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who fancies some northern soul. Well, that was a bit pathetic. Really? I thought there'd be a singalong bit of dancing anyway. Why did we play? A bit of Northern Soul will be We played a bit of Northern Sole because we're going to listen, uh, to a bit of northern soul quiet. Thank you. Thank you so much. Yes, we played a bit of Northern Sole because we're going to be listening to a bit of northern soul. We're going to be discussing, uh, the big deal, which I think has been talked about at least four or five times on stage already. So we've been talking about it. Um, it's been referred to what really is it? Well, there are. We couldn't have to better people to describe the wig and deal. It's Genesis, uh, what it is, how it's evolving, what it's achieved than our to speaker. So I think we're going to do a double act. Is that right? Fantastic. A kind of duet. A Northern soul duet, if you like. Uh, so we have Allison Mackenzie Fallen, who's chief executive of Wigan Council, and Professor Kate Arden, who's outgoing director of Public Health. Wigan Council um, please welcome them. Thank you, Matthew. I didn't want to dance. I'm too embarrassed and too shy, but I think that's the first time we've come on stage to the northern soul. So Excellent. Thank you. So thanks, Heather, for inviting us. It's great to be here. Kate and I have worked together for 14 years. Um, so we've been on a bit of a journey together. Unfortunately, the 14 year journey, we can probably only share in about half an hour today, so we'll do our best. I would point to the King's fund report. If you want to read that, there's a lot more information about the work that we've been doing in Wigan in terms of our citizens lead approach to health and care. So please read that if you get chance. We're also running a session this afternoon, so forgive me for those who are coming to that session, but we'll get a chance this afternoon going to much more detail. And also, if you're interested, please come to Wiggin. We love to invite people to come and talk to us for us to reflect and for us to learn to. So, uh, we love learning from others. So if you fancy a day and within come to Oregon and, uh, we can exchange views and reflections and hopefully learn lots together. Okay, At this point, I'll check the slides work. So, um, I have I have to be as the chief executive and place based lead a bit of walking adverts. So forgive me. I'll do a bit of a who's been to Wiggin apart from the fact that you can't do nothin soul. So we've got a few in the room, so I've got to like that. I have to keep taking my glasses off a few hands up. Well, come to Wicked. Now you've had an invite, so we aren't just wiggling. We are 14 proud towns and we we celebrate all of them a great location in the Northwest and the heart of lots of music, but particularly Northern Sole and many people who know we will. We are an X mining community, But now we've got the most beautiful green spaces. So another reason to visit nearly as beautiful as here. Um, and many of them are old mining spaces. And we just launched a national nature reserve from some of those reclaimed mind. So it's absolutely beautiful, rich industrial heritage, but also amazing sporting tradition. We are currently hosting the Rugby World Cup. Um and we hosted the women's euros. We've got two great rugby teams, brilliant football team, but really, really importantly loads of grassroots sports clubs. And it's all about communities. And if we've got any of greater Manchester in the house, anybody here from GM, few part of team GM as well so you can't talk about with and without talking about Greater Manchester. So we are 10 local authorities who work really, really well together in the greater manage to combine authority. So that's my walking advert for with, um, a little bit about us in terms of our people and what we are doing to work with our people were a big council. So 320,000 residents, as you can see there are population, is aging, and we do have lots of issues in terms of deprived communities. And we're a big a big Met in England. So one of the second largest counseling Greater Manchester in the ninth in England, and I'm afraid to say that 231 million used to be a lot more until about 40%. It was taken away from us through austerity, and we'll talk a little bit about that journey and Kate's going to go into some of our adult health and care figures. But as you can see that as a place working together in an integrated way with our NHS colleagues, the total budget is just sort of 700 million. I'm not going to talk too much about the broader determinants of health, but one of the reasons why we are doing so much work in terms of the integration piece is because we know here in terms of behavior and the socio economic factors, that's what really matters in people's lives. And that's what we've tried to do through the deal and through our integration work, and particularly now through the new ICS arrangements. Actually in greater Manchester, Eight of the chief executives are now the place based lead. So it's the local authorities who are perhaps the conveners of place, really working closely with NHS colleagues to really start to work on these broader determinants of health and also within within much of our workers for follow the market six pillars, which I know many of you will know about in great detail. So a lot of the work and a lot of our thinking which case we'll talk about. It's been two. Mirror the Six Pillars. A big, big, big thing for us has been throughout The deal journey is to have the support of our elected members. We have a brilliant lead member, Cabinet portfolio holder Keith Conliffe, who has also been on the journey with Kate and I and everybody else. And I don't think without that political support without that political backing to take some of the tough decisions to do some of the radical work to do some of the innovation. We couldn't have done it without them. And obviously they've been making those big decisions. And they know they know our communities the best. They understand where communities have got major assets and they really, really help in terms of understanding the picture. So a little bit about the deal, Um, and in some respects it was our response to austerity. Um, and as I said, we were the one of the I think in the Institute of Physical Studies when austerity started, we were quoted as, um in the top three of counselors to have their budget most cup, not trying to get into a competition about how much people have had taken out of the budget, because you can see the figure if they're over 100 and 70 million. So we made a decision to try and learn from the work that we've been doing over many years. Um, with Hilary Cottam, you may have read her book Radical Help. She done a lot of work with those working deep in communities working around people rather than seeing people as of units as needed. So we worked a lot with Hillary. We'd also worked a lot with Nestor on confident communities. So some nest innovative work about really understanding your communities. What does it take to really understand communities? And we also did some work with an anthropologist and some ethnographers who really helped us start to really understand what acid based working was. And all of that learning helped us then say Well, actually, in terms of austerity, we can't just do a death by 1000 cuts. We can't just start to slash services. We need to do something different. We need to change ourselves, perhaps from quite a paternalistic council, maybe a bit more old fashioned into something much different. So we started to bring all of these programs together and worked on the deal. And essentially, this is about putting human relationships at the heart of everything that we do. Um, and those really about trying to understand and get people to sign up to? What does it mean to have better relationships? What does it mean to have better health? What does it mean to have a more sustainable environment and how can you play your part in it? And communities play their part in it. So we started to really articulate what this was with our population with our residents and essentially talk about it all the time. About how do we really change that relationship between a big counsel, a big public service, uh, and the people in our communities and find better ways to do things. And we actually knew that all of our solutions were in our communities, amazing community groups and amazing staff. So if we could harness the power of our community groups and our staff we could actually do things in a much better way, a much different way. And it's really been our philosophy all the way through, which is thinking about human relationships, thinking about communities. And how do you put them, really, at the center of all of the redesign work, all of the transformational work, all of the staff culture and everything that we do and just a few things on the principle. So I talked about the work with an ethnographer and an anthropologist, and what we did in Wigan we really talk to our staff about what does it mean to have a different conversation? What does it mean not to go in there with a tick list of looking at people about what they can't do? Actually, if you chat to that person and know that they're interested in Spanish or art classes or sewing or singing and you connect them to a community group, it means that we're going to have a much better life. So find out what people like and don't treat them as something that they can't do, and we scale that up. So we didn't just train a few people in adults in social care. We actually scaled it across the whole organization and then across the whole partnership with primary care, with the hospital, with all of our NHS colleagues and also with the community sector. So that was really about actually, How do you go about having a different conversation? How do you know your community better? And we've got so many workers now who are community link workers working in GP practice is working in hospitals. So it's really about actually, how do you do that integrated piece to know your community? And how do we go locate in a place close to our neighborhoods and how do you build that capacity? So, actually, how do you commission differently? How do you step down some of your traditional commission, in which case we'll talk about and do a different type of commission where you build from the heart of your community and really, really important and wiggling? And something that we've worked for many, many years on is actually how do you give staff the permission to take risks and do things differently and not blame them when something goes wrong? So I asked your staff our staff have amazing capacity to know what is the right thing to do if we just give them the freedom to do that. And we've worked really, really hard to support our staff in terms of their permission to innovate. Permission to take a risk. Quick, uh, components. If you want a recipe for the deal, if you can't come and learn more about it or find out more about it and chat together. It's that narrative that's held us together and a real big belief. So it's not been a project in one part of the organization or in the N. H S or in the council. It's actually we we believe in it. Kate, don't we? It's something that we we truly believe in. So it's some and that's been part of us. Um, it has taken leadership from politicians from officers from staph from partners and making sure that we get that sponsorship change, working through the cultures and those permissions and really redesigning the system, Um, and taking on board a lot of what Sultan and Dan said in terms of embracing the things that we can do differently through innovation and digital technology. And it was a great speech, Sultan and down and lots to learn from the work that you're doing. And really, how do we then do different models of commissioning? Last two slides from me beforehand to Kate. These are not pictures on the wall in Wigan about Oh, yeah, they've got some behaviors over there on the wall there, laminated and stuck up. We chat about stuff all of the time. I mean, every new recruit that joins the organization and I talked about to them about also, What does it mean to be courageous, accountable, positive and kind? And ironically, Or perhaps, um, perhaps it was meant to be. We introduced Kate. Didn't we be kind just before coverted? Because personally important kindness in leadership is really important to me, and kindness and compassion and everything we do is important to me. So we had a chat. Um, and everybody agreed we should start talking about kindness more, and it was probably about six months before coded. But the big one there is around courageous. So we're asking people to do things differently. And we talk about what does it mean to be these things to our staff? We recruit on these, we do listening to action sessions with staph, and we talk about it all of the time in terms of So how am I going to be courageous, accountable, positive and kind? Oh, and we've Oh yes, to last slides. So too important. Other bits of the jigsaw or other bits of the journey is really strengthening community assets. And that has taken lots of nice pictures of people. We love their Kate, but what that has taken is, um, a big investment. So when we were going through austerity, it perhaps would have been easy to say. Let's cut the traditional grants to community groups, you know, Let's let's let's really sort of backing down the hatches. But actually, we reverse that decision and said, No, now is the time through the deal to invest totally in our communities. You know those investments and those grants need to change into much more about giving the opportunities for our communities to take control, letting them come up with solutions. And really, as you can see there through the through some of the figures, the economic impact on the social impact has been amazing by just those investments into community groups. Small investments, big investments, long term investments And actually what our community sector said to us, we feel like you're a counselor or a partnership, Um, that really believe in us. And without your belief, we perhaps wouldn't have even thought that we could do this. But now you're back in us. We really know that we can change people's lives in our communities. And that was probably the most important thing for us to here to say that we did believe in them. And we do believe in them. And it's really important that they do the work. So I'm going to pass on to Kate now. I think we've got some time for questions at the end and happy to explore those. Okay, it's going to go into a little bit more detail. Thanks, Kate. Well, good morning, Belfast. All right. Sorry. Good morning. Northern Ireland. Thank you. Thank you very much. Just to reiterate a couple of really key points that Alison made geography matters. Be it physical geography and social geography. And never we found out that never more so during Covidien in in Wigan the 14 proud townships that consist of wiggle borough, some of them go back to the doomsday book much older than local government or the NHS. That's the geography that matters to the community, and we tend to, with professional networks and organizational networks to impose a fake geography on communities. I think one of the big lessons for us in the wig and deal is to work with the history, the traditions, the geography that matter to local people. In other words, we fit around them, not the other way around, and never more so. And Allison will smile as much as I did when the primary care networks came in. The NHS loves to have its own geography, doesn't it? It's often different local governments. Geography. Um, you know it doesn't make sense to anyone else. One of the big leadership, I think, uh, triumphs for Tim Dalton and our colleagues in the clinical commissioning group was to persuade all their colleagues because we already worked in the twin township model based around the registered populations of schools and GPS that fitted with our 14 proud township. So it's the way the VCs see sector. It's the way we organized services in the council. They persuaded all the GP colleagues to fit the primary care networks into the same geography. Very, very, very important. What Alison and I are talking about is not a a sort of a one size fits all model. There is no such thing. And there is a sort of I think sometimes Matthew will probably smile at this. Certainly when you're dealing in the English N. H s and Whitehall a desire to look for the perfect model, there isn't any such thing. Every community, every borough has its own story. And I guess what we're sharing with you is our journey and the less some of the lessons and learning we've done from that. But it is up to you to do all of that hard work with your communities to describe your own narrative conversation I was having last night with colleagues at dinner. We get a lot of very hung up on the statistics and the numbers in the NHS. But actually to improve somebody's lung function isn't much good. If they can't go out and do the things they enjoy doing, that's what actually means. That's what health really means to people. So at the heart for us, uh, of the wig and deal was to think about other places that had actually gone on this journey. And one of those was North Carolina in Finland. North Carolina, in 19 in the 19 seventies, had the world's highest rate of cardiovascular disease. It's been very well researched by W H O. What changed was the community went to the regional government and said, Too many of us are dying of heart disease. They looked, they were spending loads and loads of money on it. This will upset any cardiologists in the room at the high end specialist treatment. And it was making not a lot of difference to population health. So the population and the regional government took the brave decision to shift investment upstream into whole societal whole system prevention, not the odd lifestyle program, but looking at the way transport was organized education, food delivery, all the things that actually make up a healthy society. And that, in effect, is what we've tried to put in place in Wigan. So what we've tried to do is to incorporate the learning from North Carolina with our work, because that was the thing that was causing the the poor rates of health. It's the single biggest cause of premature avoidable mortality in the borough. But we're also working with the Royal Society of Public Health on training Community Health Champions, because the reason people want to be healthy is not to save trolley weights in a an E. It's not to get down the elective waiting list. People want to be healthy because they've got hope, confidence and belief in their own futures and that their families and loved ones. In other words, this is about dreams, hopes and aspirations. When I first went to within 14 years ago, I used to hear a little phrase. We don't hear it anymore again, Alison will smile at this one. We used to hear a little phrase. I hate to say it. It always came from the health professionals. It's good enough for Wigan now. What they meant by that was not something they would have ever accepted as being good enough for themselves or their families. It's a bit like saying the poor will always be with us. There was a possibility of aspiration and therefore a possibility of lack of confidence in the community. You will never see that now, Keith challenged it. Alison challenged it. I challenged it because that was simply not acceptable. The saying you're here now in Wigan is only the best is good enough Wiggin. And that means who works there in the way that Alison described, but also the aspiration around the communities. In other words, believing, trusting and investing in communities is absolutely key. So we work with the R S P H to have are we now have over 23,000 community health champions in the borough from, uh, little ones, too old ones. A number of them, particularly our drug and alcohol recovery champions work through community detox as well. Okay. Got the right slide. Yeah. Um, this is just to say that just some of the quotes from people who are community health champions. We often forget if you are a high achieving graduate. I'm a double professor, but I was told at school I would never pass the exams, and I certainly never get to medical school. So there you go. My headmistress was real. Um, in fact, I think the actual words were when I said I wanted to read medicine at university. Were my dear, you'll find that That is impossible. Yeah. Quiet. I've been a doctor for 36 years, So there you go. But I think we sometimes forget Yeah, there are those of us like me who you know who are bit bolshy and we'll say up yours will go and do it anyway. But for most people, somebody actually telling them they're a failure particularly if it's done repeatedly, means they start to think like that. And one of the things we found through working in the Community Health Champions Program, which is very much that kind of empowerment engagement approach. It's a Level two qualification. So it actually helps us grow our own work force, by the way, because it's entry level to health and social care is that for many of these folks, this was the first time they passed an exam. You cannot begin to imagine how empowering that is for someone. They get to 40 50 and they pass their first exam. The absence of praise, it's very important that we could we do that right? Right. We click that. There we go. Um, the other thing we did was to work with colleagues from you know as well as the finish. Example. Some work from Seattle and heart starts are incorporating things like training and resource for kids as young as 78 through two goldens, along with health improvement training as well. There are 78 year olds. You know more about how to look after their hearts in Wigan than I did when I was went to medical school in Italy is 40 years ago. But you know, it's it's sort of just I think part of that empowerment and education is incredible. Start with the very young you know is really important. And we've done that through also working with the fantastic and inspirational Elaine Wylie on The Daily Mile, that simple concept she came up with as a primary school head. Nearly all of our primary schools do that and are early years settings, came to us and said, Can we do this? You know, sort of the under fives. So they came up with the Daily Total Brilliant have sold that one back to Scotland, by the way, uh, because they liked that idea. But the point is, it makes it fun. It's socially connected. It's getting people active, but it's doing it through the school curriculum. And we are part of the young health movement as well. Through our SPH can commend that program to you because that is something you can look at and adapt, you know, for your own sets of circumstances working with that organization. Have we made progress over the last 14 years? Well, when I first went to work and 14 years ago, every single health statistics was going in the wrong direction. I'd like to say we're still It's still work in progress, of course, but we have seen some major changes in terms of health improvement, not least in terms of reductions in smoking. So we're down to around 17%. It's gone up slightly because of Cove ID, but it will come back down again. We know, uh, we actually have the lowest routine, the manual smoking class, class smoking prevalence in the whole of great Manchester. Yet even better than Trafford and Stockport, who are wealthy, wealthy boroughs that says something around the targeting. We have got our teenage pregnancy rates down fantastic and are early deaths due to cancer, and CBD have significantly reduced. The King's fund also found that when they looked at our work in the dependently. We still have some significant challenges around adults. Obesity, which unfortunately has got worse through cove ID, partly because our adult weight management service lose weight. Feel great name thought up by the population not by me has run very much through face to face involvement of our professional sporting clubs in that particular, um, envy fact. And obviously much of that activity had to cease during cove ID. So part of the post coated recovery plan is to get back on track with that, what does it look like? Well, I wouldn't be a public health physician if I didn't show a few graphs. Um, so here is our sort of update in terms of where we are and what we've seen is a consistently upward trend since we started the deal it took, I would say around 3 to 5 years before we see started to see the impact. But it has been consistently going up and that I think you noting contrast with, for example, with uh England, where women's life expectancy, healthy life expectancy has come down. So it's actually got worse. So we have been bucking the England trend, which is quite an interesting dynamic for a former mining community like Wigan. Little bit of a sort of contrast with our neighbors in Boltons and Saint Helen's are geographical neighbors, but also statistical neighbors again. We've seen some Covad impact on this, but generally are trending. Wigan has been going upwards. Yeah, just look at that. So the the if you like if you are a sort of a little girl being born in Wigan today, generally you will have a healthier life expectancy than our neighbors. And this is just to sort of show it as a sort of trend analysis. Uh, you can see we've sort of you can see where we started off in 2009 at the left hand side of the screen and the fact we started, we went up. And then we've seen that Slight Cove effect unfortunately. But again, you'd expect that in somewhere like the northwest of England that had a particularly bad Covad experience, although, and I'm going to sort of just point out that Wiggins Covidien excess death rate, it's actually lower than England. Quite interesting that given our where we started off, this is these are taken from the latest health profile so that in this slide you can see that for England deaths from Covidien, the excess death rate was 1.16. In Wigan, it was 1.12. So just slightly below quite. And when you think England encompasses a number of very different, very wealthy boroughs, particularly in the south of England, that's quite a quite a significant finding. But it also helps to point to how we might bounce back from co vid. And I've just put here the if you like what my now successor, Rachel will be doing in terms of post Covad recovery. Sorry, I turn 60 in January, which is why I retired in July. As much as I love the job, Um, yeah, see me afterwards for for it's Clarence. I appear cursive Clarence and Andrew College, by the way. But I'm just sort of put here where we are similar to the Northwest. So if you think about things like smoking, prevalence, anxiety, happiness, interestingly, we're quite happy Borough. How that contrast with the suicide rate and self harm rate, I think, is something that perhaps wants exploring more, and I suspect There is a very particular demographic that the suicide rates pertain to you. And of course, that you're looking at small number statistics there as well. Low birthweight. We do very well. Infant mortality we've never had a particular challenge with. And, I think very Encouragingly for future health, that good level of development and even our child obesity stats are reasonably, reasonably good. They're not perfect, and they do need some work on. But they are not the biggest challenge for us. However, that focus on recovery for adult obesity is what we'll focus what will be helpful in terms of pushing the healthy life expectancy back up. And we do still need to tackle smoking in pregnancy. So a couple of last slides from me. Oh, yeah. Oh, sorry. Well, yeah, a couple of, uh, last slides from me. I think focus on marmot very, very important. Think about not just his original port for a society, healthy lives, which absolutely drove the philosophy of our politicians in particular, think about building community health alongside community wealth. That is absolutely key. That kind of investment in community skills, economy and the sort of health building determinants. Um, that kind of collaborative part partnership where we have business, academia, the community public service is all working together, and it's very much about co creation and co design. And fitting. The climate change agenda around that is is absolutely key determinant of health. So it's absolutely fits with this kind of philosophy and approach. And then my last slide think, Oops, there we go My last slide. Some key learning Find the coalition of the willing It won't necessarily be the usual suspects the local medical committee. They won't mind me saying this when I first went to work and 14 years ago wouldn't speak to me because I was a woman. When I retired in July, they gave me a crystal vase saying How wonderful my leadership was. So there you go. But it's a very different grouping of leaders in the l. M. C. Now find the unusual people the people who are radical thinkers. Um, in fact, the NHS with well, wellness Stewart, uh, director of adult social care and health, came up with that one. And yet the NHS does is good at treating and good at sickness. It needs to get good at wellness, think my colleagues who are asking the questions earlier said that I think it's also about this whole societal whole system approach learned from the early pioneers that the original Liverpool Fab Four, for example, Josephine Butlers work the work of the Peckham Center, which was the original model for the NHS. It wasn't an acute care model. Interestingly, um, and then build on that with servant leadership. I've always said I'm the person with the job title of being DPH. Every single citizen is their own DPH. In other words, be the expert on tap, not the expert on top. And that means letting go of power and control, and that, if you like some is up the approach to citizen lead Public health. Thank you. Thank you, Allison. Thank you, Kate. So after presentation like that, we can possibly do things in a conventional way. So what we're going to do is take five minutes out of your coffee break. But I promise only five minutes, but I want you to do is just to spend the next two or three minutes talking to the person next to you at the table just about what you've heard to reflect on it. And then what I'm going to do is I'm just going to take five reflections, not questions. You can maybe come up and see Kate and Allison over coffee and ask them questions. I just want reflections from you as to as to what? That presentation has kind of someone up to you. What made you think what it's made you want to do? So two or three minutes chatting to your neighbors are going to choose five reflections that you can share. Are you all right? You know, if you want. Thank you. Yeah, absolutely. Okay. Uh huh. Yeah. Okay. Thank you, everybody. Um, thank you very much. Uh, Kate just said to me, um, this seems to have generated quite a buzz, so I think it's a testimony to to the power of what you've heard. That there was such a lively conversation. So I'm just going to pick, uh, put your hands up quick reflections on what you've heard. And actually, I'm going to let Kate and Allison make one single final line to leave you with when they've heard your five reflections. So let's start here. Yeah, we can eat now. Tell us where you are. I'm Steven from Southeast and Trust. Thank you very much. Ladies. It was lovely. Especially like the one to be kind of really, really need to resonate to. The There was a word that popped out to me. And maybe maybe it will help in terms of scale and spread the word champions. It struck us and the Southeastern Trust, our champion digital champions. I think it's a really great concept. Get onboard, please. But be interested in your thoughts on championing and how it helped deliver the outcomes that you're very clearly articulate things again. Great. So it wasn't a comment. It was a question. But I don't mind if you break the rules. It's fine. Just treatment with instructions with butter disdain. Why don't you? Um yeah, Jennifer from Elemental. I've been a massive fan of yours for for a long time. And the thing that struck out for me was leadership and even just thinking of dairy, You know, that we had during the City of Culture year, we had 80 McGinley non regeneration with Valerie Watson. The council which showed the McCarthy who's the lead on the culture company side of things and anything it just felt like anything could happen and anything was possible. So the big thing for my takeaway is just your leadership watching you over the years. And it's just making me think about how do we get that same leadership here to achieve exactly what you have. Thank you. Oh, yeah. We have some reflection from the online audience as well. So the quote about being an expert on tap rather than be an expert on top has got lots of thumbs up and lots of collapse. And Emma is saying, I love that quote Door is saying she loves it. Laura and Collins is saying it's really inspired towards Citizen Lead. Uh, public health. Great. Thank you. Hi, there. My name is David McGinty. I'm from the Management Consultant Bureau, so Yeah. Thank you for your presentation. I thought, um, your passion came across so much, right? And you really care about what you were doing for the people in women. And it's more of a personal one. You said that your the teacher said to you that would be impossible. So I think, you know, as I reflect on what Dan presented to us earlier, that's that's a big and difficult, but it's not impossible. Great. Thank you. And then finally and briefly, here comes Mike comes. She's behind you. Okay? Thank you. I'm just reflecting on the distinction between the council's here and the council's in the UK and the fact that in terms of public health, uh, that aspect is, you know, in there, and it strikes me. Um, you know, the disparity of, um, difference around the approaches of councils. Councils here have a coordinating statutory responsibility for their areas, but I see no evidence of any council actually taking on responsibility for coordinating and relating to health. Uh, education. Uh, you know, the key factors that shape our society, Um really applaud the efforts in wigan. Uh, and I would love to visit and find out more, but unless we get by in from councils here, I think it's going to be very, very difficult to move. So I guess there's a point there about the importance of the local Democrat, the local Democratic dimension. We loaded councils coming for the master class later. They're they're on it. They're on it. So great, Heather, you to make a contribution. Now that's it, right finally leave one resounding thought in people's heads, Alison. And then Okay, these are? Yeah. Um, I'll probably go back to what I said at the beginning. Which was lives about human relationships, isn't it? And if we concentrate on that and lives, then hopefully we'll we'll hang onto that hope and that compassion and that kindness. Thank you. I think one from me. And this is for my fellow medics in the room. Um, use your power wisely, but with humility. In other words, that expert on tap is really important. Thank you. Great. Okay. Well, thank you, Kate. Thank you. Do follow up what you've heard. There were lots of links in the presentation. You can find out a lot more about with and deal if you just could Google Week and you'll see all sorts of interesting articles and research studies.