ollie: So as many of you know, on this podcast, Tim and I aim to mix up conversations with thought leaders, people who inspire us, and having a bit of a banter and a chat between ourselves. And this week, it's back to the two of us. We've been out of the hot seat for a while, ⁓ and we meander around some of the different, in fact, we review some of the podcasts that we've had recently, particularly the one around patient activation, which we did with Alf Collins and Jag Mundra, two great thinkers in the field.

Tim Williams: Hi Ollie.

ollie: The pauses who's going first? Tim, it's lovely to see you.

Tim Williams: Well, we're still a world trade. We don't interrupt, we, Ollie? That's the thing. We don't interrupt each other.

ollie: We could have just sat here just making kind of, know, encouraging eye contact at each other, couldn't we, for the 40 minutes? But it's been a while since we've sat down, the two of you and I, haven't we? We've had some fantastic interviews, which we might come to in a minute, but it's lovely to be sat here just having a chat with you, Tim. So that was worth having a review and recap of. And then the one around GLP1s with Nicky Coughlin. Again, such a hot topic. We thought we'd dive down a little bit into that. And that's taken us through other areas where we talk about some of the things we've been doing recently and some of the thoughts that have been going through our head. So hopefully you'll enjoy this session with us, perhaps give you little bit of a recap of what we've been doing and where our thinking has been over the last few weeks.

Tim Williams: Yeah, it's great to be back as well. I know and there have been some really great conversations you've had. So this might be a little bit of a come down. I don't know. I don't know. We'll try and keep people interested in what we've got to talk about because it'd be good to review that. So what have you been up to though in the interim? I you've been interviewing some people. been great podcast material there, but what else have you been doing?

ollie: Yeah, what have I been doing? I've been to a few conferences. I went to the Move More conference in Sheffield, which was fabulous to see. This is a movement that started with Olympic legacy back in 2012, in even before that. And it's been going strong in Sheffield. The baton's been handed on a number of times. And it was just great to see 200 people gathering around. keeping, know, helping to keep people physically active and more importantly it was more around systems that keep people physically active. I think we're moving away from, you know, individual having to be more active to how does a whole city support people to make it easy to move more.

Tim Williams: Yeah, so exactly. it doesn't matter, doesn't it, how motivated people are to move and whether they've got the capability to move, but if they've got the opportunity to move and the systems aren't set up to do that, then guess what? They don't move more, do they? I saw a lovely clip of you doing some lovely kind of move and movement. I think it was kind of almost like a dance that you were doing. So, yeah.

ollie: ⁓ that was, it was great. I mean, it was one of those things where you sort of, you think, ⁓ yeah, no. Is it a bit of a sort of nice to have a little movement break? But this is Tracy who runs a community interest company around getting people dancing. I've been to some of her stuff. It's fantastic. She does great stuff with people recovering from strokes and other sort of rehab sort of situations, often just sitting in chairs, but actually it's quite hard work. And you realize that, you know, just with a bit of imagination, you can get some movement into everybody's life. And I think that was the theme for me of this conference was, it's the kind of music systems and the community kind of sort of enthusiasm and support that really makes this sort of stuff happen.

Tim Williams: Yeah, it reminds me of that conversation I had with Callum Lees, you know, and again, he's all about kind of movement. And again, you know, us as professionals really taking the lead with that. So again, if patients and people come to see us and all we're doing is sitting around, being very active, then I think that doesn't communicate the right message. So he would say, you you start with yourself. But you don't have to go and join a gym. It's just about doing a bit more movement.

ollie: Yeah, absolutely. I think that's great, isn't it? And I think it's about everybody finding the thing that works for them, isn't it? And there's so many opportunities now, but allowing yourself, I most important, allowing yourself to enjoy it. If you're doing something that you really just think is a sort of, ought to do it and it's, you really don't enjoy it whilst you're doing it, you're never gonna sustain it. Yeah, so having some fun and some camaraderie really helps.

Tim Williams: Yeah, great. So you've been to the Movemore Conference and you said another conference as well. Have you been to see?

ollie: Yeah, I went to the Sheffield Teaching Hospitals, what matters to you conference? beautifully organised. Alain Tiefoula, one of our friends and fellow GPs has been leading that in the hospital for ages. But again, amazing to see a huge number of people there from the hospital. There are two sessions, morning and afternoon, which they repeated. So they must have had sort of three or 400 people across those two sessions. Again, it's really taken hold in that whole system, this theme of a hospital that's focused on what matters to you. They've written it into their whole next 10-year plan, their Care 2035, and it is that real, know, how do we as, again, as a whole system adopt a culture shift towards this approach.

Tim Williams: Yeah, well, that's really exciting. And I know I wasn't able to go to that conference, but I did. I am involved in training the trainers. And again, that's really exciting. You know, it's all very well for us to to train people in organizations to have what matters to you conversations. And we delighted to do that training. But even better when the organization takes it on as as as Sheffield teaching hospitals have done and then invest in their own trainers. ⁓ And I'm so excited about the trainers that we've got. We've got five trained.

ollie: Yeah, how's that going, Tim?

Tim Williams: ⁓ my goodness, they are so passionate ⁓ about the work and they've all got their own kind of personal stories as well that kind of they weave into the training and just kind of bring that learning to life really. So I'm really excited. I'm really excited. I think we've got our first session. So they've been through the training and now we've got our first session. I think it's, where are we? In two weeks time, in two weeks time. So where two of them are going to kind of go live with the training and I'm going to be in the background ⁓ as some support if they need it, which I don't think they will. But yeah, really excited. And actually having taken the teaching and the way that we do it and actually making it their own, I think that's the most exciting part for me. Yeah.

ollie: Yeah, so I suppose we have got a bit of skin in the game here, haven't we, with Sheffield Teaching Hospitals and with a few other places as well where we are inputting a little bit of education. So to actually say a bit more about that, Tim, so ⁓ what are we actually doing there with Sheffield Teaching Hospitals?

Tim Williams: So in terms of the, do you mean in terms of the what matters to you training? Yeah, well, I suppose what we're trying to do is have that what matters to you conversation as kind of part of how Sheffield teaching hospitals do stuff. So whether you're arriving and it's kind of at the front door or whether you're having some major kind of surgery or whether you're having some rehabilitation, that everyone in that journey

ollie: That's what matters to you.

Tim Williams: is very focused on you and what's important to you in that moment. So sometimes I think we as professionals and we can try and kind of, we're trying to move people along our process, aren't we? And it's all about trying to fit people into the boxes that we've got, which are very convenient for us, but maybe not that relevant to the people that we're working with. So how do you have that what matters to you conversation? And for some of us, it's kind of maybe a little bit how we do things anyway.

ollie: Mm.

Tim Williams: But for some people actually, and this has been a bit of a surprise, is that some people find it really difficult to get into that conversation. So our training is about why it's important, why we need to do something different, and then how do we get people into that kind of conversation where they feel safe enough to share what really matters and we listen to that really well, but also respond to it and do what really matters. ⁓ And it just makes such a difference to people's experience of their care. Just because someone has taken the time to find out what's going on for you in your life and out of all of that that's going on for you what's really important right now. Even if they're not able to do anything about that situation, the fact that someone's taken the time and it doesn't take very long just to get to that point, I think people feel better looked after, better cared for and they have a better cared experience. And also the experience can be tailored

ollie: Yeah.

Tim Williams: to what matters to the person, which it doesn't get that much better than that, I think.

ollie: Yeah, I think we're definitely sold it out. And so we wrote that sort of half day course, didn't we, as a sort of introduction to everybody in the system. And SDH now sort of doing, like you say, a train the trainer program and rolling it out for as many staff as possible. Like you say, from the front door, so receptionists and healthcare assistants. his support maybe even right up to those conversations that a consultant in ETHIS might be having or a surgeon or a manager might be having with their team. So it's across the whole system, right?

Tim Williams: Yeah, and I think sometimes, I think even people who are really, really experienced, think sometimes what happens is that almost that bit just kind of gets pushed down. And so even those people who are super experienced, they come on the training and they get just a reminder of like how important it is because they get to have a what matters to you conversation with each other. And they realize how delightful that is that someone has spent five minutes just listening to what matters to you.

ollie: Hmm.

Tim Williams: And as well as improving the care experience for the people that they are supporting and looking after, they also have what matters to you as part of their appraisal kind of process as well. they have what matters to your appraisals. So again, this is not something that is just for the patients. This is also for your colleagues. So you're having better conversations with your colleagues. And that has been one of the other delightful parts of the training actually is when you get teams together and

ollie: Yeah.

Tim Williams: maybe for the first time they are having what matters to you conversations with each other and you can see the level of trust just builds because they now know what matters to each other, which is great.

ollie: Yeah, brilliant, brilliant. I love that. It's great you've been doing that train the trainer with them. And we're of course starting with a few other sites as well, aren't we? But the fact that it's, yeah, it's a double. It's a double win, isn't it? You've got better skills working with patients and improving patient care, but then that same skill set is applicable colleague to colleague and appraisals or line management, or even just conversations with each other that improves the quality of the relationships and the listening and stuff. Yeah, great. Wow. And it was fantastic, to be honest with at that conference. you know, the chairman of the board ⁓ was at that conference all day and basically, you know, sort of couldn't have been more enthusiastic about this being the way he wants the hospital to go. So absolutely fantastic to just to see that commitment from the senior board right the way through the whole hospital teams. Brilliant. Wow, this is... Go on.

Tim Williams: Yeah, I'd love to. Yeah, go on. I'd love it to be kind of mandatory training, you know, but not like the mandatory training that everyone goes, oh, yeah, not that. Wouldn't that be great though? If actually when you joined an organization, part of your induction was, part of your, you know, is this is the way we do things and here's the training. Anyway, I'm not going to put suggestions to them like that, but.

ollie: the health and safety stuff or the movement and handling or yeah, yeah. Yeah. No, well, it seems to be that's what they're sort of doing, isn't it? 15,000 staff in Sheffield Teaching Hospitals and, you know, they're training their own internal trainers so that they can hopefully build that in as part of business as usual for them, you know, throughout as much of the system as they can. Wow. We better move on, Tim. We could talk about what matters to your day, we? We were going to use this as a sort of review, aren't we, of some of the... There's been some brilliant...

Tim Williams: Yeah. Yeah.

ollie: podcasts, I've been involved in them, but you know, it's really about bringing voices out to the public domain, isn't it? And a couple that really recently have really stood out to me, the patient activation one and the GLP one. But you know, you've been in more of listening mode, Tim. What stood out you? Should we start with the patient activation one with Alf Collins and Jagmundra? How did that land for you?

Tim Williams: Yeah. Well, it was interesting, wasn't it? Because you had Alf and his history, I suppose, and his wisdom, you know, that has been there for many kind of decades, actually. And he's been there from the start. And so what was really good listening in was seeing how this evolved, this patient activation kind of measure and how it was used in the early days. And then you've almost got like the new kid on the block kind of coming in. to with Jag kind of going, oh yeah, but now here, this is how we can use it in a very practical and yeah, in a very practical way. And because it's almost like being, I suppose now I'm thinking about it, it's kind of, it's been this kind of top down bit and then Jag kind of brings this bottom up actually. He's kind of said, he's gone to the people and say, okay, what's, what would be a really good question that you could easily ask people that would kind of speak to the same thing. of people's confidence, knowledge and skills. And so we've gone from this 22 question question there validated tool down to 13 questions down to 10 questions. They tried 16 quite wasn't quite sensitive enough. ⁓ But I know we've struggled. Haven't we to kind of ⁓ well, the system has struggled to incorporate those into the way it does stuff. I know there have been places where they have done it. But then here Jack comes along and go, actually, guys, let's just make it really, really simple. And if we make it really, simple. then we can make it really scalable and really straightforward for people to do. Yeah, that's one of my take homes anyway.

ollie: Yeah. Yeah, I like that. It was a lovely combination. You think of the, they could say the goat, the greatest of all time. I'd say Alfie is that experienced guru, isn't it? And he's, he has really driven this through all of us, through our whole career, isn't it? I remember he, you know, he was part of the Co-creating Health with Health Foundation and bringing patient activation into the mainstream. He was the one who introduced us into the PAM pilot. Do remember way, way back when we first started using it in Sheffield, probably 10 years ago now, when NHS England were experimenting with it. And then he, of course, as director of personalised care, he led it coming into the NHS through the new roles, through health coaches and through social prescribing link workers and that whole theme of trying to build agency and autonomy in people. And like you say, then Jag is making it real, isn't it? I mean, Jag's been around for a while. He's well himself. He's not just the new kid on the block, but he's just the way he his approach, like you say, is really new, isn't it? That sort of let's make it simple. Let's not necessarily worry too much whether it's the value validated version. Sure, you can bring that in if you really want the kind of robustness of a validated tool, but let's just use quick and dirty things to get people focusing in. And here's one question, Pam has been really effective as another piece of the jigsaw, I think, isn't it?

Tim Williams: Yeah, exactly. What is it that we're trying to measure here? And one of the things that we talk about is about how you tailor your care. Well, again, if you can get an idea of how to tailor your care from one question, then let's use that. If that one question can also, you can use that as a measure of the impact of the work that you're doing, let's just use that one question, which is, know, I think. Yeah.

ollie: And it's really effective. There's nothing like putting it into your own practice. I mean, I've been running a community pain clinic for the last year and we decided to use that one question, Pam, you know, how good are you at looking after your health? Just really simple question with the answers of not very okay, good or excellent. And I noticed the shift in people when they move from either, you know, really typically what they come in, they say they're okay looking after themselves and they move to good. And that is a really interesting change. And you can say, ⁓ and I noticed that, you know, when we've first time you say you're okay looking after yourself and now you say you're good and they go yeah I am I've got better and you can just feel that you can feel that confidence in the way they answer it back to you yeah yeah I have I'm good looking after myself now and almost that feels like it's the kind of key shift in people because after that everything just sort of flows and they start to find their own stuff and they start to things into practice and but it's it's great just it does in my experience it does back up what I see in people.

Tim Williams: Yeah, and I suppose that is where it's good for them to see that it's also good for us to know that the work that we're doing is in some way impacting ⁓ in people's kind of perception of how good they are looking after themselves. ⁓ Yeah, so it's

ollie: Yeah, no, completely. It's a great one for health coaching, isn't it? Because you wonder what does health coaching do? know, what is it? What is actually achieving? And sometimes people are worried about is it going to stop people turning up at A &E or is it going to reduce the prescribing or whatever? And we know ultimately it does. But of course, initially, what health coaching does is help people to feel more confident themselves, isn't it? You know, this skills, knowledge and confidence to look after yourself is a great first step, I think. So having a way of measuring it and capturing change. it can really underpin the first steps of whole system change, I think.

Tim Williams: Yeah. So yeah, and again, there was a paper that you had written, again, with them as well. And again, I don't know if you want to say a bit about that because I think that was really helpful in terms of this new move to kind of neighborhoods. What I loved about the paper, which again, people can get to on our website, on our blog page, there's a longer read there. And what I loved about it was that it wasn't just here's a whole lot of theory, it's kind of here's some practical points. that actually if you're starting to work in neighborhoods, here's some things that you could practically do that shines a light on activation.

ollie: Yeah, no, I was delighted to have shared the authorship of that with with Alf and Jag and that's really what led into last podcast, actually, I don't know if that came across. In fact, we were talking with Manal Bakai when she was leading the NHS neighbourhood programme, the NHIP programme. And she she had specified that people activation was a core part of neighbourhood development. She'd done a lot of co-production, a lot of co-design and then I really emerged strongly, not surprised. So she'd asked Alf and Jag and myself to write a bit of a pragmatic sort of overview for emerging neighborhoods. And it was a great process and it was a real shame because Menal changed her role in Itchis England and it was going to be sort of published in their domain. So was very generous that Alf and Jag said, let's get it out there, put it on your website. So we'll put a link in the show notes to the paper. But we tried to make it really pragmatic and really doable. And one of things that really I was particularly proud of really with this is that we talked about four domains where activation or the concept of activation comes out. And I think this is around thinking about systems and, you know, integrated neighbourhood teams are really going to be an opportunity to think about how systems work together. So we thought about these four levels where activation is important. So, you know, on the personal individual level, for sure, as we've talked about, you know, building someone's individual, you know, confidence and knowledge build around what matters to them. But then on other levels as well, so on a group level, a service level, and then on the community level. a group level is how people work together socially, so whether that's peer-to-peer support or group consultations or group education, that you focus on the dynamic of how together people build their activation. And then the service bit, I guess, is how you design your service purposefully. Do your clinicians value activation and the value of building people's agency and autonomy? And are your systems set up to measure whether or not you're doing it and whether or not that's actually happening? And if it's not, how do you tweak your system? So it's real, the whole team and sort of pathway design together. And then the last one really is, is your community activated? And I think that brings in things like the value of social prescribing and attention to the wider determined to health like housing and finance and access to know spaces to exercise in green spaces blue spaces and that I guess is wider than just the NHS it involves the local authority it involves you know all those community groups that contribute to health in general health and well-being in general and so I was really proud of the fact that we were trying to describe a whole system approach but then went into really pragmatic, of easy, easy wins that Jag is so good at.

Tim Williams: Yeah, and think that's the key, isn't it? the thing that kind of has got in the way of, think, the activation being taken forward and focused on has been the slight clunkiness of the measuring tool. But now actually we've got something which can, well, maybe give us a bit of an idea about someone's activation just from that single question. ⁓ I think it feels doable. And what I loved about what Jack was saying when he was on the podcast was... was actually, if it feels like, if you feel like you're not making progress, it's because you're aiming too high. So just bring it down to, it's a very kind of way, he speaks like a coach, doesn't he really? like, if it feels too difficult, just bring it back, bring it back, make it, what's the easiest thing you could do? What's the first step? What's the easiest first step you could make towards this thing? So let's not make it too hard, let's make it too difficult, just bring it right down.

ollie: Yes, yeah, yeah, absolutely. He's a master of that. you know, he's going to go again, sort of four steps of how you might sort of, you know, integrate this into your system. So I'd really love people to have a look at that paper and to sort of, you know, tell us what, tell us what you think. I mean, hopefully we'll get it more widely published. It would be good to have proper sort of peer scrutiny of it. But yeah, for the time being, please do keep using sort of LinkedIn and social media and let us know what you think and, know, sort of I know we'll all be very much involved in this emerging conversation because it's emergent, it? Neighbourhoods are developing, our approach to integrated care is developing, but we need to keep the dialogue going.

Tim Williams: Yeah, just the one last thing on that before we move on is what I loved again in the paper was about the attention not just to patients and the people we're supporting, but also our staff and kind of thinking about kind of staff well-being and staff activation and paying attention to that. And again, you know, using things like, know, that kind of that single kind of measure of, know, you know, is I'm just trying to think of it. Is this a good place to work? What's the question? Does this feel like

ollie: Yeah. Yeah, we did some employer net promoter score thing actually, which is, which is.

Tim Williams: That's right. How likely are you to recommend this place, this, this is a place to work? How likely are you to recommend this as a place to work? Lovely question. And then the follow-up question, like what's one thing that would improve your score? Again, it's just a little nudge. One, we're interested in, we're interested in what you think about this place to work as is we are interested in how good are you at looking after your health? But then the follow-up question is like,

ollie: Thanks. Yes.

Tim Williams: What's something that would help you look after your health better? What's something that would make this place a better place to work? It just gets the conversation going, doesn't it?

ollie: It does, and it's that coaching style of inquiry, isn't it? And I think what's... What's great is this is not just limited to healthcare, isn't it? You actually those sort of questions you can bring into workplaces and you know, where we're starting to see health coaches go into employment settings, those sort of questions are generic across that. So, you know, if you've got someone in the workplace and you're coaching them and you're helping them feel better about themselves, actually they often feel more engaged with work. They're more likely to recommend it as a place to work. And that's a great marker of how you're creating a system where people thrive in the workplace and we know we're not going to go into it now I know but you know all those associations then with increased productivity, reduced absenteeism, reduced staff turnover are really good for businesses as a whole so this is really is a win-win all-round but these are sort of generic skills I think that are very applicable across lots of settings.

Tim Williams: Yeah. So I think we do need to move on. But I think the other podcast that kind of stood out recently was the one with Nikki, which was the metabolic health and GLP-1. So it's about GLP-1, wasn't it, specifically, because she had loads and loads of experience of, well, I think it sounds like she was there before it became big almost, really, in terms of her support for people who were taking GLP-1. Let's say a bit more, Oli.

ollie: Yeah, completely. mean, yeah, before it was really super trendy, wasn't it? I mean, it's crazy, isn't it, to think now that, know, so Nikki Coughlin, she's, she defines herself as a GLP-1 coach. And she's been doing it for over five years now and was working with a company in Ireland that was one of the pioneers of prescribing GLP-1 injections, as it were then, there's oral tablets now even, but giving really good wraparound support, which is interesting, isn't it? That wraparound support is

Tim Williams: Yeah.

ollie: increasingly being seen as the enabler. I love the way Nikki put it, she talks about the drug giving you a window of opportunity, but actually how you use that window of opportunity is very much around how you're supported and how you deal with a whole lot of the other human stuff that sits alongside the kind of the chemistry and the kind of pharmacology that you're adjusting with the medication. Yeah, was a pleasure, real pleasure to talk with Nikki.

Tim Williams: Yeah, and I know when GLP ones were first ⁓ kind of ⁓ being used for weight loss specifically, I remember feeling really like my heart sank a bit. I have to say, and be honest, that actually I thought, ⁓ no, here's another kind of quick fix. But I have to say, I've been on a bit of a journey with that. And I think a lot of the health coaches have been on a bit of journey with that as well. Because I remember a supervision session and someone was like, ⁓ well now they've got these injections. Now people aren't really engaged with health coaching. And there was that kind of

ollie: you Yeah.

Tim Williams: that feeling. But actually we turn the conversation around and actually people were thinking actually this is a real opportunity. You know if people are using these medications then let's see what can a health coach add to that and of course what a health coach can add to that is loads.

ollie: Yes. ⁓ well, that was the thing that came out with I mean, Nikki is part of our GLP one course now as well as I've had the chance to do it teaching with her and do the podcast with her and the thing that's really the penny drop for me has been around, you know, the way the GLP ones work is they sort of block your, you know, sort of, they block them in the brain and the stomach, your sort of drive to eat food. And that's great, because it takes away that food noise, the sort of where a lot of people really have this pressure for food to, you to eat food to sort of like keep them, you know, emotionally regulated. But of course, if you haven't got that, how do you keep yourself emotionally regulated? And that's the really big thing, isn't it? Is that you take away this kind of like crux that food's provided for a lot of people, and you need to fill it with something else. You know, we're all emotional eaters, that's what Nikki says, we're all emotional eaters to some degree, it provides, you know, some positive feedback for us, you know, it's often social, or it's kind of like just downright enjoyable. isn't it to have a meal or just a food that you enjoy so you take that away and how do you cope with that? And so that's where health coaching really comes in. How do you manage your emotions and how do you manage? One patient that Nikki said, she talked about, it was like losing a friend. So you sort of block that kind of friendly support that food gives you and there's a massive hole in your life. So you can imagine, can't you, how health coaching can be really helpful about helping people navigate the emotional side alongside, if you like, the kind of purely drug effect.

Tim Williams: Yeah, and also, of course, we know the importance of maintaining muscle mass and all of that as well. So again, there'll be other things that health coaches can support people in, being aware of that, but also, like you say, at the emotional side. So it feels like a real opportunity. So I'm glad the conversation has shifted. And also my mindset has shifted. So I'm glad that's happened because I can see that there's real potential here. And I gather that, and again, this came across in the podcast, that there's maybe moves to start to use it in addiction.

ollie: I'm going to reset.

Tim Williams: kind of work as well. So again, that's all very interesting. but it's not just the chemicals aren't enough, are they by themselves? You can imagine it's hugely complex. And therefore what you need is someone like a health coach who's got lots of experience in how to help people think really well for themselves about what they're going to do, how they're going to fill that gap. What are they going to do now that that food noise has died down? Yeah.

ollie: Yeah, no, I think it just emphasised to me that we're always on a journey, we? You whether that's a, you know, you're on a journey of weight loss or obesity, know, obesity management, which is really a lifelong sort of, you know, sort of a commitment in a way, really, isn't it? How we manage ourselves. It's very variable, you know, it's a journey. It's not just a one-off thing, an intervention, it's a journey. And I think, I feel like we're on a journey as clinicians and as a system as well, aren't we? And I'm seeing emerging, yeah, this feeling that it's not just a drug. It's the wraparound support that's really important. And I even saw something on LinkedIn from Eli Lilly, which is who are one of the big manufacturers of these drugs and they're they're starting to team up with, you know, the behavioral support platforms, which by the way, usually include some human element in there as well. It's, you know, we could I'm seeing this this kind of mix of, you know, sort of AI led health coaching. Fantastic. I've used it myself. I'm really impressed. But even the biggest company are looking at the importance of having some human element in there as well. So it's really interesting to see this evolving.

Tim Williams: Yeah, and it is a challenge. mean, this definitely this came up in supervision recently. What was that kind of question for someone who was it was supporting people ⁓ was supporting ⁓ people via text and how interesting that is, you know, and how do you build rapport? How do you build that trust just via text messaging? So again, it's going to be an emerging kind of skill for people to be able to do that. But interesting, you know, not.

ollie: Yeah, how fascinating. that was in supervision. I obviously can't reveal too much, but what came out of that then? Where did the conversation go? That's fascinating.

Tim Williams: Well, it was interesting. We didn't get to that question. It was just, but it has sat with me. It has sat with me because I'm thinking, yeah, how do you do that? Because we rely so much, don't we, on body language and, you know, paying attention to the tone of voice and all of those kind of things and everything that kind of communicates meaning. And some of that is stripped away, isn't it, when it's just a text message. It's even more stripped away than even like a telephone call. So.

ollie: Yeah.

Tim Williams: We didn't get that. I'd love to have that question back. So hopefully that person will come back to another supervision session and we will kind of tackle that question because even though that's not most coaches experience, they're not doing that. I do wonder whether it's something that we need to explore. It's a little bit like, how do we support people who are using coaching AI tools? You know, how do we support people who doing that? Because it's not like, ⁓ well, if you're doing that, you don't need me. Course you do. Course you do.

ollie: Yeah, yeah. Yeah, it's a fascinating time. It is a fascinating time, isn't it really? Because you've got so many different modalities. I guess once you've got that coaching mindset that you're going to try and help people to discover what's going to work best for them. I like that Tim about the supervision even. You didn't answer the question. You just raised the issue and I guess you're all going off to think about it, maybe come back to it next session. But you've got asynchronous stuff now, haven't you? Whether that's a text from a human.

Tim Williams: because we need the human element.

ollie: you know, an automatic message coming out from your GP or of course, you know, AI chat bots now that we're all interacting with, you know, it's so many of us are using them, aren't they? And, you know, there's the one I'm using, there's no tone of voice, there's no, there's the sort of the turn of phrase in the messages coming back, which is very impressive. But, you know, it's totally asynchronous, isn't it? You can put it down, you can have a conversation over the period of a week, you can have a conversation of a period of 20 minutes, you know, and it doesn't forget what you've said. it kind of recalls and it's just fascinating the different levels of modality of interaction you can have, you know, but of course then it doesn't have that same sort of warmth and... to some degree vulnerability that you have with talking to another human live in person where you can see each other's body language, all like this over Zoom, you know, where maybe you've got eye contact and you've got some movement, but you've not got quite that in the room rapport. There's just so many different modalities that we can use now, aren't there?

Tim Williams: Yeah, and I suppose it's got no, it's got no, well, it hasn't got empathy. I it has got no idea what it's like to be human. And again, yeah, the AI.

ollie: What, the AI? Yeah, no, that, we're gonna, I know I think I'm planning to sort of have a bit of a session on this, maybe a ⁓ panel discussion or a group debate. I'm work out what we're gonna do, because I think this is such an emergent area, isn't it? Where do AI chat box and AI health coaches sit alongside human coaching? I think it's a fascinating area, isn't it?

Tim Williams: Yeah, and again, it's been an area for us to engage with and see where it goes. You know, we mustn't ignore it. bit like how we've maybe moved our viewpoint a little bit with GLP ones. You we need to kind of see where the opportunities are to add value rather than dismiss it as either this or that. I don't think we'd be thinking like that now.

ollie: Yeah, no, I mean, it's interesting, it? sorry, you started to talk there about what you think the sort of differences are then between an AI health coach and a human health coach. I know it's gonna be an ongoing conversation, it? What's your thinking at the moment then,

Tim Williams: Well, think there's, yeah, I suppose, I mean, you've had more experience because I think you've been using that for yourself. So I'll be interested in your views on that, really. because I Well, I've got, you know, I've got assumptions, you know, that actually maybe there might not be so much challenge potentially, although I'm sure you could set it to be more challenging. But I don't know how well it will sense, you know,

ollie: ⁓ nice turn around. ⁓

Tim Williams: what you're coming in with because it doesn't have that empathy, but you've got more experience.

ollie: Well, I've been deliberately putting myself there and I've used some of the just off the shelf, know, just a simple pay version of ChatGPT and had some very interesting interactions, particularly when you think about the sort of prompts you might feed it with to kind of encourage the large language model to use coaching style techniques. But then I've also been using some of the packages that have been set up as well, deliberately set up and... I sort of didn't want to like them, do you know what mean? I wanted it to be a sort of failed experiment. And interesting, I've seen Ben Allen talk about the failed experiment of an AI receptionist that just can't replace that kind of like deep connection that receptionist makes to the patient. But these tools have worked really nicely for me actually. I've been, you know. unfortunately, pleasantly surprised. And you have to embrace it because this is the future, isn't it? It's going to enable people.

Tim Williams: Yeah.

ollie: to have many more people to have coaching style conversations. ⁓ But what fascinates me is where does the human fit in? I think that AI, no matter how good it'll ever get, can never actually have that shared human experience. won't know what it's like to have guilt, fear, shame, anxiety, ⁓ feel stupid, feel elated. It just won't ever have that shared experience of being human. So there will always be a block to how far you can go with it I think. But it's great helping you to hold you to account, know, scaffold what you're doing and how you're doing it, but maybe it's not so good at the deep emotional bit of why you're doing it. So I think how we work out where fellow humans hold each other to account and explore the deep emotional bit alongside, you know, the sort of democratisation of access to coaching style approaches is really interesting.

Tim Williams: Yeah, and I'm also now thinking, obviously, mean, trained as a time to think coach. And I think a lot of that is about how do you hold the space? How do you hold the silence? And I wonder whether that's something where the human really, yeah, is able to do that. A well-trained human is able to do that where a machine just doesn't in the same way, because it's different sitting in the same space with a human.

ollie: Yeah.

Tim Williams: holding the space for you as opposed to, you know, a chat bot which is just silent. It's not quite the same, I don't think.

ollie: Yeah, no, no, no, no, no, no, big fan, we have Nancy Klein's time to think, know, what is it that creates an environment for human brains to think well? And I think some of these tools are going to support us, but we've got to be careful that they don't undermine our ability to think well as well, because ultimately, that's the that's the bottom line, isn't it? It's it's around I mean, I love it. I saw a thing just recently again in OpenJama where they were looking at using wearables and sort of like feedback, biofeedback, whether it's from blood tests or wearables or whatever, coupled with some coaching, some of it automated, but some of it human. And what I really liked about it was that the end outcomes were how much you valued yourself, how good you felt about yourself. It was in sort of the context of burnout at work as well and ⁓ Did people appreciate and enjoy their work, feel their work was meaningful and manageable and those sort of things. But I think the focus on people's sense of self-worth and self-value and as Nancy Klein would say, how well they're thinking is really crucial. yeah, good if we're kind of focusing on the right things.

Tim Williams: Yeah, well again, and we've talked about this previously, but that kind of that hierarchy that we think is really important, that kind of the base of the kind of of that triangle is self belief, self efficacy, self worth. And actually, if you don't have that, if you don't invest anything in that, then it doesn't matter what else you do in terms of health behaviors, because they won't last if you don't think you're worth it. So we have to invest in that part, I think.

ollie: Yeah, completely, completely. Amazing, amazing. Well, Tim, we wondered if we'd have much to banter about, but we've managed to kind of fill a good 40 minutes or so, haven't we? And it's, I wonder if we should sort of draw to a close. Is there anything else that you want to add, Tim? Anything that's been going through your mind recently?

Tim Williams: No, I think that's a good time to end. Again, there'll be some more brilliant podcasts and interviews coming up. So again, please keep looking into those.

ollie: ⁓ yes, you've recorded one with Paul Haasman? Is that one coming up soon Tim?

Tim Williams: Paul Houseman, yes, so that should be coming up soon. again, I think this may be, yeah, we'll have to see kind of which order we release them. But yes, I think Paul Houseman, which again, he came to speak at our conference and he's got a lot to say about how you look after staff, how do you look after your team? So lots of really good stuff and insights from him.

ollie: Right. Yes, I think this is coming next and he'll be the next one up. yeah, fantastic what Paul's been doing. And of course, he's been spanning really, isn't he? The sort of health sector and the workplace sector and workplace support. So, so much coming in together. I'm looking forward to that one. Tim, it's been an absolute pleasure to chat again. Enjoy the rest of your week.

Tim Williams: Yeah, annually. OK, see you later. Bye.

ollie: Take care.