Name: Adam Kay and Why Retention is no Laughing Matter
Uploaded: 2026-09-24T10:01:08.150Z
Duration: 45 min 48 s
Description: Adam Kay and Why Retention is no Laughing Matter

Transcript for "Adam Kay and Why Retention is no Laughing Matter": Good morning, everyone. We're gonna get started in just a minute. Do tell us where you're dialing in from. We would love to hear. Good morning, Dom. Tunbridge Wells, Tracy. Love it. Excellent. Leicestershire. Welcome. Welcome to Amsterdam. Oh, we're getting exotic. Kingston. Not that that's not exotic. Cheltenham. Excellent. Racing Suffolk. Cork, well done. We love a bit of Irish commentary. It's all happening. Italy. Matteo, you're very welcome. I love it when we're international. Brussels, even better. Superb Wicklow, Very, very exotic there, Dara. I love it. Lovely, lovely part of the world. We'll give it one more minute, and we'll get started. Very happy to have you all here. Vilnius. I don't know where that is, but that does certainly sound exotic. My goodness. I'm not very good at geography, man. Lithuania. Oh, I see. Wow. We really do have an international crew. While we're waiting for everyone, I'm just going to say that we have one of our panel members who's dialed in from, Seattle, and it is 2AM in Seattle. So, Eric, thank you. It is particularly extraordinary, that anyone is able to do webinar in, at 2AM. Frankfurt. Welcome, I. was gonna be up anyways watching this. webinar, so I was, happy to as well join in. You. may as. well join in. Exactly. There we go. There we go. Okay. Super. We're going to go ahead and get started. So welcome, everybody. By way of introduction, I am the head of EMEA for Rippling. I am delighted to introduce our two panelists. Eric Greenwood is, as we said, in Seattle. He leads our people, analytics, and operations team at Rippling. And, of course, we have the incredible Adam Kaye, who was no stranger to anyone, an award winning, a former NHS doctor, an author, and an all around brilliant human being. So thrilled to have them both here today. Thank you both for joining. We are talking about all things retention and employee retention and why that is no laughing matter. And I'm sure everyone on this call has been in a position at some point where they might have been blindsided by someone leaving before they expected. And I think the way everything is changing right now, AI is accelerating how we work, how everyone... What happens in day to day life. And today is this discussion around what is the gap between what is actually happening when you get to the exit interview, and how can you avoid getting to that exit interview and understanding what are all the signs of burnout or the signs of potential likely future attrition, and how can you get ahead of that so you manage to retain and keep your very best people. And so without further ado, we're gonna jump straight in. And, Adam, I'm going to come to you for the first question. Tell us a little bit more about you. Who are you before you became the, best selling author? What were you doing? What What My life was as I was working as a doctor, what was called a junior doctor, which is a strange term, life the NHS that means anyone, who's doctor is not a yeah. Consultant level. And so I? guess I'm here as the poster boy for, not for being a non retained member of staff. So I essentially, I was an ops and gynae doctor working on labor wards, which means for spending sixteen hours a day being covered in bodily fluids, not in the the fun way, you know, in a sort of horrible, you know, sort of medical way. And, and, you know, functioning on, you know, three minutes of sleep and a stolen bit of toast and, and being the person responsible for, you know, for mum's and baby's lives. And, and I was a, you know, a very tired cog in a in a big machine who eventually realized, that I wasn't right for the job, the job wasn't right for me, I had a bad day at work and decided to take six months out, and that was fifteen years ago and I'm still on my still on my sabbatical. Yeah. Yes. And you tell us you're unemployed. I asked you if you had a LinkedIn profile, and you're like, no. Because I don't do any work. And yet here you are. So we're very happy with the work that you are doing, but, this... Your book was obviously a a huge bestseller. This is going to hurt. I reread it last week ahead of this. And, honestly, for anyone who hasn't read on the call, it is one of the most brilliant books I've ever read. Brilliant, but also absolutely terrifying. Terrifying. So what did you actually tell the people when you were leaving as the NHS as a doctor? What was the story you gave them, and then what was the real story? So the story I gave was, I just want to to step away for a bit and sort of, I I think I was I probably used the new challenges cliche, But the the truth of it was it was very difficult to leave, actually. Very difficult. The the job made it very difficult to step away. Lots of people telling me, you know, in a sort of cultish way, but you're only eighteen months off being a consultant and you know, think about your pension and what you're gonna and and so that took a took a very long a very long time, you know, in the scheme of things. Essentially, I had a bad day at work. You know, we've all had bad days at work. I imagine a whole bunch of you, watching are going to, you know, after this have a bad day at work. It's just what happens. But. when you're the most senior doctor on the labor ward, the the bad days can be extremely bad. Essentially, all you want is your minimum from every case is healthy mom and healthy baby. This was. a case where, very sadly, ends up with neither of those two things. And, you know, obviously, it's a it's a it's a million times worse for the for the the the family involved, but but there's always a bit of bit of blowback to the, to the health care side. It's known as being a second victim, slightly strange term, which I'm sure most of you are aware of. And, you know, the idea like in physics, they teach you at school that every action has an equal and opposite reaction. There's always a bit that comes back to you. And, I dealt very badly with it, and I I wasn't given any support to speak. of. It was like I'd it was like I'd sprained my ankle or something. Everyone's like, oh, no. That's awful. You alright? But, I mean, obviously, you can do clinic tomorrow. Right? Because who else is gonna do it? No. No. No debrief. No talk of time off. No mention of counseling. Just for a bloody doxy. Bloody get on with it. And so I did until I realized that I couldn't. Right. Well, I think it's starting... You know, we use a phrase in the tech world a lot, like, about when we're stressed about something or there's a conference or there's a client problem. We're like, oh, well, we're not saving lives. Whereas in your case, you really are saving lives. So, I mean, it is just... I can't imagine the pressure. And at the end of the day, there's a very human element to it, but, we'll come back to on a second. I want to ask Eric, in the interim, when you think about the gap between the official reasons that people say in their exit interview versus, what's actually driving someone to leave? Like, sort of what insight can you give us on that from everything you see with your work? Yeah. Absolutely. And from from both, like, an analytical, you know, looking at the data perspective and then also just putting on my manager hat, I think it's bigger than you think, but not as quite as big as you might be, you know, actually worried about. And I I think the reason why is employees actually do want to make wherever they, you know, work actually work out. They they want to make sure that the decision that they made to join the company, is that they were right. And so they actually do come and they leave bread crumbs, if you will. But, even in Adam's story, you hear about, you know, raising concerns and then, you know, leadership or management failing to see those signs and actually, do something about it. And so I I think you, you do get different reasons and there is a gap. But I do think that there's lots of breadcrumbs that employees across the board will leave and show before they make that final decision or the straw that burped the camel's back about why they actually end up leaving or when they actually, end up leaving. Adam, coming to you, just picking up on that point with... When we talk about the breadcrumbs about people before they leave, like, what was your experience? Did you speak to your superiors at the NHS about how you're feeling? What was going on about the, frankly, completely unsustainable lifestyle that you were having to lead and make decisions with no sleep. Literally life and death decisions. Like, what was it just it was just considered the norm or you had many conversations about it? I'd love to hear your experience there. I never spoke about it, because it's I felt whether this is true or not, but it was my experience and a lot of other people's experience. It was genuinely a sign of weakness. You know? Oh, you're just going. to someone and say, oh, by the way, I'm not coping. Okay. Well, go and work somewhere else. Do something different. It's a system that, that sort of rewards stoicism. And, there's a it's very hierarchical and and old fashioned in medicine. It's like a I think anyone who's worked in a modern workplace who steps into the NHS would be, I mean, shocked at what I love the NHS, by the way. Mhmm. I'm keen to say, that it's, I think, it's our greatest achievement as a civilization. But at the same time, it can be that and also one of the worst employers. So, like, like, my boss at the time, I had to address by his surname. Like, if I'm if I have to call you professor whatever, if you've never once bought me a coffee, if you've never been in any situation other than you telling me off, really, truthfully, am I going to go to you and say, I'm really sorry. I'm I'm struggling. Can you can you can you help? And HR is a is a bogeyman. It's still like the eye of Sauron in the in the, you know so so sorry, HR. I know. I'm I'm. talking to have a lot of HR leaders. listening. Yes. But but within the. NHS, that's how. it felt. And not with that. And this isn't just sort of anti HR prejudice. It's, you know okay. So here's a couple of couple of stories I I mentioned to you, when we spoke before, Wendy, which I think sum up an an attitude that is sort of, I think, unacceptable. So, like, number one is, someone I know who and who wasn't able to get the full day off work for their own wedding, and she had to, do her morning clinic and, and and hair and makeup. And that was that, absolutely extraordinary. Imagine doing your hair and makeup in in, like, a dot... In the surgery or something. yeah. It's insane. Right? So it's it's. it's deranged. Yeah. And then and the and the other one is a is a friend, who's, whose partner, very sadly, they were they were engaged with her fiance, unfortunately, ended up in ITU in a different hospital, and she not unreasonably asked for compassionate leave for Dale to to go and, you know, to to, you know, to to see him and sort things out and, and was told no. Because according to the rules, if you want to have compassionate leave, it needs to be a first degree relative or you need to be married. And technically and so if that is the environment that you're you're working in and you're thinking, I'm really, really not doing well here, what you do is you keep your head down and you just get on with it because it's, I don't know, it's unwelcoming. And do you, think it's... Adam, sorry to jump in here, Wendy. Out. of curiosity, Sure. Go for, it. did you did you confine in peers? Did you was there anyone you talked to about this, that was on staff at NHS? I mean, this is this is really interesting. So I, this book you you kind of mentioned, Wendy, this is gonna hurt, were the diaries that I kept at the time. When I published this book, that was the first time that anyone in my life knew what had happened. So, like, my partner knew I'd left medicine, but had no idea why I'd left medicine until it was in the book. My parents, knew I'd left medicine. Again, no idea until they were and I didn't even send them a free book. They had to buy it themselves. I'm not stupid. So I need to get all the sales. Okay? But anyway, so so they they read this and and did anyone know? Well, the people who worked on the ward with me, my. pals, it's not such a big place that when there's a a huge incident like this that the people don't find out. And people could see that I was struggling. My mates wanted me to feel better. And they would tell me, it wasn't your fault, which I I don't think it was. And and and but they would say that if you work as the most senior doctor on the labor ward, you will have some kind of big disaster every five or six years. And it doesn't matter how good you are or, you know, what courses you've got or qualifications you any of that. It's just a horrible fact of the job. You will have some big disaster. And that made me feel a lot worse because it made me think, if that happened to me ever again, that that would do me in. This is something that you can't do without support and actually realizing that this wasn't just a one off. This was actually I was this was a a pattern that I was now set in whereby, it would happen again and I'd be on my own again made me, made me have the made me step away. And, Adam, ultimately, you know, it takes so much courage to do that job in the first place knowing that the consequences really are life and death. Like, it's absolutely extraordinary when you think of people who go to work every day holding that weight in their hands. And it's just so it's so distressing or, to think that the the support wasn't there for you, or for... I hope... I am hoping it is evolving. But the questions I suppose I have is what were the what were the warning signs for you personally? Like, how did you know you're getting to that point? Or were there any red flags when you look back in hindsight that you were like, okay. Yes. That... These were some of the signs that I was getting to a point of, I'm almost done here. It's it's really interesting because now I'm in a a space where I'm, I'm talking to a lot of other health care professionals who've who've who've left the profession or thinking about leaving profession. And the the word that's used is burnout Mhmm. and which and I think, certainly, you know, as a, you know, you're all HR professionals. You you know what burnout looks like. As a it's like as an outsider or just a, you know, just a, a guy working there, you know, a cog in the machine. I thought burnout was, you know, the the, you know, the stock photo of someone banging their head against their their computer. But, actually, it's the it's the little things. It's the stuff that I think was showing up at home more than it was at work. It was I was sort of withdrawing socially, not that doctors have an enormous amount of free time to sort of, you, know, it seems to get. a cab. You can't go to your own wedding. You can only do an afternoon wedding. On the morning, you need to be in. the Operating Theater, so you don't have a lot of free time, it seems. But... Yes. But I was I was I was getting I was just generally a bit ratty and, Yep. you. know, and when the text came in, do you want to go for a drink? It was just like, no. Just leave that. Mhmm. And and I found myself I was losing my sense of humor which was like, you know, something I've always had through my entire life. And I was just thought stuff wasn't stuff wasn't funny. And, and I was I never really took time off work as, again, weakness, but I was having you know, I was getting the tension headaches, and I was getting the, you know, the stomach stuff. And it's it's, I don't know. And but I think like a lot of people, I only really identified it. I only have pinned it to the job when it hit that, when I decompensated, you should say, in medicine, you know, when when I when I actually burnt out, when it was essentially too late to particularly help. I'd have been a very cheap person to to help when I just needed, you know, you know, a bit of, you know, holding hand during the way. You become a very expensive person to help when you you end. up with PTSD from. some of this happened to work. Yes. I can only imagine. And I think, you know, Ian O'Callaghan, I just asked... I made a great comment in the chat there about, like, the businesses and the environment people are in and sort of seeing the warning signs. And, Eric, I want to come to you and ask you with your people on live analytics hat on, what are the warning signs and what advice do you have for people around that? Yeah. Absolutely. I think, you know, there's typically a number. And and the reason why I actually asked you, Adam, about the the your peers note. Right? Even though you didn't, you know, raise it up the flagpole, if you will, is because typically, I would I would say that a lot of times that's a place managers don't go and look, is go and and with this kind of, hey, I wanna come talk to you. Adam just departed and understand, you know, what you saw. Did that surprise you? Did that not surprise you? I'm trying to become a better leader and actually asking those people the questions. But when you think about, you know, what other warning signs you as a business have, you know, looking back on your career conversations or performance outcomes. Was there misalignment between the expectation of that employee and then what you as the business, you know, off, you know, kind of told them that where they sat in the hierarchical scheme of performance. Right? And there's engagement surveys. Of course, those are, you know, trending, but these are all things that are can be hopefully leading indicators. I think a lot of times people think about exit surveys or they they try and do things after the fact, even chatting with, you know, peers, which which are all, you know, after the attrition has already happened. So how do you stop attrition if you don't even know, why it's happening until after? And so I think that, for me, those are, like, some of the places that you can kinda begin to look. I also think, you know, I have the luxury of looking at a large number of people whereas sometimes managers, kind of can focus on just their org and get really, locked in on on one specific case. Right? Adam departed. Right? Just and focusing on Adam and why did this happen. But taking a step back and and kind of at a aggregate level, understand where people are going next. Did Adam go to a, you know, a similar esque role, or did he just completely left the industry entirely, or did it go to a smaller sized company, larger sized company, as you think about this? So, personally, one of my favorite things to do, take whatever period you want, actually go grab those folks' LinkedIns, and then you can actually refresh the data pretty easily. Online, there's a number of tools. I use one called Gem personally, and you can find out where people went after they left the company. And that's one of my absolute favorite things to do, and you can start to see trends. And I actually just did a report on this ourselves, earlier this summer, and it was it was all about going to smaller companies. And and so being able to bubble that up and why is that and and looking at then you can combine it with the exit survey. So I think one of the hardest parts is that there is all this different data in all these different places and especially, you know, if you aren't on Ripley, you you might have it in entirely different systems. So getting that together and trying to kinda make sense of it. And so I'm sorry for going on a rant here, Yes. but it's this is, like, something I'm very passionate about is that you have all these signs. You have all these different places to go get the data. And usually, it's just the work of getting it to a place where you can analyze it, coherently together. And and AI has been helping greatly with that, and and being able to speed that up without needing data scientists or doing ETLs or data lates or data scrubbing. K. And we'll come back to that actually topic, very shortly, Eric, because I do think the AI is absolutely changing how we surface these signals because, obviously, when you get to the exit interview, it's too late. Yep. But, Adam, I want to talk to you for a second about, the human cost of this. We're obviously talking about the human cost of burnout, but there's a really serious element to this. And we spoke when we did the pre call. You told me that you were a trustee of doctors in distress, and you told me about the rate of suicide amongst doctors. And I'd love you to tell us a little bit more about that because I was appalled when I heard the stat from you. And I think that's something I'd love you to share, please. Yeah. Thank you. And it is really important because, you know, as you say, what what most people see in terms of burnout is people being less productive or. people leaving the job, but it also can mean people thinking they've got nowhere left to go and taking their own lives. In the NHS, one doctor takes their life every three weeks. One nurse takes their life every single week. And those are just two of the huge, you know, number of health care professionals making up this huge jigsaw. And, Doctors in Distress as a charity, as as I do, believe that suicide is, is preventable, particularly, you know, in these in these situations. And part of it, I think, in the NHS is people feel they have absolutely nowhere to to go. And I started getting involved with these with this this charity. They're called Dobbs Inspect. They look after all health care staff. And when the book was published and I talked very openly about how I struggled and how tough life was, afterwards, talking about the doctor was a human being. You don't want your doctor to be too human because humans make mistakes, so we just pretend they're not, and they can't get ill, and they don't get sad. I had literally hundreds of messages from doctors towards the start of their career saying until I read that at the end of your book, I thought that I was the first person who never cried in the toilet, that everyone else was absolutely fine. And it's hugely isolating and really damaging to think that you're the only person who's struggling and that you have nowhere to go. Because if I tell my boss I'm gonna get sacked, and if I get sacked, then I have nowhere else to work. And and when your entire life is your job because you're working a hundred hours a week, that's it's a big deal. And so and some of you will be shocked by those numbers. And, you know, and they're proportionately higher than almost any other workplace, in the, in in the country. And the reason you're shocked is you never hear about it. I think anytime this happens, it should be a headline. Yes. But instead, taboo, stigma, shame, it means it gets brushed under the carpet every single time and we never hear about it. And you can't fix a problem unless you acknowledge the. problem. And. and no one is looking at the size and the scale of it. Like, I've been in this absolutely awfully in multiple hospitals where colleagues have have died by suicide. You find out by rumor. There isn't, you know I think this should be, you know, the alarm bells go off if that happens in your organization. This is awful. This is terrible. This has happened. How do we stop anything like this ever happening again? But. instead, someone tells you because they're on a shift when this happened and that happens and you hear by rumor and hearsay and it's and it's and the numbers aren't even getting any better. And so. some of you will be in you just and it's human beings, isn't it? You know? It's, you know, it's you know, we can aggregate it, and we look at these these numbers and these statistics sound shocking, but every single one of those is a human being who needs to be looked after and supported and protected. Well, I thank you for raising awareness of it. I I have definitely not realized that before, and I think the terrible tragedy is, of course, these are the people who are saving human lives and at the cost of their own life, it would seem, because nobody's looking at their mental health or how they are showing up to work every day, and there can be no greater irony or tragedy. And I remember reading once that it's, a line which said that nobody actually wants to die. They just want the pain to stop, And that's when they think suicide is the only way out, and I agree with you that it is preventable, but it does involve at removing the stigma or removing the sense of shame from any of these conversations because we're not robots. And, every... A bad day of work for someone in the NHS is very different from a bad day work for someone in a tech firm. The consequences that come at one versus the other. So I would just say, Adam, thank you for raising awareness for that. It's, something that's very close to my heart as well, and I think I'm certain everyone on this call has been touched by this in some way. So, Thanks, Bill. Let me talk about it, Wendell. I do. appreciate it. course. Of course. And I would say, you know, one thing we spoke about also in the prep call then is... And what you sort of told us is your your day to day life as an NHS doctor. And I might be getting the stat wrong, but I think you actually said to me that there's... There was only one third of your work that was actually patient facing and two thirds of it was all this drudgery behind the scenes and, Yeah. and clerical work and filling in documents and filling in everything. And so in terms of thinking about how things have changed today and how technology is going to evolve, hopefully, to help not just the, people's work on a day to day basis, but ultimately also contribute to better work life balance, better health, better everything. What's your sort of view on, what in the likes of AI if they took some of that work off their plate? Like, how could that change out on NH doctors' day to day life? I mean, that's the thing. So I think I I've had two careers in medicine and now in writing in the creative world. Mhmm. And I think people's go to reaction, the term AI, is to sort of rear back. But, I think within within medicine, I don't think either doctors or patients want a robot to be the person who's, who's making the decisions or doing the communication. And I don't think realistically that is where we're going. I also don't think realistically in the NHS that's going to happen, like, physically because I remember about a year and a half ago, there was a big announcement that's, you know, every NHS trust in The UK will have access to AI by the year. And I remember speaking to some of my doctor mates, and I was like, we're still using Windows 95. Do you realistically think we're gonna get AI running on any of these devices we've got? But but no. That stat you mentioned was actually born out in, in a recent study that if you're, you know, working as a doctor in a resident doctor, junior doctor capacity, your job is one third clinical, two thirds clerical. I mean, And extraordinary. we it's it's it doesn't make any sense. And so we have this huge crisis in recruitment and retention Mhmm. of the staff. If you were to be able to get the support that you could go from one third clinical to full time clinical, you've it's in real terms, you've trebled your, your workforce. And, obviously, you're never gonna eliminate all of it. But anything you can do, I think drudgery is exactly the the term. It was sort of a lot of my job was really secretarial. And, you know, I was a, you know, I was a very well paid secretary. I mean, I don't think I I'm I don't think, doctors are, you know, are paid what they what they should be. But at the same time, if you're being paid that whack of money and literally all you're doing is updating, you know, spreadsheets and filling this in and and and faxing, you know, which is, something that hasn't entirely changed. Is it the only organization in The UK that routinely uses faxes? I. was like, do fax still exist? So it's like, just in the NHS, the irony. Well, But, like, yeah. I. don't think anyone would object to, you know, someone coming in and saying, I think we can help here. We can. take this off off your plate. You didn't. spend, I'm sure almost a decade of medical school to have to fill in spreadsheets or write up documents, and, it's an extraordinary waste of human potential. And one that I think will resonate with the HR leaders who are listening in right now, because I know there's many of them also wasting human potential, through just mundane admin and what we call the no joy work. And, Eric, I'm gonna come to you and just say in in terms of what you're seeing, in terms of how AI is transforming, this sort of element of companies and HR leaders' day to day roles, what does that look like from a practical perspective in terms of what has changed with the with the advent of AI? Yeah. Absolutely. And I I think a lot of times when we think about, you know, attrition or why someone left, the systems that we've always been using have kind of forced us into there's one single reason. Right? And that's because there's usually a drop down you're selecting. Why did this person leave? Was it compensation? Was it work life done? You know? What what was that reason? But that singular there's it's not a singular reason. I think AI is helping us kind of get to that point because most I'm sure every leader, in in this webinar now probably has their basic attrition data. What's our attrition rate? Where is it happening? When is it happening? What's the tenure of the employee? And they have those core things, which are which are great objective measures. But what's really missing is and that AI is helping with, I talked about early earlier is connecting all those kind of soft things that you would have to spend hours combing over and getting to and understanding and combining with that objective data and trying to figure out where the trends are, where is this happening. But it's it's also for leaders. To bring back to your point, Wendy, I think one of the hardest things with AI in general is understanding when what is it allowing us to do that we weren't able to do before versus what is it doing that what can it do that we were having to do before and taking it off our plate, if you will. And, I was in an interview. This is the just the the other day. And on the resume, this person had written that they were part of an AI initiative rollout at their company who had saved twelve thousand hours for the company. I was like, woah. That's a big number. Let's I wanna talk about this only for the the entire interview. And this person worked at a very large large corporation. It was a very document heavy corporation where everybody left comments. That was kind of the way that employees gave their voice to leadership and to different policies that were coming out, and they left comments. And this person then went in and said, well, now with AI, we can analyze all this sentiment, and we now can look at, you know, the 30,000 comments that we get on documents a year and understand what the employees launch. And it was just it was kinda funny to me because I was like, that's great, but you were you weren't doing that before. So you didn't save your company twelve thousand hours. You just kind of allowed the team members to do more than they ever could have before. And I kind of equate it to, like, that's like me buying a ticket from Seattle to Miami, and saying that I saved three years because I didn't walk, because I flew instead. It's like, that's yeah. You you I guess, but that was never an option. Right? And so. us. as leaders, have you distinguished between what is taking work off our plate versus what is just allowing us to do something we weren't able to before? Right. Okay. Alright. We're going to come to the last couple of questions, and I... I'd encourage you all to put questions in the the chat so that we will take some of your questions in the next few minutes as well. But before we wrap, Adam, I want to ask you, if you look back at your time at the NHS, what is the one thing you wish someone had noticed or asked you before you got to that pivotal crunch moment of deciding to leave? It's it's a that's a really good question. No one really asked, are you okay? Are you okay? I know. And and and when people no one at work ever asked that. People outside work that ask that and they say, how was your day? And you just go, fine. Thanks. Yeah. Fine. Thanks. And it's important people do do that because, you. know, if you do have those really bad days where you think you have absolutely nowhere to turn, if one person has kept asking you how how was your day, that might be the person whose shoulder you do go to cry on. Yes. But no one at work sort of cared enough, which is sort of you you said it was ironic before that it's that it's caregivers who are who are like this but, just a genuine moment of recognition that I was a a human being who was slightly unraveling, who wasn't coping with the weight of it. But the thing is people don't want to ask that because they are also feeling the same and the entire thing might start to unravel. If every you know, I think I think that might be the sort of these aren't unkind people. These are people. who are also struggling in a system that relies on you just pushing through. Alright. Adam, are you more optimistic about the future now or when you... You know, I am. it... You are okay. Good. I am. I mean, we are not there, but we are getting there. So, like, I speak at a huge number of, of organizations, you know, within the NHS about this and how do we better support people. I would say that every single NHS organization organization now does have something for their staff. It's not it's often not enough. It's often just, a Zumba class once a fortnight or 30% of a mindfulness app. But at least the acknowledgment Yes. that the organization is thinking about the well-being of their staff. And I think that one of the crucial points here, a turning point was was COVID, which was unimaginably awful for a a thousand different ways. Well, one positive I have found from it was that we were we did start to look for the first time about the well-being of the people who look after us. And I will also say I will find it very moving during COVID for people to come out and stand on their front doorstep and clap for the NHS staff, and I hope, you know, the small gesture was an acknowledgment of the warriors at the front line. So, so... Yes. It would I think and I think speaking with my colleagues still working on the front line, it that did make a big difference. And, also, like, this sounds pathetic, but I've thrown away 90% of my stuff from my time as a doctor. You know? That was a long time ago. I have still kept every single thank you card I ever received as a you know, I only had, like, six of them. Wasn't that. good? But they those little things got me through not just bad days, but bad weeks and bad months. The human acknowledgment from a patient who don't don't feel that it's often very difficult to remember in the time in the acute situation. where, you know, is the mom gonna live? Is the baby gonna live? This is you know, we don't think about the health care staff at that point. But someone saying thank you. You did a good job. A pat on the back because it was an organization where there was an awful lot of stick and very little carrots and very little thank you. So you can't say you can't say thank you to your staff enough. Right. You can't check-in on your staff enough. You are the people who can make a difference. You have the overview of everyone, and a small gesture, a free gesture can often make a huge difference. The power of those two words. Thank you. Well, Adam, not only will I make a bigger effort to to use that with my with my crew at Rippling, but I will also make sure now I'm currently undergoing some tests. And as I go through those tests, I'm gonna say thank you more often to the medical professionals, because I do think you're right. It is free, and it is, it is it's very meaningful what you just said there that those six thank you cards. And I think that's a lesson for us all, frankly. So thank you for sharing that. I'm gonna, end with. some hard hitting questions for you now, before we go to the broader questions in the audience. So one work... One workplace phrase that you would ban forever. Okay. Synergy. I keep hearing? it. I don't know what it means. Don't think anyone who's saying it knows what it means. I hear a, lot of synergy. Let's let's just say. whatever it means, whatever that is. You'll be deep diving and and circling back in no time. It's a slippery slope. Don't go there. Okay. Worst career advice you ever got? Oh, yeah. Keep your head down and push through. Like, that is terrible. It is terrible. potentially if you're a scrum half. That is bad advice. That really is dreadful advice. I agree. Unlimited annual leave or never attend another meeting again. And, like, for someone that never took. their. holidays, Easy peasy. that's easy. peasy. No. No. Get rid of meetings. at... Meetings. Get. rid of, the meetings. meetings. Oh, I. once did a job. I'm sure the chat will say whether or not this is legal. It didn't feel like it was legal. I was on the six week rotating rotor. So I did three weeks straight through including the weekends. Then I did one straight week of nights, and then I, had. two weeks off. So sort of three weeks of days nonstop, one week of nights, then two weeks off to lie in bed and pant. I had a third of my year as holiday. You can't you can't you can't have there's too much such thing as too much of a good thing. You can't have a third of your year as holiday. That's nuts. No. Okay. Last question. Finish the sentence. Your people aren't the problem. Your people aren't the problem. Your people telling the people what to do at the problem. Your people telling the people what to do are the problem. Okay. That might be me and my org, so good to know. Oh, yes. Sorry. Oops. Never mind. Okay. Let's have a quick look at the q and a here. Where are we going? Thank you very much. Alright. Let's have one here from Dom Green. Were your friends at work surprised that you left, and did any of them leave for similar reasons? Great question, Dom. Yeah. People were still surprised because I was struggling, but everyone was struggling. And most people subscribe to the cult mentality. It would just keep keep keep keep going. And, like, not only did lots of people leave, but some people left and became comedians as well. I I know, I sometimes get interviewed with my other hats on, you know, when I'm talking about, you know, comedy writing and stuff like that. Why are there so many, doc former doctors in comedy? Like, because there are so many doc former doctors in every profession, because we can't hold on to our doctors. In a in a month and a half, I'm touring in Australia. I'd, I I do a lot of, once a year ago, I went to Australia. I I think I've got such a big following in Australia because there's so many Brits who've left the NHS to move out there. They had to go to Australia to make sure the NHS didn't get them back. Is that it? They were like, we need to go to the other side of the world go to be sure. because the money's better, Yeah. better looked after, and, the temperature's better. The temperature is better. Yes. I imagine so. Eric, question for you. What would a system or AI need to do differently to flag your attention risk early rather than explain it after the person's already gone? Yeah. Yeah. I think the biggest thing is you have to tell it where to look. Right? AI is is great when you give it a clearly defined task. This is what you're looking for. This is the outcome. Here's the guardrails. Right? There's all these things around skills, that you give your AI so that you get what you need. But the biggest thing is actually telling it where to look and what you're trying to accomplish with that and and getting the pieces of the puzzle at least on the board, on the table. so you can start to put them together. So, I would say that, you know, to do differently to flag this is you actually need to tell it what you're trying to do and bring that human element to it and let it help you with the mundane tedious task. But you just go out and, actually are the one making the decisions or or steering the ship, for lack of a better term, Wendy. Yeah. One thing I would say as a leader, I have an org about a 150 people, and I am technically incompetent. Don't tell my bosses that, but it's true. So AI for me, what has changed in a practical point is I can write two sentences into, a chatbot, and, ultimately, it will surface information. So, for example, I can say, who on my team has had the highest number of six days this year because normally sick days are an. indication of disengagement and leading to burnout, who my team has the most unused PTO or holiday days, and you're making sure your people are taking your holidays. If you see a trend in sickness, that is normally... Or disengagement. And then you look at employee engagement surveys and you connect dots and performance reviews. The beauty of AI is that it pulls all of those pieces together. And you can just write two lines in a chatbot, and it will show you this. Where are the signs that there are people in my org who are not happy and who are retention risks? And that has changed everything for me. And And as we said, it can be used for good or for evil, and I'm encouraging you all to use. it for good as I'm sure everyone on this call would would would do. But it is life changing in terms of how I go to work every day and in terms of what information is available to me, certainly, as a nontechnical person. Yeah. When you flip it from, you know, employee always having to request PTO or request. vacation, and instead you as the manager going to them and saying, hey. You haven't taken PTO or vacation a while. Why don't you take some time? We got it. Don't. worry. You know, it it flips entire script and and also changes the feelings you might have as an employee for the company or your manager. Yeah. I agree. I always say that leaders should holiday loudly. I holiday loudly. I go on holidays. I'm allowed to have a life outside work. I am. more than my title. Okay. Add another question for you here. Have you had the opportunity to discuss your experience with or influence NHS leadership or HR since your public profile rose? Yep. It's something I worked quite hard on. And, there was a I'll I'll tell you a very quick story. I. was I was invited this is a few years back. I was invited by, Matt Hancock who's, who's the secretary of states health to for for a chat about, a couple of weeks into his job. And he said to me, if you could change one thing about the NHS, if you were sat in my seat, what would you do? And I said that that week, I was I was on stage at the Garrick Theatre in the West End. And in my changing room, in my dressing room, behind me on the wall, there was a poster that said, theater helpline. If you've got any stresses about money, about bullying, about anything in your workplace, whatever it is, give us a phone call. It's free. Paid for by unions or whatever. Twenty four hours. We'll sort you out. I said, there is no such poster anywhere in The UK in a hospital. There was nothing like that stuff. And he was like, I've only just started, mate. I don't know. But it doesn't sound right. Let me get back to what support there is. A few weeks later, he came back and said, you're you're right. That that isn't the thing that's that's offered. And I'm not a a man, a Matt Hancock, apologist or, but in in general, but I will say that following that meeting, he took a service that was just for London GPs or the practitioner health program and expanded it to be for all doctors across all of The United Kingdom. And that single meeting has saved more lives than. any, you know, than I would have done in a in a lifetime if we were working on on labels. And I'm hugely grateful for that because this is an arm's length organization that NHS staff can access and get the help and, keep them, you know, keep them in work, keep them alive, and those are important things. So I try to use my platform to to help where I can. Well, Adam, I think you're marvelous. I roared laughing and, cringed in equal measure, listening to your book again last week, but I just, you know, the the bigger broader points here around doctors in distress, mental health of our medical professionals is so heard and so such a crucial, crucial conversation. So thank you for educating us. I, for one, am going to approach my NHS, the NHS, workers very, very differently saying thank you, saying thank you to all of our staff and also to all of the HR leaders on the call and any other leader, please think about the fact that AI is here to help you. It is here to give you. The answers are there if you're brave enough to ask the question and you embrace the technology. And I think when we think about Adam's point around one third of actual patient facing work and two thirds clerical, I know so many HR leaders are in the same boat here, and it doesn't need to be this way in this... In the world that we're living in in 2026. So, I just wanna say on behalf of Rippling, thank you to Eric who's been up at 2AM in Seattle. Thank you, Adam, so much. You have created many more fans, I know, with this webinar, and I think I think you're brilliant. And more of Adam, please. So thank you very much, everyone. We're going to leave it there. me. Thanks for coming. Take care. Thank you, everyone. Bye.