Welcome to the fourth edition of the
This is the North podcast newsletter.
Beyond the Medicine Cabinet:
Reimagining Health
by Alison Dunn, with insights from Dr. Brigid Joughin and Steffen Laukard
What if treating illness involved more than just prescriptions?
This week, I had the privilege of sitting down with two remarkable individuals who are reshaping how we think about health in Newcastle and beyond. Dr. Brigid Joughin, a GP and former trustee of Ways to Wellness, and Steffen Laukard, who leads their Persistent Physical Symptoms project, shared insights that left me both challenged and inspired about the future of healthcare in our region.
The Wider View of Wellbeing
Our conversation began with a fundamental question: what actually makes us well?
As Brigid explained, Ways to Wellness emerged in 2015 from recognising that medication alone rarely solves complex health challenges.
"We know it's well recognised that unfortunately, people with long-term conditions, people with any illness, are not just getting better by taking medication.”
What struck me most was how this organisation looks beyond the obvious to what they call the "wider determinants of health" – your housing situation, your social connections, your employment status, and even whether you find joy in your daily life.
These factors, Brigid argues, can be "just as important, if not more so, than what is in your blood pressure medication."
The evidence speaks for itself. After nearly a decade of operation, Ways to Wellness has demonstrated that patients who work with social prescribers use secondary care less frequently. It's a powerful testament to what happens when we expand our definition of healthcare beyond clinical settings.
When 15 Minutes Isn't Enough
As someone who has worked with vulnerable people throughout my career, I was particularly moved by Brigid's reflection on the constraints GPs face. With just 15 minutes per consultation – "barely enough to touch the surface", as she put it – doctors simply don't have time to address the complex social factors underlying many health conditions.
What's more, as traditional community supports have eroded over decades, GP surgeries have become one of the few constants people can rely on. "Sadly, the one place people always know where there will be somebody to help, hopefully, is a GP surgery," Brigid told me. This reality places enormous pressure on an already stretched system.
I couldn't help but think of the many clients I've worked with at Citizens Advice who arrive with "7, 8, 9, 10 issues" simultaneously. Health, like other aspects of life, rarely presents as a single, isolated problem with a straightforward solution.
Final Thoughts
What remains with me after this conversation, and I hope you to after listening to the podcast or reading this, is the profound importance of seeing people as whole individuals, not just collections of symptoms or problems.
The orange box metaphor has particularly stayed with me – that visual of our lives contracting under the weight of pain, and the possibility of expansion through compassionate support.
I believe the approach Ways to Wellness embodies represents exactly the kind of systemic change we need across the North. By addressing what truly matters to people, by listening deeply, and by recognising the complex interplay between social and medical factors, we can create healthier communities even in challenging times.
Until next time,
Alison Dunn
Listen to the full This is the North podcast:
> Spotify
> Apple Podcasts
If you enjoyed this newsletter and/or the podcast episode shared, please like, share and subscribe. It takes less than 10 seconds to do and would make you part of something essential: a community of people who believe transformative conversations can become the catalyst for positive change.
This is The North Podcast is your source of transformative conversations. An intentional challenge to the systems holding back the North of England. Hosted by Alison Dunn, an award-winning charity chief executive and former solicitor. This podcast is supported by Society Matters Community Interest Company and is dedicated to curating and sharing knowledge, powering the change we need for a more equal and inclusive society. Subscribe to never miss an episode and join our mission to build a stronger, more equitable society for all. This podcast is produced by Purpose Made, empowering change through intentional leadership and shared knowledge.
The Orange Box: A Powerful Metaphor
One of the most illuminating moments in our conversation came when Steffen introduced what I've come to think of as "the orange box metaphor." Imagine your life as an orange box containing everything you enjoy – going for a drive, walking on the beach, meeting friends at the pub. When persistent pain enters your life, it gradually shrinks that box.
"When pain happens, for example, it starts radiating into your life and sticks around. All of a sudden you start feeling it in all aspects of life," Steffen explained.
The box gets smaller and smaller until sometimes pain becomes the only thing inside – crowding out work, social activities, and joy.
What Ways to Wellness aims to do is expand that box again, creating space for people to rediscover what brings them joy while acknowledging their conditions. It's not about pretending the pain doesn't exist, but rather about incorporating it into a life that still has room for meaning and pleasure.
Breaking the Cycle of 'Failure Demand'
The Simple Power of Being Heard
Uncertain Future, Certain Purpose
Perhaps what moved me most was learning about the fundamental importance of listening in Steffen's work. In sessions that sometimes last more than an hour, patients can share their full stories and experiences, often for the first time. This act accomplishes something profound: acknowledgement of both the pain and the grief that accompanies chronic conditions.
Steffen, who lives with chronic back pain himself, shares his personal journey with patients, creating a bridge of understanding. "Sometimes that can be quite powerful because people can appreciate your own story," he reflected. This sharing opens space for patients to reimagine their relationship with pain.
I was particularly touched by the example Steffen mentioned of a woman featured on their website who has reengaged with crafts and social groups. While her pain persists, she's developed a more balanced perspective where pain isn't the sole focus of her existence. There's something profoundly hopeful in that transformation.
From a systemic perspective, this work shows tremendous promise. Brigid introduced me to the concept of "failure demand" – when people keep cycling through healthcare services because their core needs remain unmet. "We're managing the fact that people have not managed to have their demands met, so they just keep coming round and round the system because nobody is actually giving them what they need," she explained.
By identifying "what matters to you" and addressing those specific needs, Ways to Wellness breaks this costly cycle. This approach not only improves individual outcomes but potentially reduces emergency department visits and other high-cost interventions that result from desperation rather than appropriate care planning.
Our conversation naturally turned to sustainability, particularly in light of recent government announcements about disbanding NHS England. With widespread budget cuts looming, I asked Brigid how organisations like Ways to Wellness can sustain their vital work.
Her response revealed both concern and determination. She worries about the NHS tendency toward economies of scale, which often fail in healthcare delivery. "The problem with the NHS is they think that everything is better with economies of scale, but actually economies of scale just doesn't work in health," she noted. "We're not a sausage factory, we're individuals."
Despite these challenges, Ways to Wellness maintains a forward-looking approach. Their goal is to seek out innovative ideas that address social determinants of health and reduce inequalities, offering resources to test and evaluate promising approaches. "We welcome anybody who's got ideas, something they want to test out, who may not have the skills, the resources, the knowledge on how to set about doing that," Brigid shared.
Get Involved
Ways to Wellness welcomes innovators with ideas to address health inequalities and social determinants of health. If you have a concept that needs resources, skills, or evaluation support, visit waystowellness.org.uk to learn more about their work and how to get involved.
Coming up on the podcast…
Our next episode of This is the North is a conversation with Praful Nargund who the Founder and CEO of the Good Growth Foundation. Praful is a social entrepreneur and campaigner. Until 2023, Praful was the CEO of Create Fertility, which he built with a mission to innovate and make fertility treatment more accessible and affordable for families. He is also a co-founder of Social Impact Enterprises which aims to drive sustainable growth. Praful has won innovation and business awards from The Spectator, The Telegraph and London Business School. He ran as Labour’s parliamentary candidate in Islington North in the 2024 General Election, and shaped education policy as part of Labour’s Council of Skills Advisors.
A deep dive into the archive…
The conversation I had with Brigid Joughin and Steffen Laukard this week about developing and piloting initiatives to support not just patients with persistent pain but to improve the efficiency and cost effectiveness of the NHS reminded me a very early episode of This is the North. In episode 5, I spoke with Kevin, Robin and Estelle about the role of technology and innovation in solving social problems, not that dissimilar to the problems highlighted by Ways to Wellness and the discussion with Brigid and Steffan.
Kevin Telford, is the Co-Founder of Finpact. Robin Ferris is the CEO of Bankuet, the UK's first zero-waste digital food donation platform, and Estelle Blanks is CEO of the Innovation SuperNetwork, a unique North East network supporting businesses in growth and innovation with a passion for supporting female entrepreneurs and innovators.
If you’re interested, today I’m reading (or listening to) …
Today I’m reading “All in her Head” by Misty Pratt, a provocative and deeply personal book that explores how women experience mental health care differently than men – and lays out how the system much change for women to flourish. It tackles topics such as “why are so many women feeling anxious, stressed out and depressed?”, and why are they not getting the help they need in a healthcare system which is steeped in gender bias, with treatments that routinely fail to address the root causes of distress.
I just can’t get enough of the brothers Van Tulleken. If you’ve not checked out their new podcast series What’s Up Docs? on Radio 4 and BBC Sounds you are missing a treat. A personal favourite is the episode aired on the 22nd April 2025 entitled “Am I getting enough sleep?” and the answer is …. yes, thankfully, I believe I am – but are you?
