Welcome to Episode 2, 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 Jo Trask , Health Inequalities and Patient Involvement Lead for Cheshire & Merseyside Cancer Alliance.
Jo tells her incredibly inspiring story of how the alliance are tackling Health Inequalities – one thing at a time and opens up about her experiences as a young carer fuelled her desire to make Health Care equal for all.
Slipper socks on, tea and the ready and enjoy the listen!
Kerry McGinty – @KerryEMcGinty
This transcript was provided by sonix:
Kerry McGinty: [00:00:08] Oh so hello and welcome. Thank you so much for joining us today. Um, this conversation I’m really excited about, because we’re going to hear a little bit more from another amazing change agent doing amazing things in the realm of health inequality. So let’s do the Cilla Black. What’s your name? Where do you come from and what do you do?
Jo Trask: [00:00:33] Hi Kerry, my name is Jo Trask. I work at the Cheshire and Merseyside Cancer Alliance. I’m lucky enough to be a Health Inequalities Lead for a health inequalities and patient engagement program. Originally I’m from Liverpool, worked across the region for a long, long time, feel really passionately about about tackling health inequalities. Spent 30 years working in the third sector, working with voluntary organisations and and only in the last two years I’ve come into the NHS really. So I’m a late starter in terms of the NHS, but it’s given me a huge background, a huge knowledge of how people think and feel really about services and what we need to do.
Kerry McGinty: [00:01:10] Fantastic. And actually we recorded a podcast yesterday with some of the Health Inequalities team and a little bit about the fact that I think everybody’s in the same boat in the NHS. It’s something that people have worked on, but this formalised like drive to do it and having all that experience from all their different walks of life has just added to it. So from where you work, what are some of the biggest health inequalities that people are facing?
Jo Trask: [00:01:37] So it’s really interesting really, because Liverpool is quite famous. Unfortunately for some of the wrong reasons. We have some of the highest rates of cancer in the UK and we have staggering rates of people living in poverty. You know, we have the statistics come out and we’re frequently in the top five poorest boroughs at the moment. Liverpool’s caste clusters are third poorest borough in the region. But also I covered Cheshire and Merseyside and we’ve got lots of other, other challenges. I think rurality and really big challenges with public transport are happening in our rural areas, and I think whereas we would consider a no offence meant that, but that Merseyside would be considered in deprivation with pockets of affluence. Cheshire would be considered affluent with pockets of deprivation. But that in itself creates challenges because things are hidden and you can’t look at a regional level and get an honest picture. I think we more than than ever, we need to get down to granular level in data to understand what health inequality looks like.
Kerry McGinty: [00:02:43] And I think that must be quite a challenge for lots of different people and regions. You know, even I’m from Coventry, but sometimes we get, you know, banded in Coventry and Warwickshire and obviously there’s going to be different issues in rural Warwickshire than there is right in the city of Coventry, which, you know, has got a lot of health inequalities as well, inequalities even. And so how do you, with all of that complexity, get down to start making improvements? Because there might be some people taking part in the school for change agents and, and, and listening to this and watching this, who are thinking we’ve got the same troubles. It is kind of a bit overwhelming at times. Well, how if we sort out this problem here, that’s not going to work over here. So how do you overcome that and have you got any examples.
Jo Trask: [00:03:32] Oh okay. Big question. So so I’ll tell you how we’ve done things. So two years ago I was invited into the Alliance. I was given free range from my senior management team to tackle health inequalities, a big task, but also full backing. And when I looked at the problem, the first thing I can see without doubt is that we can’t do it on our own. You can’t have a head of health inequalities. Introducing health inequality projects that that is not a system that’s ever going to work. So the first thing we did, we looked at a legacy approach where we will train, support and facilitate staff so that every single person becomes responsible for health inequalities. And we have a saying at the alliance that health inequalities is everyone’s business. It’s part of what we do. And it’s taken about two years, but we now have an approach called the one, two, three approach, where we provide our teams with resources, we train them, we provide them with a workshop and we provide ongoing support. But with all of that, all that big offer that we give them, we then expect it’s their responsibility to tackle health inequality in every piece of work that they start, that they touch, that they work on.
Kerry McGinty: [00:04:45] Just really struck by what you said there about, you know, it’s about the legacy. It’s not having one great project or one great leader, come in, do loads of work, then dare to go on holiday or take retirement. This is about changing the system at a large scale, like scaling and spreading it. That okay if you’re working with us, this is this is integral to the job description. This is part of your role regardless of what that is. So what was people’s responses been like to this approach.
Jo Trask: [00:05:19] So so initially people are anxious obviously because it just feels like a huge piece of work, let’s be honest. And people are working to capacity and beyond in the NHS, and I think that was something I was really mindful of, that we can’t just come in and say, you’ve got to do this or I expect this from you. So what I did, I designed the project with my colleagues, said, what will work for you and our the piece of work we’re most proud of is called change one thing. And it kind of comes as part of the the training approach. So Health Inequalities has stood still for a very long time. And I know the secret. I know the reason why is because it’s in the difficult box. It’s because it’s massive and it’s as big as an international, you know, challenge. And and it looks at much more things than. Hospitals and clinics and what the NHS does. So we feel we feel paralysed really by, by, by the inability to act. So we kind of took this right down to the nth degree and said, right, okay, let’s consider this a social movement. Let’s stop thinking about strategic change. Let’s stop thinking about how leaders need to to initiate differences. And we just said every single person in the organisation needs to change one thing about the way they work, just one thing. And actually it needs to be a small thing because if it’s a big thing, it’ll never happen. So every single person in Cheshire and Merseyside Cancer Alliance has a change. One thing form attached to them. It is requested by managers. How’s that going? It’s kind of part of our process and we have built into every project that we work on and every new piece of work, that kind of philosophy that we can change one thing to improve things for people who experience barriers.
Kerry McGinty: [00:07:08] I mean, that is so exciting in a way that actually with the greener NHS doctor, Nick Watts, who’s the head, he is a very much a big champion of if you can do one thing and think it just makes the problem so much better to solve, because instead of like, you know, 20 people working on one big campaign, you’ve got hundreds of people doing little changes that are going to have that bigger impact. Can you share any examples of the little one thing that people have been doing?
Jo Trask: [00:07:39] Okay, so so we looked at things like patient letters. So. Lot of people are experiencing deprivation and challenges around heating and eating. Travelling to an appointment, can I afford to go and feed my family? So we decided to look at things like the policy around claiming your expenses back. So we’ve made that much simpler for people to claim expenses. But we’ve also we can’t tell people what to do, but people have started to include in their patient letters. They’ve started to include the fact that you can claim your money back because it is a policy nationwide, but we perhaps don’t shout it from the rooftops to people. People perhaps don’t know what to do.
Kerry McGinty: [00:08:24] Definitely never heard of it. And actually just thinking about that scheme I recently had to go to for for a scan. And luckily I’ve got a partner that can drive, but I live right by the hospital in Coventry. Like I can see the sirens and the lights, but where my appointment was, was in rugby and and working with the Health inequalities team, I thought, well, I’m lucky because I’ve got my partner, I’ve got my dad, I’ve got friends that are like, oh, I’ll give you a lift. But actually to get there and get public transport was going to be super expensive. You’d have to leave at the crack of dawn, and you don’t know what people you know are experiencing.
Jo Trask: [00:09:08] We have to add into that, that people might be on zero hours contracts, so they’re going to lose a full day’s pay, and a full day’s pay at the moment is almost impossible to lose. So that stops people going. If people have to care for an elderly relative or have childcare or even we discuss pets as being barriers to accessing treatment, how can people possibly, you know, with a support network? Things are very different, but loads of people don’t have support networks. And actually we’re moving into a time where less people than ever have support networks. So who does take you? Who sits outside and drops you off? You know, so they’re the things we look at and they’re the things people have told us over the years. So. So some other examples would include a meeting point in reception we’re talking about at the moment, with the hospitals being redesigned. And actually there’s nowhere to specifically meet people. It’s all a bit white, but what we’re discussing came from a meeting that I was in recently. Is that for their first appointment, hospitals, as nice as it is to have somebody on reception and there’s volunteers, actually, people don’t come. They don’t even have to have a challenges around their mental health, the anxiety of being told, you have cancer and here’s your first appointment and you have to get to this place and then you have to find your way within it. Well, well is a preventative barrier, you know, so having the letter say, just get to reception, stand under the big arrow. Someone will come and get you.
Speaker3: [00:10:36] Yeah.
Jo Trask: [00:10:36] There is a huge difference. So so that. And you know what? Kerry. And this is something that’s really important. We’re not guessing these things. I think this is really important. This is a point I’d love to make. We’re asking patients and I and I think when we talk about patient engagement the quality of it really varies. I mean, we say to patients, what would you like to do in this process? We have a snakes and ladders board, which is the cancer journey. And we say to people, you know, what are your snakes and what are your ladders, what helps you get to your next appointment and what stops you going. So we use these really simple approaches with people to say, you know, where would you see change? You know, read a letter. We know that 1 in 5 people in the UK doesn’t read so well. You know, the statistics are that 99% of people read. And that’s true. But also about 18% of those people are functionally illiterate. They couldn’t read a document that was unfamiliar. So on the NHS loves words like really words. So. So we always got that in our minds. And part of my job is to do the actual practical stuff. And part of it is to remind my colleagues, hey, you know what 1 in 5 people can’t read. So what? What are you going to do about that?
Kerry McGinty: [00:11:52] I mean, the energy is just amazing. And I think, you know, having that lived experience input is just such a non-negotiable. Now in order to make real change happen, like it’s the only way that it’s going to it’s going to work for a lot of these projects, you know, and, and, you know, people have the best intentions and we can all club together and come up with a brilliant idea. But without that voice of the experience, you know, practically. Is that going to work? But what were some of the responses, for example, the arrow at reception, knowing that somebody was going to greet you? How what was the reception to that?
Jo Trask: [00:12:30] So, so because I’m an early days, we’re not collecting our responses yet, so I apologise really. You know, some of the other things, the letters have gone down really well. Some of the really simple stuff we’re doing is ringing people who didn’t go for, say, a that where I do have good feedback for you is we’re going out and speaking to people who didn’t come for screening. So one of my colleagues, Nick, is part of a scheme where anybody who had a DNA on a breast screening gets a phone call, but Nick’s got this away about her. That’s just like, right, let’s have a think about what’s in your way and let’s remove it. So she dead practical. She talks about being able to wear a cardigan with buttons. So you’re actually never naked, you know, talking about what’s culturally appropriate and reassuring people that there will be a woman available and, and she rebooks those appointments. And we have an 85% rebook rate where people go after not showing. So I mean, that’s incredible.
Kerry McGinty: [00:13:29] I think it just takes the fear factor out for people because obviously panic stations for a lot of people, if they hear, oh, there’s something on here, we’re going to have to screen you. That is panic stations. And then you know, exactly as you say, just having that friendly voice and actually think as well. It’s it’s time with people, isn’t it? People just want to feel understood. So a five minute conversation, instead of all being bam, bam, bam, this is what’s happening. Giving people options and choices makes them feel more in control of what is going on with them.
Jo Trask: [00:14:04] Yeah, 100%. I think all of our challenges at the moment are based on the fact that we’ve eroded phone access. I think loads of people would just just a phone call to say, am I definitely supposed to be here at 1020? And can you just tell me if I get off the 62 bus and walk through that entrance, will I be in the right place? Because that is what stops people. They are they might have cancer, but actually they’re the things that are making people worry. They’re the thing. Will I be on time? We’re working with several generations, and there’s generations of people who will never, ever tell a doctor anything challenging. Yes, I’m fine, thank you. No you’re not. You’re here. But we have to ensure that those people feel. And I struggle for the right word here. Valued. Eligible is the right word. So one of the things that I’d love to kind of just briefly cover is about visual, um, imagery. So when I go to the, the, the doctor’s waiting room and if this is podcast and not live, you’ll be able to see I’m a white middle aged woman, right? So I feel incredibly valid. Every leaflet looks back with a vision of another version of me. Yeah, every leaf and everything that talks about blood pressure. It’s always someone that looks like me. So I feel like I’m allowed to be there, I feel eligible, I feel wanted. And the LGBT Foundation did a great study and found that if they put leaflets or, you know, posters on a wall or on a website of a same sex couple, that the patients are 25% more likely to disclose their sexuality and talk about the health conditions relating to that sexuality, like, that’s a picture on the wall. Yeah. All it is, and we’re not very good at. I’m thinking about that, you know, just about what variety looks like, what diversity looks like visually. So that’s a really great example of of a simple, simple change. And we and we’ve done that through change one thing as well.
Kerry McGinty: [00:16:08] And I think it’s really poignant what you’re saying. And there’s also seems to be a sense just from the stories as well. People, the news is saying the NHS is overwhelmed or, you know, or like a lot of things happening. So a lot of people feel, well, if I’m not literally on death’s door or won’t bother you or I won’t bother you or no, I’m fine. But actually that’s where problems can happen later on, where something’s been left too long and detected. So, I mean, the just one change thing. Um, have you had any other tourists or hospitals or people being like, hey, hey, up, this is a good idea. Can I nick it?
Jo Trask: [00:16:48] So we started at the Alliance and my role was just to work. With the Alliance. Tough because they are, in essence change makers. They design in improvements and new pathways. So and that’s gone really, really well. But I’m really for my starter. Their news got out about the work we were doing, and people across Cheshire and Merseyside were calling me and saying, can we can we be part of this? Because I feel like frustrated that my management team don’t understand what I would like to do here. And, and I just like a bit of support. So kind of off off schedule, off scope. We just decided to create a staff health inequalities network. That’s for everyone working in Cheshire and Merseyside who works in oncology in any way. And we have kind of 60 members now. We only meet once a month for an hour online. That’s it. There’s no more commitment to people. We try to have a speaker from somebody within the group who’s doing something around health inequalities. One of these change one thing forms, or they might just be they might have a great idea, or they might have a challenge and they bring it to the meeting. We try and have a bit of patient voice if we can, and then we open the floor.
Jo Trask: [00:17:57] People just talk about what’s going really well, where their challenges and blockers are. And often, as you can imagine, those people link together really well. You know, I’m doing that in my region or I’d like to do that. And they and we can it’s a connecting basis. So yes, that does happen. And also other alliances across the country are really interested in this work because I’m a massive fan of not reinventing the wheel. You know, we’ve created a great kind of 1 to 3 package, one being resources, two being training, three being support. And we share that widely. You know, I’ve shared that on the futures platform. That’s a piece of work that, you know, you probably want to do it your own way. We think it works really well because it’s it’s regional, because it touches people locally. The statistics are relevant, but I think there’s loads of great stuff out there. But there’s there’s loads of not great stuff. And I think we everything we’ve designed is with the, with the patient’s voice in it. And I know I’ve talked for a long time, I just want to talk for a moment about patient voice, if that’s okay. Yeah.
Kerry McGinty: [00:19:03] Of course.
Jo Trask: [00:19:04] So lots and lots of trusts and organisations at the NHS. Well all of them, it’s obligatory. Have a patient voice kind of panel. What I found and what I was genuinely surprised about within the NHS is that voice is very similar in a lot of places. So with great affection I call some of my my patient reps the usual suspects. So they are they are white traditionally retirement age, so they’ve got time on their hands, educated and honestly I love them. They’re great people to have on board, but they are just one voice if we don’t have a range of voices. If we don’t listen to more than one type of person, that is not patient engagement. You know, and often we leave it to chance. We see who comes forward. And it’s people with time, and it’s people with education who feel valid and who feel entitled to to to share their message. And to be honest, that wasn’t good enough for us. So we we went out, we just went into communities and we asked people come and be a patient rep for us. Yeah, well, I can’t because I’ve never been to a meeting in my life. Well, you’re exactly who we need. I don’t mean so good. You’re exactly who we need. English isn’t my first language. You’re who we need. And so we built a large patient rep panel of over 50 people from all walks of life. So we identified through the demographics that there wasn’t many people from rural areas. So we focussed and targeted that area, and we went out and recruit people actively. This where lots of the work I do talks about really short and simple solutions. This is the opposite because this panel influences everything and in the NHS we often design services with patient voice involved. But if it’s the same patient voice or it’s people who continually attend the NHS anyway, if it’s people we already see and not those popular populations that are further away from the NHS. Then were only designing the same surfaces again.
Kerry McGinty: [00:21:18] I just think, you know, it’s so important what you’re saying. But what people might not know is the grin you’ve got on your face, and the passion and the light up in your eyes. So where did you where do you get this drive to to make the change? Because working in change, it’s not a straight road. Love your snakes and ladders analogy. It’s a bit like playing that, but, um, what what keeps you going as a change agent? And and basically you’re saying about the social movement, which just so links into the school for change agents, but we have one segment of the course where it really focuses on, you know, when you’re the change maker, how do you keep going and how do you keep. Well, because if you’re trying to improve everything for everyone, there’s always something to improve and change. So guess where do you get that drive from and how do you kind of keep going and and look after yourself in the process?
Jo Trask: [00:22:11] Okay.
Jo Trask: [00:22:12] So so personally I was born into an area of quite extreme deprivation and I had a tough upbringing, not in terms of I had a fantastic family, but and this just brings to light some statistics. Um, we often talk about people from not people, but statistics that. Areas of high deprivation have lower life expectancy. And you’ll hear that that won’t be a new statistic to anybody listening. And I think what that means in real life is that I didn’t have any grandparents growing up. And I think that’s something that’s really important to say out loud. So for me personally, a statistic meant that my parents had no support network and I had no grandparents. And and that’s just one statistic, isn’t it? That’s just one thing. So I think for me, my school burnt down. It was burnt down by arsonists three times. And nobody because of the area I lived in. Nobody sought out alternative education during that time. So I had.
Speaker3: [00:23:17] Huge.
Jo Trask: [00:23:18] Swathes of my my youth not in school, you know, big periods of time that, you know, nobody and nobody in my family had capacity to buy a book and open it and educate me. So. So I didn’t grow up with a burning desire to I need to justify this. But when I take time and look back, this is where my burning desire comes from. Because not everybody has the same start and not everybody has the same opportunity to access services. But if you didn’t grow up and experience that, it’s very, very hard to imagine. And so you’ve only got the statistics to work on. You’ve only got those figures and those figures, what they mean to you is, oh dear, the death rate is high in that area. But if you’re in that area, that means the support networks around people are smaller. And we’ve already spoken about support networks and how they. Without support networks, we find it a lot harder to access the NHS. So for me, the reason why that was the start. But then I went and worked. My first job was in a. So I went to university and did environmental science and don’t laugh. But people were like, what a load of rubbish that’ll never catch on. So obviously watch this space 30 years later. So I came out of that and I became a carer. That was the first job I did and I worked in. So this definitely dates me. I worked in at the time of change where institutions were closing and we were bringing disabled people into their own homes in the community.
Jo Trask: [00:24:50] And honestly, I genuinely think that’s a fantastic piece of work. But the delivery was poor. We never asked people if they’d like to live in their own homes. So people we assume people would, and 100% people did, but they should have been phased in because you’re looking at people at 50, 60, 70 who’ve never, ever lived in their own homes, put into a wonderful, appropriate flat and just desperately lonely and unhappy. And I it really hit me. I was 21 years old and I thought, I never want to work in anything ever again, where we don’t ask people what the service should look like. So it really hit me hard and I have been really privileged. Like I say, from then on, I worked, I worked with children with disabilities for a few years, and I worked with children with heart conditions, and I went on to have children of my own, and I worked a lot around the inclusion agenda and the shift from exclusion to inclusion. But I had my own children, my son was poorly and I became a carer, so I became a welfare rights worker part time. But what what you’ll see throughout my entire career is that I was front facing. I was listening to people who were marginalised. I was listening to people for whom the services didn’t fit them, and their total powerlessness to change that. And then about five years ago, I started working with Macmillan and I did a similar job. I listened to people with cancer and I you know what we never ever with in the NHS, we don’t have a chance to make it right if we get it wrong.
Jo Trask: [00:26:29] You know, it’s a time of people’s life we can’t ever go back and fix. And that’s a huge amount of pressure for people. But what I found, people are immensely forgiving, but they also have some really bloody great ideas. Yeah, people are incredibly resilient. And they’ll say to you, this won’t help me, but if you did this next time, somebody is going to have a much better journey. And I think that’s brave, you know, that’s really brave. And I find myself promising those people. I promise them I’m going to take those ideas forward. I’m listening to them. So I’m basically kind of a vessel of 30 years of listening to people. And then I was really privileged to get a job in inequality in the NHS. And I feel all those promises I made for a really long time are what drives me forward. I genuinely believe that. I think those peoples, I can hear those people telling me their stories, and I promise that we’re going to make those changes and and having this opportunity to speak to you, Kerry, and to share that with other people, it’s just so I’m so grateful for that opportunity because. We work, perhaps with restriction, and we’re under a lot of pressure. But I’m you know, I’m not asking people, oh, you have to make all these changes. I’m asking them to make one because that’s all all the people that I’ve worked with would ever expect just do one thing to help improve that journey.
Kerry McGinty: [00:27:48] I mean, I’m incredibly moved by that. Your story. And, you know, I’m so passionate that stories create change. Just having a conversation, dropping the jargon, just speaking to somebody as if you’d speak to them down the pub or over a cup of coffee. But, um, thank you so much for sharing that I think is just so striking. And I know that it will impact a lot of people as well. And we’ve just got a few more questions, but and I think you’ve probably really covered it. I mean, if I was listening to this, I’d probably like take up a flag and start campaigning or doing something. You’re very inspirational. Um, oh, I went all a bit lame. Is then with my. That’s the picture I had in my head anyway. Um, but what would you, um. What? You know, what would you say to people that are listening to encourage them to think about and put health inequalities at the core of their work? What would your piece of maybe one piece of advice or what be? Come on, share your share even more. I’m draining you of all your wisdom today I’m ringing you out like a sponge.
Jo Trask: [00:28:54] So? So I would say get.
Jo Trask: [00:28:56] Out and listen to the people that you’re serving. Um, I know people are. Some of the staff will be speaking to a frontline and they’re doing that anyway, but they have such short amount of time, you know, it doesn’t hurt to say to people, what would you do different? If you were looking at this as people coming in and ask everyone, don’t ask the people who it’s easy to ask. Ask the people. It’s hard to ask people who might have had a tough journey. Why has it been tough? What can we do? And I would say one of my big things to say is share. Like if it’s going well, show and tell. Like share with your colleagues what you did. Share with your colleagues, your challenges. And when I say set the set the bar high, I don’t mean create a massive, complicated strategy. You know, set the bar high, pick something and do it. And if you experience setbacks, still do it. Share it with a couple of colleagues. Keep it tiny. This is a social movement. This is time for change. We’ve never, ever been more ready. I mean, I’ve worked in health inequalities for a long time, and I haven’t really seen any change in the last two years. I’m starting to see. Everyone pick up the mantle and think, that’s you. That’s the crucial thing. I have two sides in the Alliance. People are on board and so things are moving quite quickly. And in the staff network staff are experiencing colleagues who aren’t on board and things are moving slower for them, but they’re not going backwards. So both are equally valuable. So if there’s something you can do in your organisation, something small, do it. You know, our admin teams are like when we when we go out for meetings, we ask.
Jo Trask: [00:30:36] We ask, do.
Jo Trask: [00:30:36] You have any dietary requirements and do you have any additional needs in the same question? But they’re not the same thing.
Jo Trask: [00:30:43] You know, and if you.
Jo Trask: [00:30:44] Were neurodiverse, you might not not pick out the two different elements. So actually they now have do you have any dietary requirements. And then underneath that do you have any additional needs. For example would you like this. For example would you like that? That’s a small change but a big difference.
Kerry McGinty: [00:31:01] I love it. I could talk to you all day. Let’s clear the diaries. I just want to hear more from you. But I think it’s. It resonates with so many people. And what even that example you just shared there. It’s so simple and easy to do. It’s literally a matter of pressing enter on a space, pressing the spacebar enter and adding, you know, two more words in. But I just think, you know, it’s super inspirational. I think what you’re doing in Merseyside, Cheshire is just absolutely fantastic, and I know that people are going to really resonate with your story and the way that you guys are creating change and and talking about sharing things. You need to let me know what colour lipstick this is after we’ve recorded what shade is it? Mac a bit of Rimmel. Um, but honestly, I think you’ve been absolutely fantastic. What? Um, you know, people sign up to the school for change agents. It starts on the 13th of November, runs for five weeks. You can get a free upgrade if you go to horizons.com/school. You’ve got all the information on how you can get a free upgrade and get your certificate and just learn and hear more amazing stories from people like Joe and and Joe herself. So please do sign up. But thank you so much for listening. And Joe, thank you so much for joining me. Think obviously fangirling a little bit too much now. So dragging out the goodbye. But goodbye everyone. Thanks for listening.