Young leaders in health and care: courage, passion and talent

Key:

JV:       Jo Vigor

HM:     Hannah McCaffery

RJ:       Rini Jones

BS:       Beth Sutherland

JV:            Hello and welcome to the King's Fund Podcast where we explore the big issues and ideas in health and care.  In this episode we will be asking what does the future of health and care look like from the perspective of three young leaders and how can they help to shape that future?  I am Jo Vigor, and to help me answer this question I'm joined by three wonderful guests, Hannah McCaffery, Registered Manager at Richmond Fellowship, Rini Jones, Senior Policy and Research Manager at Marie Curie and Beth Sutherland, Senior Project Manager in the National Ambulance Team at NHS England.  Hannah, Rini and Beth, welcome to the Podcast.

BS:         Hi Jo.

RJ:         Thanks for having us.

JV:            Lovely to see all of you.  I'm really, really excited about this episode and I think we will be learning lots about your perspectives of being leaders in the health and care system at this point in time.  So what attracted you to working in the health and care system and what surprised you about it as you've come in?  So Rini, I'm going to ask you first.

RJ:         Sure, yes, it's a question I have been asked quite a lot, especially from my more seasoned colleagues in this space, why would you want to tackle these really entrenched issues?  For me I grew up in a really medical household.  Both my parents are doctors, a lot of my cousins, uncles, aunts back home in India are medics as well, nurses, so it's something I was surrounded by growing up.  The move from India to England and seeing the differences in the health and care systems and also the really entrenched inequity in the provision of health care in particular really motivated me to use my voice, use my more politicised skills to be able to effect some really meaningful change in the space and I think what's surprised me the most is how circular it can sometimes seem.  So, for example, the conversation on health inequalities has been going on for decades and a lot of the same points have been raised multiple times but yet, despite that, very little action has been taken. 

JV:            Hannah, could I come to you next?

HM:       Yes, so I started off working in the health and social care sector as a care assistant, again runs in the family, quite a lot of my family have got care and support needs, always been in an environment where we've needed health and social care services and they have become quite prominent in our lives growing up.  So for me working in this sector contributing to a cause that I feel so deeply about and whether that's supporting the vulnerable populations, addressing social issues.  I started off recruiting volunteers into services and seeing the difference that made and progressed from there to a team manager role within the organisation and then to registered manager.  So I've seen the different stages of it where you are actively involved on that ground level, you're supporting these people day in and day out to now be the person that can implement certain changes and certain agreed ways of working to make those positive changes to support people to live independently, to move on with their lives, to get their care and support they need to be able to do all those things and achieve their outcomes.

JV:            And again, from your perspective, was there anything that surprised you when you've come into the role that you've got now?

HM:       Honestly, all of it.  The system is so complicated, it is so wide, there are so many different types of services, different areas of expertise, it's not just one service that will support an individual, there are many different services involved, there's the local … for us for instance we work for a mental health care home, there's the community mental health team, there are the practitioners, there are hospitals, the GPs, there are social workers, care coordinators.  There is a whole magnitude of people and professionals that go in to supporting people and I think for me seeing how these people can work together from different backgrounds with different areas of expertise was really surprising.

JV:            That point about how to deal with complexity as a leader and as you all go further into your careers is going to be really, really important, so thank you.  Beth, coming to you now.

BS:         Yes, in terms of what attracted me to working in the health and social care sector, my first ever proper job was in a community pharmacy and I worked there whilst I was at school and sixth form and it really gave me an insight into how important NHS organisation institutions are to the local community.  I'd see the same people day in day out and how important it was that they had a good relationship with their pharmacist and the GP as well.  So seeing the impact that that would have on people's lives, and then I went to university I studied biology, I thought I was going to go into the academic PhD route and then very swiftly realised that lab work was not for me and I wanted to do more team working and then, yes, had in the back of my mind those experiences of working in the NHS and then saw the NHS graduate management training scheme and really appealed to me to understand from that level how to enact change and the policy and strategy specialism appealed to me because of the analyst core background that I had I also wanted to have the chance to do a bit of blue sky thinking that you can sometimes get to do in policy and strategy as well to see longer term how you want to enact change.  So yes that's what drew me in.  In terms of what I found the most surprising and still do, is how the histories of the NHS, there are different parts and the staff within it, can still really be felt today and that affects how the stakeholders work together now and also surprising and maybe disappointing in terms of how political short termism can really get in the way of real change and how difficult that can be for people working within the system when there are really great ideas but sometimes it's really difficult to implement them because of the different challenges being experienced.  So yes, the complexity and sometimes how difficult it is to get good ideas off the ground.

JV:            Thanks Beth.  Let's just have a think about this concept of young leader.  Did you actually self-identify as a leader or has it only been when somebody has said to you, "You're doing a great job, you're such a great leader in this space,"?  Rini, can we just start with you and then maybe go to Beth and Hannah?

RJ:         Yes, sure, it's such a good question and no I still don't self-identify as a leader.  I think when I got the invite to this podcast my eyebrows were raised, I think that's really common amongst young women.  I think it's even more common amongst young women of colour.  When I really think about what makes a leader or when you imagine what a leader is in your head, or if you were to Google workplace leader, you could imagine a middle aged white man, like people that look like me are very rarely called leaders and that's reflected in the non-profit sector more broadly.  So I think it's 3% of all non-profit CEOs are racialised or minoritised ethnic, the rest are white and less than 10% of the staff are racialised in general.  So being in this space you do feel othered quite a lot especially in policy, especially when moving in parliamentary circles, in academic research circles, as I often have to do.  So that I think for me it's when I get people who are even more junior coming up to me and asking me, "How did you get into this?  I really want to work in policy, I'm really politicised and I care about social justice, how do I do that?" because I think the routes in can be really mystifying.  So for me I only really feel like a leader when I'm helping other usually women of colour in the sector and that's the honest truth.  It's when they ask me about my expertise or if I'm asked by colleagues, "Oh you're the expert in this particular field, can you come along to this event?" or, "Can you speak to this parliamentarian?" that's when I'm like, oh, actually, no you're right I do actually know quite a lot.  So there are a lot of moving parts in it.  When we talk about intersectionality I think that's exactly what it is.  I'm not just a young woman, I'm also racialised and how I'm perceived as well, and I've seen firsthand how poorly I can be perceived as well as how well I can be perceived.  So it's a real tightrope is what I'd say.  I don't know if I'll ever feel like a leader and I don't know if that's an inditement on myself or the sector more broadly, but that's the honest answer.

JV:            Thanks Rini, I think some things to hold onto there.  There's something commonly called imposter syndrome and even as you get further on in your leadership journey and your career you'll find that many people even very senior people still feel like they've got that little bit of imposter syndrome going on and I'd love to spend some time unpacking that whole area about intersectionality and what it means when you're saying people get othered and that experience as well and what advice you'd have for people so thank you.  So Beth, can we come on to you now?

BS:         Yes, sure and I think, yes, similar to Rini, I don't self-identify as a leader.  The imposter syndrome is something that I think everyone struggles with.  Being on the  NHS graduate management training scheme it's slightly different because leadership is quite a … it has a heavy focus, we do the Elizabeth Garrett Anderson Course in health care leadership as part of it.  So we are introduced to leadership styles, reflecting on our own styles and styles of others, so you have that present within you but a lot of the time I felt like I was doing that analysis on other people and not on myself, but what did help me was the first placement I joined there was an allyship group there and I felt like the actually from my time as a university student and just my interests in social justice, I had something to offer in that group and even though I was a really junior member of staff and I was pretty new, I took a leading role in that allyship group to understand and map out how that group could … we created an allyship pledge and tried to implement and make sure that everyone had an antiracist objective in their yearly personal development plan and things like that.  So that helped me feel a bit more of a leader because I felt like I knew something in that space and I think that really helped shape my understanding of leaders can be at any level in organisations and what I think I take from it is that the best role you can play as a leader is helping power other people to step into their leadership positions.  Doesn't matter what band you are, what grade you are, if you have an idea and you think that you can effect change, then you should be empowered and enabled to do that and that's probably the most impactful thing a leadership can do.  It's very much about what you're doing for other people rather than the other way round.

JV:            Hannah, how would you respond to that question?

HM:       So I think for me it's definitely a case of imposter syndrome, every day when dealing with even questions from the staff team, questions from people we support, questions from people in the organisation, you have a minute of self-doubt, is that right?  Have I given the right advice?  And then when people come back in even you get really good feedback, you get compliments, you get … we have people come and inspect the service, we have audits, and it's all really positive and you take a minute and think, I do know what I'm doing, there's a reason I'm in this role, but it's definitely a case of imposter syndrome.  Every day I feel like how have I ended up here and should I be doing this?  Especially in a bigger organisation when there are lots of people with similar roles, there are lots of RMs across Richmond Fellowship, but being able to contribute to that, being a part of that working together group, and similar to what Beth said, when your feedback is recognised and when  you make suggestions or you suggest something that works in your particular service and that's adopted then by the organisation or by any other RMs as good practice then, yes, you definitely think maybe I'm all right in this role, but I think that feeling of imposter syndrome doesn't necessarily go away.  I mean I've been in a management role now for just over two years, registered with CQC for just over a year, I'm hoping in the future I'll feel more confident I'd say but …

JV:            Yes, it's challenging, isn't it?  And the advice I can offer you is that as you go further in your career you learn how to manage that little voice in your head that's going, "Can I do this?  Can I do this?" and it's about the approaches and techniques to help you manage that through.  I just wanted to touch back on this point about you're all three women leaders and Rini you talked also about being from a black and ethnic minority background as well.  Do you think the experience has changed for women in leadership particularly?  I'm just  … today or this week we've been hearing about the discrimination that's been reported by women in surgery, do you think things are changing for women from what other people have said to you, other women who are a bit further on in their careers?

RJ:         I think there's still a lot of equality issues within the health and social care sector that need to be addressed, but I definitely think we're making more noise now and as I say a lot of my role models they are either my line managers or work in the operations, work in head office, are female, and I think especially as a young leader at 22 years old that's really inspiring to see that my area manager is female, her manager is female, they've got to where they are, yes, there's more work that needs to be done but it is going in the right direction.

BS:         I would just add to that the NHS is overwhelmingly female so there's no shortage of female role models to look up to, for example the NHS England Chief Exec Amanda Pritchard is a woman and I think that that doesn't mean that we should think that the job is done.  For example, NHS England has just launched a sexual safety charter and whilst that's great, the fact that we need a sexual safety charter for organisations to sign up to speaks volumes in and of itself and I think that there are some things to be done around leadership in women doesn't mean emulating what male leadership has looked like in the past, and about stepping into what does female leadership look like and what does leadership more generally look like and how can that change from the past.

RJ:         It's really conflicting territory again for me because I can't separate out those two identities that I have and I have others as well.  Yes I see a lot of white women in leadership, I see a lot of it, what I don't see is racialised leadership, what I don't see is widespread disabled leadership or LGBTQ+ leadership or intersections of all of those.  In all of my roles I've come up against discriminatory behaviour whether I've reported it or not, but what I will say is some of the worst discrimination I've faced has been from white women.  So when I think about women in leadership it's a real conflicting feeling for me and I think that will probably be echoed by a lot of racialised staff in the NHS, in social care and in the VCSE sector, that we're spoken about a lot but we're often not in the decision making positions and this is my first I guess decision making position, I've worked in policy in more junior roles before.  What has changed, actually what has … what I've been more empowered to do is be much more vocal about it.  When I first started out in policy I was very cautious about raising this or raising interactions that I'd faced in a parliament context or in a policy event context with my colleagues because I thought they would take me less seriously.  Now I'm very, very vocal about it because the ramifications are very, very real and it's a microcosm what happens I guess in our organisations compared to what patients, families, carers face.  So I feel a huge responsibility.  Whether I should feel that responsibility or not is another question, but I do feel a huge responsibility.

JV:            What would you like to see change, because you've absolutely brought that … shone a lot on that intersectionality?  So for you what would be one thing that you would like to see change now that you're in a decision making role?   

RJ:         What I really want to see is an acknowledgement that structural oppression exists and then action to tackle it.  What I've seen in the VCSE sector, in the NHS and in government is a denial, it's a denial that it exists and a huge backlash because of it.  I think acknowledging that it exists is very a low bar but then moving forward … I mean I can get into heavy policy speak around across sector government plan to tackle health inequity that addresses wider determinants of health.  Obviously I really want that to be a reality, I think it's within the realms of reality, I just want more courage from people who occupy positions of power in our respective sectors, because it doesn't work in just the VCSE sector, we need to see it in the NHS, we need to see it in social care, we need to see it in government for it to work and for it to be properly resourced.  When I think about just even on the workforce issue, and in social care in particular, and Hannah please correct me if I'm wrong, the most precariously employed, the most undervalued yet the most … one of the most diverse ethnically workforces and yet historically underfunded.  It's all of this is very, very interlinked and I think we've all said that we're in these roles because they align to our values, if we (inaudible 00:18:26) we want to see that change and action being taken rather than words being spilled.

HM:       We're in the kind of roles we are because we've got a passion for it, because it aligns with our personal values, because we see how powerful the sector can be and how much it's needed and how much progression there is to make anything.  Starting off so young in our careers you're filled with all these ideas about we can do this and we can do that, but that requires the health and social care sectors working with the government, working with local councils, working with the NHS, all that integrated work and that partnership working is not going to be one organisation, one person, one sector on their own that's going to make that difference, and I think there have definitely been positive changes but nowhere near enough. 

JV:            We'll be back in a moment.  Are you interested in exploring innovative and inclusive approaches to meeting the workforce challenges facing the health and social care sector?  Join us at our virtual conference, Those Who Dare, Thinking Differently About the Health and Care Workforce on 4 and 5 October.  At the event we'll cover areas including recruitment, retention, wellbeing, equity, diversity and inclusion.  Sign up via the link in our show notes or on the King's Fund website.  Welcome back.  You've all talked about having voice and skin in the game and agency, you're talking about your own agency, what's your experience of having your voice recognised by older and senior leaders and what tips have you got for other people struggling to do that?  So Beth, do you want to kick us off there?

BS:         Yes, sure.  There have been times where I feel maybe I've struggled to have my voice heard by more experienced colleagues and I think that's one because of my 'relative inexperience' in the area, but I think also there's a role to play within teams and other leaders of understanding that people come to roles with essentially a fresh pair of eyes for things and you can look at things in a slightly different way, and I think that the utilisation and valuing of lived experiences, so I can't overstate the importance of that, but not using it as a buzz word.  The onus is on us working with our partners to be really actively listening out there including to people in social care for example, in the voluntary and community sector as well, so we're not in an echo chamber of what we think is the right thing to do is super important.

JV:            Absolutely Beth, absolutely, and Hannah and Rini, if you take some of the concepts that Beth has talked about there and look at that in terms of colleagues and the workforce that you … the people that you work with, what would be the one thing that you would say to them about helping them to have their voice in a room or recognised?

RJ:         There are times when I would deliberate silence myself because of fear of backlash if I'm talking about certain concepts that I know aren't popular to that audience.  What's been absolutely essential has been outside of the workforce that I'm currently in or outside of the colleagues I also work with, I organise with a collective called Charity So White, we're a racial justice campaign and we've been working for three years on dismantling the structural racism that's in the charity sector and working with them has really empowered me to then go into the spaces that I go into that are overwhelmingly male, white spaces that I go into, to speak with authority and I do have authority, there is both lived and learned experience here, and there's a reason why I've been asked to go or there's been a reason why I'm in that room.  So I think that's a really important part, especially if anyone is listening who is marginalised multiply marginalised, like it's so vital to have that community and if you can't find it in your workplace because your workplace is very white, find it outside of it.

JV:            And Hannah, what would be the one thing that you would … advice you would give to others to bring their voice, and I think Rini you talked about bringing your authority and your agency into your work, what would you say?

HM:       The importance of advocating for yourself, advocating for your team, advocating for the people that you support.  Those strong communications and interpersonal skills they not only motivate yourself, they motivate the people around you and I think without giving direct advice by just being that person who even if you're not completely confident in yourself being that person, coming across confident, advocating for yourself, really just encouraging people without (inaudible 00:23:25) doing it I think that inspires so many people and that resilience and really taking time for your self-care strategies and for looking after your own wellbeing and just feeling empowered in yourself, I think that really goes a long way.

JV:            So I'd like now to really get your thoughts on the future of our sector.  You've come in, you've recognised it's complex, there's a lot of stuff going on, there are levels of discrimination you've talked about being leaders in your own right, and you're still here and you're still coming to work every day.  So what do you think or hope the health and care system will look like in the future?

RJ:         What I'd really like to see is we know that especially coming out of … the pandemic is not over but coming out of the height of the pandemic, and those really entrenched inequities being exposed in a way that I don't think they have been before, certainly not in my living memory.  What I really want to see for the health and social care system is top down government action on addressing health inequalities across the life course from cradle to grave.  If black women are four times more likely to die in childbirth and racialised people are even less likely to receive end of life care than their white counterparts, we know that this is a whole life course issue and when we hear … I hear a lot of speak about prevention, preventing those experiences, preventing adverse end of life experiences, is part of that.  That is an example of poor health.  So for me what I really want to see is targeted, coherent, across department government action on that. 

HM:       So for me from the social care sector, I know there is a lot of work going on at the moment to reintroduce that partnership working now we're coming to the end of the pandemic, to reintroduce those face to face appointments, that real connection between social and health care.  I know there's been a lot of work gone on, but for us when … so we're 18 to 65 care home whereas I think a lot of the integrated working is between older adults and the NHS and health care services, there are things like the community … urgent community response, which is for care homes but again it's for predominantly older adults and there are the GP ward rounds and things like that that although we're a care home we miss out on that kind of thing.  So that integrated working I think there needs to be a really big push for better systems for partnership working, for that early intervention services, that inclusivity that people who have social care needs also have their health care needs met.  At the moment it's very much one element of that can be done however there are barriers to having that holistic approach.

BS:         For the question what I would like to see I've got a list as long as my arm to be honest Jo, but I'd say working in the sector I think we're so often reminded of the constraints that we're working under, whether it be financial, resources or just having the time to step back and think about the bigger picture, but actually my time at the Fund working on a project about how we can simultaneously tackle elective backlogs and health inequalities together really demonstrated to me that because of the constant operational pressures we often miss those opportunities for innovation and I really hope in the future we can start to move from thinking of priorities as disparate asks of the system and start to identify how we can marry some of this work together for the benefit of patients.  I spend a lot my time thinking about workforce because that's what my role is primarily focused on, I really want people to be confident that the NHS and the wider sector can offer them a really clear and rewarding career pathway.  They will be supported in navigating and the opportunities to meaningfully contribute and impact people's lives in this sector is unrivalled.  So I want to see people excited about starting their careers, feeling assured that they will have the support in their workplaces that are free of cultures of bullying and harassment and hope to see initiatives to widen access and supporting diversity and that this diversity is really celebrated, and my last big call to other decision makers is I really hope we utilise public appetite for change to drive transformation.  Notably within public health we think about things like the 2007 smoking ban and at the time lots of people thought it truly couldn't happen, but it was really strongly supported by the public.  There's a lesson in that to platform and listen to the ambitious voices of people and patients because often they're further ahead than we are.  

JV:            And if we look at this area of integration the need for collaborative leadership behaviours, from your perspectives what do you think should be different about the way that culture is developed and leaders lead?

BS:         A lot of leadership work is focused on individual leaders, you sometimes run the risk in organisations that their leadership only lasts as long as they do in the organisation, so once they leave then potentially toxic or unhelpful behaviours and cultures can start to creep back.  So I think it's really about going really, really deep into your organisation and seeing what the norms are, what the values are there.

RJ:         I'd like to see a lot less ego.  I can say this with both my charity 'leadership role' on at Marie Curie and my campaigning role with Charity So White, it is something we talk about a lot.  There is a cult of personality in a lot of campaigning spaces and I want to move away from that.  I think we desperately need to move away from that and move away from a scarcity mindset especially as the VCSE sector, as the charity sector, we're not competing with each other, me and end of life care palliative and end of life care are not competing with mental health services, I'm not competing with maternity, it is not a question of either or, it's a question of and.  We should be demanding more.  This I think really shocks people that charitable hospices are some of the biggest providers of specialist palliative end of life care but are only a third funded from statutory sources.  Two thirds comes from fund raising.  If that was maternity I think there would be riots.  It should be a source of shame.  When I talk about moving away from a scarcity mindset, I talk about us working with our sector partners, at Marie Curie we work really closely with our sector partners in this space.  I know in the mental health space there are loads of coalitions as well doing really great campaigning joint asks, and that's where we see really seismic change, legislate changes that have been achieved in the past few years because of really powerful joint campaigning.  So I think, yes, moving away from personalities, moving away from scarcity to actually if one wins we all win.  If we focus our efforts on those who are at the sharpest edge of inequity, who are most affected, it cascades down, it cascades outwards as well.  It improves services for everybody.  So I think that's what I'd really like to see.  I think we have seen in the past few years just how dangerous it can be to rely on the passion and the energy of committed individuals, it should be a structural and systematic change rather than burning individuals out.

JV:            Absolutely Rini.  I think it's the … for me and the research we've been doing, it's that shift towards true collaboration, true collaborative leadership and that's hard, kind and compassionate leadership, it's not soft, it's really, really important that we are able to be compassionate leaders in the way that we approach our work.  Hannah, is that true from our experience, I'm talking about compassionate leadership and I could imagine in your role being at that service delivery end that there are a lot of day to day immediate decisions you need to make and sometime that's really hard and how do you do that and stay compassionate and kind at the same time? 

HM:       So for me I think especially being in a leadership role it's been really hard to find my feet in terms of balancing compassion and authority.  So being empathetic but also being assertive when needed is definitely challenging and I think you need to have that person centred approach so it's not one fits all.  You need to know who you're speaking with, you need look at your audience, you need to look at what outcome you're trying to achieve, you need to take in environmental considerations.  Especially when dealing with personal issues it can be really, really complex and, as you say, working in a fast paced environment there are decisions that need to be made every day, formal and informal decisions, and you get to an end of the day and so much has happened and that self-reflection is really, really important to look back and to really reflect on the decisions you've made and the reasons behind them and to know that you've been able to manage compassion and leadership and you have done it for the right reasons. 

JV:            What's going to keep you here?  What's going to keep you working in the health and care system?  It's messy, you've got newspaper headlines about what's not working, it feels enormous, etc, so what's going to keep you going in your leadership careers?

BS:         For me I think if I had to sum it up in one word it would be impact … well two words, sustainable impact, that's what will keep me here.  It's kind of what drove me to join the NHS in the first place, but I think that the workforce and the NHS and the wider sector are really tired, COVID was huge and recovery from COVID in some ways has been even harder because of the burn out that exists within the sector, but I mean there's still no lack of passion to enable and make change to patients.  So I think it's a sustainable impact and within that, speaking to Rini's point about health equity, I think what would keep me going is if I think that focus remains, stays and is acted upon.  So it's not just about recovery from COVID and getting back to where we were before, it's about being further ahead and it's about those things that were brought to light, not shunning away from them and really engaging and confronting them head on and making sustainable change, but inequity has to be a part of that otherwise I feel like we wouldn't have really learnt anything at all.

HM:       I think for me working in the social care sector there's a strong sense of community, there's that common mission and passion for creating positive change, we all feel enabled in some way to do that, we all feel empowered to do that and that's really great.  The satisfaction is that and the fact that it aligns with my own personal values, is something that encourages me to continue with working in the sector and stick it out when we face hard times as well.

JV:            And Rini?

RJ:         Yes, just I care too much to give it up.  I think a lot of my colleagues, peers would probably say that it's very hard for me to let something go.  So for me when I think about health inequity it boils my blood, I've seen it firsthand personally, I've seen it on wider scales, directly working in health policy, the end of life, death is considered an equalising event, it's not, there are huge inequities in end of life experience, there are huge inequities in mental health services across … just across health care and the piece.  I can't imagine ever not wanting that to change.  What keeps me in this place and what keeps me willing to put myself in very uncomfortable positions and sometimes unsafe spaces, going in and advocating for unpopular policy interventions for example, what keeps me going is I'm not … this might sound really big headed but it's our generation of people in this sector they give me a lot of hope and future generations too coming up behind us give me a lot of hope.  Their lack of tolerance for inequitable practice, their lack of tolerance for discrimination in the workplace, for rigid egocentric white male audiences, their lack of tolerance for that really gives me a lot of hope.  It empowers me and a lot of people that I know to be much more vocal when we're speaking out.  So I think yes that's what keeps me here.  I don't want to say it's pure spite, it's not, it's energy, it's vim, is the only kind of way I can characterise it.

BS:         Just to add to that Jo, it's people like Rini and Hannah that -

RJ:         Definitely.

BS:         - that keep me here.  Like I said it's really easy I think to get bogged down on how much work there is to do and how difficult it is, but I think when I meet people who are as courageous, passionate and talented as Rini and Hannah then it gives me enough energy for the next couple of years to carry on going because I know that these people exist in the system.  So, yes, people like yourselves. 

RJ:         100% yes, back at you.

JV:            That's brilliant.  Brilliant.  I mean I've absolutely loved working with you and talking with you all this afternoon.  It's been an absolute privilege to meet the future, meet people who are so inspirational in your leadership roles.  The three of you are absolutely inspirational.  So please hold on to that.  I think deep down you know that, but you are so … you offer me so much hope for the future as well.  So fantastic to discuss this with you.  Unfortunately, that's all we've got time for today.  Thank you to Hannah, Rini and Beth for joining me.

RJ:         Thank you.

HM:       Thanks.

RJ:         Thank you Jo.

BS:         Thanks so much.

JV:         Thank you, thank you.  You can find the show notes for this episode and all of our previous episodes at www.kingsfund.org.uk/kfpodcast.  The show notes for this episode and all our previous episodes can be found at www.kingsfund.org.uk/kfpodcast and you can get in touch with us via Twitter, our account is @thekingsfund.  The producer for this episode was Emma Sheffield and it has been edited by Bespoken Media.  Don't forget to subscribe, share, rate and review this episode wherever you get your podcast and of course, th