Otherwise, Abdul might actually have to dress up as a penguin and get a get a boat down to Antarctica himself. But, um, thank you so much. I think that the school for change agents this year were so excited to be partnering for anybody listening, if you haven’t signed up to the school for change agents, you still can. It runs from five weeks. We also offer a free upgrade for anybody that’s working in health and care and partners with the as well. All of the details on how you can sign up and where to join can be found at horizons.com/school. Thank you all so much and I hope you have a fabulous day. Bye for now.

All: [00:30:27] Bye bye. Thanks, Kerry.