Ollie: Hi there, Tim. It's lovely to be back in the studio with you again. As many of you know, in Health Coaching and Beyond, we mix up conversations between the two of us and interviews with people we admire. Our aim is always to help you think well. This week, it's our turn again. Tim and I cover two topical areas, the Live Well With Pain conference, where Tim was speaking alongside some of those prominent thinkers in the field. There's a real sense of change in the air around persistent pain management.

Tim Williams: I know it's good, it's good, it feels like it's been a bit of a while but it's been, you know, it's only been probably a couple of weeks, isn't it really? We've had some other interviews and some good things going on in between. So yeah.

Ollie: Yeah, yeah, well, we try and intersperse it, don't we? It's nice to have a chat and a catch up on the airwaves, but I did love your interview with Alancy and what she's doing with her, what matters to you. She's really changing her system in the hospital there, isn't she? Then we reflect on last week's National Social Prescribing Day and how significant the rise of social prescribing has been improving the health and wellbeing offer in this country. Do listen to the end to hear our two recommended books on the topic, reads that will inspire and enthuse as we hope this conversation will do too.

Tim Williams: you know it's just that it's that quiet persistence I think you know you kind of start with this idea and then slowly by slowly by slowly but it but yeah I think it's ⁓ it feels like it's taking off now it's kind of it's got legs it's got legs so it's yeah it's exciting

Ollie: It really has. Yeah, that crucial shift, isn't it, away from just being concerned with what's the matter with you to what matters to you. I just think that power dynamic shift is so important where you're valuing the role the person takes and the role that the system gives to people's views and preferences and skill set and so on. It's just central, isn't it, to health coaching as a whole. So to see that approach being rolled out at a whole hospital trust level across 15,000 staff. That's the sort of game changing stuff we're looking for, isn't it?

Tim Williams: And the other thing I think for me is the focus on staff wellbeing there as well. It's not just about them, about the staff asking the patients and the people they're supporting, you know, what matters to them, but it's about colleagues asking each other what matters to you and that being embedded in the appraisal system and just the way that people are with each other. think it's really exciting.

Ollie: Yeah, I mean, I've always been impressed by ⁓ Michael West's work. Sheffield has been a key researcher in the field of workforce kind of like wellbeing, but also productivity with the NHS. And I'm always impressed that he says, paraphrase this really, but how meaningful and manageable people find their work and how involved they are in decision-making is the strongest predictor of everything in the NHS. It predicts wait times in A &E, it predicts outcomes in primary care and... outpatients, predicts ⁓ infection rates in surgery. If the staff feel they're able to do meaningful and manageable work, it just leads on to outcomes in everything.

Tim Williams: So what are we going to talk about today, Ollie?

Ollie: Well, you've been off to a pain conference last week and it was National Social Prescribing Day last week, wasn't it? We feel like we dropped the ball there a bit, didn't we, in terms of we weren't, we were watching social media, we were contributing, but we didn't put them together. So we thought we might put some love into social prescribing today. But let's start off with your, you were at a really interesting pain conference at the end of last week, weren't you? Tell us a bit about that.

Tim Williams: Yeah, so that was the Footsteps to Change Conference and that was ⁓ put on by the Living Well with Pain group. So Francis Cole and Laura Hissy ⁓ and Emma Davis, they're the people who are of spearheading that. ⁓ yeah, and again, we've known that group for a long period of time, but it was really, yeah, ⁓ was quite honored to be invited to come and speak at the conference because they had some... kind of high flying kind of folks presenting. And it was really interesting. So there was a group of people, there were lots of people who are ⁓ supporting people living with pain, ⁓ lots of people with lived experience, and then a few of us kind of working in the health service ⁓ supporting people. So there was some secondary care pain consultants I met, and there was also some ⁓ folks from primary care and community care. ⁓ And there was a really... positive buzz, I think, at the conference about how we can all do, I suppose, more to kind of support people who are living with pain. And also there was that little bit of a tantalizing kind of a bit that we I know we've touched on on the on the podcast about how we can also help people to not just live with pain, but how we can maybe help some people to recover from and live well without pain. I suppose that was that was the other bit that was just on the edges there, which which I was quite excited about.

Ollie: Hmm, yeah, no, I picked up well, you know, Tim, you put yourself down. think, you know, you're one of the stalwarts of modern approaches to pain management now, aren't you? You know, we've been both been GPs with specialists in pain, which generated our interest in health coaching. But yeah, no, I picked that up from social media. There's definitely this sort of transition, isn't it? A shift in optimism, I think, around, yeah, sorry, you've got chronic pain, you're just going to have to learn to live with it. To actually, we're discovering new and exciting techniques that means that you can recover from it. it's shifting dynamic, isn't it?

Tim Williams: It is and I think there's lots of people who are catching up to that. I mean, we had some, it was great to see kind of rogernags from the British Pain Society kind of open the event. And again, we need to be making sure that we are involved with what's going on there in the British Pain Society. ⁓ And yeah, it feels like there's some way to go, but it feels like this is the first starts of some kind of some really, ⁓ I suppose, meaningful collaboration with British Pain Society. That felt really good. And then there was ⁓ Tony Avery, who's a GP of 30 years, who then talked about the kind of the 10 year plan. And I was really pleased to hear him talk about or reference the Boulder back pain study. And again, think some being cautious about it, but I think it was just the fact it was on the table. I think that was quite exciting. And then, and then we have.

Ollie: That was the seminal study where they used pain reprocessing techniques, didn't they, to cure, get rid of chronic back pain. I think about 65 % of the people that started the study actually got down to zero or one out of 10 pains, effectively no pain, which is unheard of really in chronic pain, isn't it?

Tim Williams: Exactly. In fact, I remember I listened to a podcast where I think they had to they had to invent this new category of pain free or virtually pain free because no one had ever done that in a study before. It was all about how much of the pain decreased. wasn't, you know, but there was still an expectation that there would be pain there. But this was in some ways the first study where they had to invent a new category because people had never got there before. So, yeah, two thirds of people pain free and I think an average length of time that people have had pain before that of 10 years and some people had pain every day for decades more than that. So yeah, it's exciting. It's exciting. And I know we're quite interested in that. And so it was good to see that referenced in that talk about the kind of the 10 year plan. Yeah, so that was exciting. And then Benjamin Ellis was again. Yeah, I know again, you're amongst all these people, you know.

Ollie: Mmm, our friend Benjamin Ellis, MBE.

Tim Williams: At least I think there were three or four professors, you know, and then me and Benjamin, I think, who were on that first kind of line up. But he was really, there's something that really stuck with me, which I'm gonna steal, because it was great, but he was talking about the Wizard of Oz and the Yellowbit Road and Dorothy, you know, being sent on this Yellowbit Road to go and see this old wizard, you know, the Wizard of Oz. And he was saying it feels a bit like that sometimes when people are referred to a pain clinic or a pain service. They kind of go on this yellow brick road and they have this kind of adventure, but nothing really, in some ways, nothing happens to them because they're waiting to see the wizard. Like the wizard has all the answers. And of course, know, no spoilers here. I'm sure most people have seen this, but when they get to see the Wizard of Oz, they realise that it's just behind the curtain. is just this guy that really hasn't

Ollie: Mmm.

Tim Williams: got the answers that they are looking for. But on the journey, they found the answers for themselves. I think that's the point. That's the point. And ⁓ he had a lovely kind of his phrase was because the most important thing that the thing that made the difference to Dorothy was, of course, she had these red slippers, which when she she tapped them, she went back to Kansas, which is where she wanted to get back to. And his point was that the answers that people need are often much closer to home. than they think. And I think that's one of the things that again that might be helpful to kind of our discovery isn't it that actually people know the answers to their own problems and actually whilst we send them off on this yellow brick road to go and see the old wizards which again he said you know we are kind of a little bit like the old wizards. That's that's not that's not ⁓ that's getting you well you know I'm

Ollie: You're not an old wizard Tim. You're more like Harry Potter aren't you?

Tim Williams: Yeah, I was thinking of you when I said old wizard, obviously.

Ollie: ⁓ thanks, mate. Yeah, yeah, yeah. Well, you know, it's interesting, isn't it? I think you and I both feel a slight mutual accountability, don't we? Because we've been in the pain field for a long time. We've been part of that movement when we were campaigning for pain to be a long-term condition, accepted that is something you just had to learn to live with. And in the acceptance, often people could move on and change their lives and readjust and so on. But I think what we've realised, haven't we, is that piece can further. It's accepting that something's happened something's changed. But actually, if you understand what's really going on, and this field of neuroplasticity, that your brain can get locked into different modes where it creates symptoms and it creates a sort of pain that is not necessarily related to tissue damage. If you can accept that, you can actually then start to take on some treatments and therapies that will reverse it. The plasticity means that it is reversible. And I think that's really exciting. I mean, we don't like to be too promotional on the podcast, but we are trying with our training, aren't we, to embrace this new approach and to bring in the new approaches to pain, the new explanation and the new treatments. And I think we particularly see how effectively it can be delivered by health coaches. That's what's really exciting, isn't it? You don't need to be a medic, you don't need to be a wizard for this. You're more like the lion and the tin man, aren't you? Actually, you're walking alongside people and you're learning together. holding that optimism and discovering things, which is exactly what health coaches are brilliant for, being a discovery part.

Tim Williams: ⁓ was the next talk ⁓ Benjamins. so again, there's loads you could talk about with that. I'm gonna think long and hard about that in terms of, you know, ⁓ tin man wanting a heart and the ⁓ needing courage and the scarecrow needing a brain. All of those things, which we kind of think, well, they're really important as well. I'm sure we could talk about that in terms of pain management. But yeah, ⁓ so much you can read into that. ⁓

Ollie: Mmm. Yeah, it's a great metaphor, yeah. ⁓

Tim Williams: But the next talk was from Cormac Ryan, you know, know Cormac Ryan from the Flipping Pain, the public health campaign around pain. And, you know, he's just spoke so brilliantly. And I was slightly, it was tricky really, because I'd had a bit of a joke with him before the event said, I said Cormac, you're my my warmup act. And he goes, yeah, yeah, of course Tim, yeah, I'm very happy to do that.

Ollie: Yeah, from flipping pain, yeah.

Tim Williams: And of course then he told everyone that he was at my warm-up act, which kind of, you know, and then spoke brilliantly and got everyone laughing in the aisles, you know, as he does. And at the same time, absolutely was able to communicate some key messages about chronic pain and our new understanding of the pain science. So again, if you haven't heard him speak, please go and visit the Flippin' Pain ⁓ website and have a listen in. And I suppose for me, That's really important piece, it? The knowledge piece is so important for people to understand the new pain science because that gives people new opportunities, new ways of working with their pain and what's going on. And at the same time, our recognition that actually what people need is knowledge, yes, but they also need confidence and skills. And I think that's the thing that the health coaches and social prescribing link workers and care coordinators, other people working in those roles, those are the things that...

Ollie: Yeah, yeah. Yes.

Tim Williams: able to help build in people confidence and skills as well as knowledge.

Ollie: Yes. And you're talking to him, I can almost sense your internal imposter syndrome coming out here. There you were. You'd had, you know, Roger Nags and Tony Avery opening it sort of, you know, president of the British Pain Society, MBE, Tony Avery, experienced GP, then Benjamin Ellis, MBE, then Cormac Russell. And then it was Dr. Tim Williams and peak health coaching. So what did you do? How did you follow them, Clearly you were the main act.

Tim Williams: I get one correction, it's Cormac Ryan, not Cormac Russell. Just because. No. I know.

Ollie: Sorry, ⁓ another, yeah, another Cormac, sorry. Cormac Russell, great, great guy as well, but Cormac Ryan, sorry.

Tim Williams: That's fine, that's fine. Just in case there's any confusion. But yeah, yes, well, the pressure was on basically. I had a little bit of a throat thing going on, which is just tailing off now. But yeah, the aim was to kind of keep the energy up. So I hope I did that. I hope I did that and kind of get three people. It was between,

Ollie: Yeah, no, fair enough.

Tim Williams: you know, I was the person that was kind of standing between the people and their lunch. So there was kind of a little bit of pressure on that as well. But...

Ollie: What messages did you get across into him around health coaching and chronic pain?

Tim Williams: Yeah, well, the main thing is like why we need a different approach now. And I think we kind of maybe talked about this on the podcast before, but actually if we want people to be able to take responsibility for their own health and wellbeing as far as they're able, then what they don't need is more of us kind of taking over and taking control. What they need is to build their confidence and their knowledge and their skills. So that was the main thing. And then I spoke a little bit about my, you know, the penny drop moments for me kind of working in general practice where actually, you know, When you work in the pain clinic, you have 45 minutes for a new appointment, but actually in the GP, you were lucky if you get 10 minutes or 15 minutes for an appointment. So how do you, in that limited time, how do you do that? So I talked a little bit about how you split your assessment into two appointments, that two appointment approach, which again, we talk about a bit on the, or I have done it in the past, talked about that on the courses. And the main thing for me is making sure that we listen to the story. And in fact, it doesn't matter what else we've got up our sleeves. If we don't take time to listen to the story, we don't get to take time for us to connect to the story, for the person telling the story to connect to their own story and understand what that journey has been like. Picking up all of the things along the way in terms of what people have said to them about their pain, what they understand about it. Is this pain? the same pain they've always had or is it something that's new that needs new investigation? ⁓ So that's the kind of, I suppose that's the main thing I was trying to get across that the pain story was really important and also tapping into what matters to that person, that's key because actually when it comes to the coaching bit, and I did share, you one of the coaching models that we talk about, the do it model, I did talk a little bit about that. ⁓ But actually what we need to do is to kind of tap into what matters and then, okay, so let's do coaching around what matters to you in this moment about this particular issue. So that's what I share.

Ollie: Lovely, lovely. And I think what we're seeing, aren't we? And again, we do teach about this is that the capacity now for listening and hearing the signs of neuroplastic pain helps you to make a positive diagnosis, doesn't it? It helps you to move people on to some degree until you've heard all the features of neuroplastic pain from someone's story. Hey, they won't feel heard, which is part of the kind of engagement process in itself, but then you can then confidently... explain to people why you feel that pain is neuroplastic and why actually some of these pain reprocessing techniques are much more lighter to be useful and have that hopeful optimism that actually with this new style of approach we can aim for ⁓ significant reduction, recovery, cure, whatever you call it. Recovery is different to everybody, isn't it? We're never going to get to a point where we have no pain, pain is useful for us, but can we get to the point where it doesn't? dominate your life anymore and you can go back to things that mattered to you, like you say, the most important. So yeah, really, really exciting times.

Tim Williams: Yeah, really, it was actually, and it was good to be in that space with all of those people who are all kind of, all going in the same direction. And again, they were, know, yes, you had the professors and the people with the OBEs and all, but also you had the people,

Ollie: Mmm.

Tim Williams: the ordinary folks, know, myself included, who were kind of doing our best to support people. And also, of course, the people with lived experience, they're the people with the most powerful. Of course, we had Lee there, Lee Vaughan and Narinda as well. who do some of the work with us as well. And DPAC was there. Lots and lots of folks all making their contribution.

Ollie: Well, it's exciting to see that movement going. Thanks to Emma and Frances and Laura for their leadership and for making these things happen. They're not easier though. We're organizing a conference ourselves, aren't we, coming up May the 6th? And it can be nerve wracking. Is anyone going to turn up to the party? What's the vibe going to be? So you stick your neck out by organizing these things. And we really appreciate people being brave and bold to do that. But maybe we should switch over to where the other thing we're going to talk about was social prescribing day, wasn't it? March 26th was National Social Prescribing Day.

Tim Williams: Yeah, so well, let me ask you then. So what does that mean to you, Oli? Social prescribing.

Ollie: has been core to my practice recently, actually. And I suppose it's nice because social prescribing was invented in the UK. It's really one of those things that was made here, I think. And you can argue about where it goes back to, but certainly in the last NHS contract 2019, they started to develop social prescribing link workers in the NHS and put a real effort behind developing social prescribing as a thing. And I think if you have to sort of say, what is it? It's around, I guess, realising that the determinants of health are more than just the medical sort of doctor-led approaches and actually things like your social context, how connected, how socially connected you are with your isolated or lonely, what your housing's like, what your work's like, what your finances are like. All these things, they often termed the wider determines a health are really, really important and that we need to pay attention to them. And if they are not good for people, then they often ⁓ are the key factors in whether or not they're healthy or not. So social prescribing, I guess, is trying to connect health and the social context together and ⁓ create a mechanism for us to take those into account. So social prescribing, link workers were born. back in 2019, probably building on similar roles that have been going on for a while in community sector and voluntary sector. But perhaps this was a more deliberate effort of the NHS's part. And now we've got 3,300 social prescribing link workers in the UK. And what they do, because most of social prescribing starts with a social prescribing link worker, but recent research showed about 90 % of people that get involved in social prescribing start with a conversation with a social prescribing link worker. And these are people that really use health coaching type skills. They listen well, they learn about people's social context and situation, they understand about what matters most to them. And then they help them try and connect with opportunities and resources that can help them to improve their social context and in doing so improve their health. That was a bit of long-winded answer, wasn't it? But does that make sense?

Tim Williams: Yeah, I mean, so important, isn't it? Is that tapping into what matters to that person? There's no point saying, well, look, you know, here's, you know, we've got the walking group or the knit and that or whatever, you know, and that's your choice. You know, it's kind of, you've got to tap into what is it that matters to that person. And I suppose if those things aren't currently in existence, the thing that really matters to that person in someone's community, then I think social prescribing at its best. then goes about how do we design these things then that do matter to people so that they can connect and do something together. I don't know, what do you think?

Ollie: Yeah, no, absolutely. And there's so many different contexts that that can happen, isn't there? I mean, particularly this global social prescribing day, I organized by Gareth Pesch from the World Health Innovation Summit, ⁓ collaborated with Parkrun, interesting, another organization we really admire. And I think they tuned into one of the key factors about social prescribing. Often it's around getting outside. You know, green social prescribing is a big, big avenue of it, recognizing that being outside, outdoors, in connection with nature, often with other people as well, not always, can be a really important asset to mobilize. So, part runs great for that. And I know they were very involved in it. But, you know, like you say, it very often is arts related. It might be, you know, people joining a choir, singing together. creating art together, going to museums or galleries. It could be things purposely designed to reduce social isolation. So like you say, it can be sort of men's sheds projects. It can be sort of knit and natter, walking groups, cafes. I mean, we've seen pain cafes, haven't emerge ⁓ to draw in people living with pain, but it might be a cafe just generally to help people feel like they're welcome and less isolated, or it might have a theme. ⁓ And of course there's a big... big avenue, particularly at the moment with the cost of living around helping people to understand their finances and connect with the Citizens Advice Bureau and organizations that can help you make sense of your finances and manage debt perhaps. So there's all sorts of opportunities to connect people up, isn't there?

Tim Williams: Yeah, and actually if we don't address those things, then it doesn't matter how good the kind of the health aspect of the what we've got to offer people is. Actually, if there's other things which are higher priority and they often are. And in fact, when we do the kind of what matters to you training and we ask the group, you know, what matters to them, health is not top of the list. And this is people who work in the health service. So it's definitely, you know, the things are often friends, well, family is often top.

Ollie: Interesting, isn't it?

Tim Williams: and then friends, connection ⁓ then health maybe kind of comes in there. And for some people not even at all on that list ⁓ things. So ⁓ it's really important if we don't address those things, as I said, it doesn't matter what else we've got really.

Ollie: Yeah, well, there's that classic research, isn't there, that showed that, you know, being socially isolated, can you imagine what it must be like to live without any friends or family around you, to be on your own, particularly towards the end of your life when perhaps your mobility is not so good, your opportunity to get out is less, that social isolation is this bad for your health of smoking 15 cigarettes a day. So, you know, if we want to have an impact on someone's health, we have to consider the social aspect, don't we? In fact, I am... I've always in my career, I've always thought there's this sort of like three-legged stool. It's like the overlap, isn't it, of the health interventions, ⁓ the social interventions, and then what we do to enable people's self-management skills as well. So it's health, social and self. And I think where we see the interaction, don't we, of social prescribing link workers, health coaches, primary care and the medical specialists, ⁓ they all come together. And I guess for us, isn't it, health coaching particularly focuses on that. the self skills, building the self skills. But the interaction then between health coaches and social prescribing link workers is really strong, isn't it? Because there's no point in building up people's personal skills and capability if they're isolated and they're not connected to the sort of social context that will help them to maintain those. So there's a real interplay between those two and of course then between the health system that will perhaps do the tests and the diagnosis and the analysis of what's going on for you physiology and health-wise. Again, if you can't look after yourself and you're not in a context of support, it's never going to work.

Tim Williams: It reminded me of a patient I saw this is going back some years and they came for their diabetes review and I said, know, what is it you'd like us to think about today? And they talked about their situation, their kind of housing situation. And I was thinking, okay, this isn't diabetes, but let's have a bit of a coaching conversation about their housing situation. And about kind of halfway into the appointment, they said, right now, doctor, how about my diabetes? And it just made me think, do you know what that was for that person in that moment? That was the priority. Had I gone and started talking about their HBA1C and all of the other kinds of stuff, it would have just probably not gone anywhere because at the forefront of their mind was their housing situation. And so it just made me think, you know, that's what we need to do in the precious time that we have is focus on what matters most in that moment. And then we can then bring in the stuff that we've got maybe around health.

Ollie: Yeah, yeah.

Tim Williams: Trying to do it the other way around is a complete waste of time in my experience.

Ollie: Yeah. And it wouldn't it be lovely if as a system we can hold confidence that that is diabetes care, you know, that actually in that moment, building someone's confidence in their social situation is a fundamental to them then building good diabetes care. And I know they might come to the doctor and want the doctor's specific skills, but if you're a really skilled system, you're able to recognise that these are, these are the barriers that stop people engaging, you know, in the more sophisticated stuff. And I think it's where no one can make more time for themselves, they? If you have that conversation, then you go, ⁓ my goodness, now I've got to kind of squeeze all the diabetes stuff into the two minutes I've got left. It's having the confidence that that was a really good, valuable intervention in itself. And I think then even looking wider to the system and saying the health system as a whole and the role that the workplace plays is really important to help people navigate their social situation. often before they take on their health stuff. It's such an enabler that we shouldn't forget about.

Tim Williams: I'm reminded, I saw on LinkedIn, Hussein Al-Zabadi, he's been on the podcast, and he was saying a little bit about how frustrated he was that healthcare professionals just didn't feel comfortable and confident having that conversation about movement and people getting out and, well, not even necessarily exercising, but just moving more because the healthcare professionals were thinking, well, I don't know enough about it.

Ollie: Mmm.

Tim Williams: And it was like, that's not the thing. It doesn't matter that you don't know. What you know is keeping active is useful and is helpful. And therefore, why not just ask someone, you know, how are you managing to keep active at the moment? You know, with everything that's going on, how are you able to do that? It's just asking the questions just to prompt the thinking. You don't have to know where the various groups are. The social prescribers might know that information. You don't have to kind of keep that in your head, but just having the confidence to ask the question.

Ollie: Yeah, yeah.

Tim Williams: even though you don't know the answer, I think that's where we need to get to.

Ollie: Yeah, and that's one of the fundamentals of having health coaching skills under your belt, isn't it? Is that you can feel confident that you're not having to sort of prescribe and diagnose the solution, that actually there's a real value in you exploring what's going on. And to come back to part-run, I think it's really interesting, isn't it? There's over 2000 GP practices now that are part-run practices. And I was involved at the start of that in setting that up with ⁓ Dr. Simon Tobin and Hussain, who's... really flown with it. the principle at the start I was really keen to get across is that you shouldn't lead off with the offer. You know, it's brilliant to have all these sort of opportunities around these social prescriptions that are available, whether it's part run or choirs or niss and natter or whatever. you have to do the work to find out what people want first of all. So if you just kind of say, hey, part runs brilliant, why don't you come along to this? It's so good for you to be more physically active and I go and it's outside and it's with lots of people and it's free. You're pulling them towards what you think is the right thing for them. I always think you have to start with that coaching conversation of how you're feeling, what are you doing at the moment? What do you like? What are your preferences? And if it leads you, it can be quite quick, but if it leads you towards, I used to quite like running. I like doing things outside. I like doing things with other people. Maybe then part runs a great thing to bring on the table and you can then have those, you know, the knowledge about that, your sleeve, and it can really slot in beautifully for them. But if you lead with the product before you've found out what matters to someone and what's at the heart of their preferences and choices, ⁓ you're missing out on you, and it will never be as effective. So that's why we often don't we, having those health coaching skills is just a sort of fundamental. enabler to doing it well, but also a get out of jail card for you as a clinician, I think.

Tim Williams: Yeah, we sometimes can be really evangelical, can't we, about these things that we know that will be really good for people. yeah, it is actually, I think that can get in the way. That can be a barrier for people accessing those things. And I remember, well, I've just seen on the BBC this morning, the local BBC, that there was someone who had, their GP had suggested, I think, hopefully along the lines of, as you were saying, they kind of tapped into what what mattered to them first. But...

Ollie: Cool.

Tim Williams: Part run had come up for them and they had gone to part run and they'd gone there. They had poor mental health I think they some inflammatory bowel problems as well They're on 15 tablets a day and now they're going regular part run. They're down to one tablet a day. They're feeling great And they've got their community. I think they described their kind of their running group as they're like their second family Which I think was really yeah, it was just really a heartening kind of story to see the power of that for that And that's just one person. That's just one person

Ollie: Yeah, no, through my involvement with Part Run over the years, one of the things that really stuck with me ⁓ at one of their conferences was one of their comms team saying, the remarkable thing about Part Run is those sorts of stories are not remarkable anymore. They're very, very common. And in fact, you hear it all the time, don't you? ⁓ To such an extent that you just, yes, the risk is that we're evangelical about. social prescribing, health coaching, part-run, whatever it is. But it's the whole system together, working, isn't it? And realizing the relative value of these things alongside the other stuff we can do. And I think the real power of this is just showing that this has really hard outcomes. It has a hard impact. It's not the soft, fluffy stuff around the edge anymore that just backs around the operations and the prescribing and the kind of clever medical science. This is really... hard impact stuff and getting good at it means that we take advantage of all the sophistication we can offer in terms of creating health and wellbeing. And you have to be good at it. You have to be good at it alongside the expertise that you expect from medicine and from the health science. so it's, yeah, I think that recognition that this is not to replace, but it is equally important. And I think for me, the recognition that you, when you've got time, like you said, you've got 10 minutes or 15 minutes, you can't squeeze everything into them, but you can use your professional judgment to say, at this point with this person, I actually think the most important thing is to help them to feel good about themselves or to motivate them to connect them with some sort of social input or to indicate that addressing their social situation might be the most important thing right now. Doing that job is... equally as important as prescribing a blood pressure tablet or starting someone on a statin or maybe referring them to a specialist. You know, it's using your professional judgment to decide the value of those two equally important things.

Tim Williams: Yeah, I agree. you know, because you have such limited time, you know, maybe your job is setting up those other colleagues to do their best work. So like the Ling workers, like the health and wellbeing coaches, you know, you get to know them, you know who they are. So rather than saying, well, you know, you're going off to see the social prescribers, know their names, you know, and I'm going to say, I'm going to send you to see Jane and this is what Jane does. This is how Jane works. You know, what do you think? Would that be something that might be useful for you? Is different to...

Ollie: Yeah, yeah.

Tim Williams: you know, sometimes I think people sometimes feel fobbed off with the social prescribe or the social prescription was actually like you say, if we knew that it was at least as valuable as anything else that we do, then then we would prioritise it and we would get good at how we talk about that with the people that we support, I think.

Ollie: Yeah, completely. to be honest, you were hearing you say that it is such a relief to have those facilities available. And I'm proud to say in our primary care network, we have a really robust social prescribing team, nearly five whole time equivalents, which is lots of people, part of an even bigger team, that really provides robust facilities. And we have a number of health coaches as well. I don't know why I do, you know, we have a pain clinic, you ⁓ know, sort of, support diabetes self-management, support diabetes education, we run pain cafes, run peer support education, and health coaches and social prescribers alongside sort of GP assistants, those sort of roles make those things happen. We do have to invest in them. And I find it so reassuring to know that we have a robust setup to do that. Because you can't just do this stuff on your own. You know, there's so many GPs around the country or practice nurses. who are frustrated because they know this stuff is important, but they don't have access to facilities that can make it happen well. So there's still work for us to do on that front, I think. I'm very grateful for all the national leads and the National Academy of Social Prescribing, ⁓ Charlotte Osborne-Ford, Bogdan Chiva-Gradkac, sorry, I've probably really butchered his name, but Bogdan. People like that who have been driving social prescribing, people like Hussain. You know, just putting stuff out on social media, continually pushing the value of it, it makes such a difference.

Tim Williams: great. Well, I'm conscious of time, ⁓ ⁓ my goodness, I can't believe that time has just flown. ⁓ is there anything more that you want to share about kind of subscribing

Ollie: YUM! I think we've covered everything that wanted to cover there, Tim, actually. Let's just keep going with it. Let's keep growing the number of link workers. Let's keep growing the number of health coaches. There's been 5.5 million social prescribing ⁓ contacts since the NHS set up the scheme. It's well exceeded the 900,000 they wanted to achieve. And it's growing and sustaining, I think, because people see how much it works. ⁓ going. And thanks to all the people that driving it.

Tim Williams: Yeah, and I agree, it's a bit like, you know, we were talking about kind of, I'll empty kind of shining a light on what matters to you and having to continue to do that. So I'm glad that we had the kind of, we've managed to have a conversation about the social prescribing day. That feels like a really important thing to have marked and a way of keeping that spotlight on what we think is the most, you know, one of the most important things that we can do in the healthcare sector.

Ollie: In fact, you know what, I've thought one last thing, have I got time to do this? That, you know, the best book, I have to promote the best book around social prescribing, The Connection Cure by Julia Hutz. I am a bit biased because there's the story in there about myself and Frank, my friend Frank, who I've learned so much about. And if you want to hear a collection of stories, but also principles and sort of actually very robust system changes that have gone on from around the world. That book, The Connection Cure, is a great read. So if there's one book I'd direct you towards, that would be it.

Tim Williams: ⁓ now that's made me think, Oli, because there is another book, there? The book about Froum, you know, the town that beat loneliness. And I'm just trying to think.

Ollie: ⁓ yes, yeah Helen Kingston and Gillian Abel down there in Froome.

Tim Williams: Yeah, so again, a really inspiring book. mean, it wasn't kind of social prescribing as such. They had these kind of community connectors, know, people in the community that kind of knew what else was going on. And again, there's lots of different ways of doing this, isn't it? But that was another inspiring book, I thought.

Ollie: Let's finish it there. Two great books. So that's The Connection Cure by Julia Hutz. And what was your one, Tim?

Tim Williams: Was the town that beat loneliness, but I'm just trying to think if that's the title. But anyway, if you put that in, I'm sure you'd find it.

Ollie: Brilliant, great chatting with you, Tim. And we will be back next week with another interview. We've a fantastic interview with a lady who overcame chronic pain herself. Really fascinating to hear someone's real life story, builds on what we've talked about today.

Tim Williams: and you. Great. Okay. See you.

Ollie: Cheers Tim.