@HelenBevan #HQT2016

Leading into

the future

Helen Bevan

@HelenBevan

#HQT2016

@HelenBevan #HQT2016

Joining in this session

• The theme of the session is connectivity and platforms for change

• Please tweet using hashtag #HQT2016

• A challenge: make our Twitter conversational

• We will get some feedback on Twitter activity during the session

@HelenBevan #HQT2016

What is happening in the field of change and transformation in the

wider world?

@HelenBevan #HQT2016

Change is changing

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What approaches to change are needed in this environment?

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Kinthi Sturtevant, IBM 13th

annual Change Management Conference

June 2015

We rarely see two, three or four year change projects any more. Now it’s 30-60-90 day change

projects

@HelenBevan #HQT2016Source: Bromford P (2015), ”What’s the difference between a test and a pilot?”

Pilots are being replaced by rapid tests and prototypes

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Acceleration of connectedness

Change is changing

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@HelenBevan #HQT2016

Digital skills are a critical capability for future leaders of improvement

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How does the NHS improvement community prefer to communicate?

Digital

Non-digital

ProactiveReactive

Source: RAND evaluation data from the Q community of improvement leaders

@HelenBevan #HQT2016

How does the NHS improvement community prefer to communicate?

Digital

Non-digital

ProactiveReactive

Source: RAND evaluation data from the Q community of improvement leaders

@HelenBevan #HQT2016

Hierarchical power is diminishing

Change is changing

Acceleration of connectedness

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@HelenBevan #HQT2016

Change is changing

Acceleration of connectedness

Hierarchical Power is diminishing

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The Challenges

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@HelenBevan #HQT2016

Change is changing

Change is moving to the edge

Acceleration of connectedness

Hierarchical Power is diminishing

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Starts on the fringe (at the edge)

Starts with the activistsGary Hamel

always

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An example from the Cabinet Office

http://www.slideshare.net/Openpolicymaking/060715-change-cardscollated?next_slideshow=1

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Why go to the edge?

“Leading from the edge brings us into contact with a far wider range

of relationships, and in turn, this increases our potential for diversity in terms of thought, experience and

background. Diversity leads to more disruptive thinking, faster

change and better outcomesAylet Baron

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Jeremy Heimens TED talk “What new power looks like” https://www.youtube.com/watch?v=j-S03JfgHEA

old power new power

Currency

Held by a few

Pushed down

Commanded

Closed

Transaction

Current

Made by many

Pulled in

Shared

Open

Relationship

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The Network Secrets of Great Change AgentsJulie Battilana &Tiziana Casciaro

As a change agent, my centrality in the informal network is more important

than my position in the formal hierarchy

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WHO will make the change happen?

Source: adapted by Helen Bevan from Leandro Herrera

List A• The STP Transformation

Programme Board [or equivalent]• The programme sponsors• The Programme Management

Office• The [insert number] STP

transformation work streams • The Clinical Leads of workstreams• The Directors of participating

organisations• The Change Facilitators

@HelenBevan #HQT2016

WHO will make the change happen?

List A• The STP Transformation

Programme Board [or equivalent]• The programme sponsors• The Programme Management

Office• The [insert number] STP

transformation work streams • The Clinical Leads of workstreams• The Directors of participating

organisations• The Change Facilitators

List B• The mavericks and rebels• The deviants (positive). Who do

things differently and succeed• The contrarians, because they can• The nonconformists who see things

through glasses no one else has• The hyper-connected. Good or bad,

they spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on

• The hyper-trusted. Multiple reasons, doesn’t matter which ones

Source: adapted by Helen Bevan from Leandro Herrera

@HelenBevan #HQT2016

WHO will make the change happen?List B

• The mavericks and rebels• The deviants (positive). Who do

things differently and succeed• The contrarians, because they can• The nonconformists who see things

through glasses no one else has• The hyper-connected. Good or bad,

they spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on

• The hyper-trusted. Multiple reasons, doesn’t matter which ones

Source: adapted by Helen Bevan from Leandro Herrera

List A• The STP Transformation

Programme Board [or equivalent]• The programme sponsors• The Programme Management

Office• The [insert number] STP

transformation work streams • The Clinical Leads of workstreams• The Directors of participating

organisations• The Change Facilitators

People who live and

perform in formal

organisation land and

people with the power

who have make or break

change are two different

lists (and we need BOTH)

@HelenBevan #HQT2016

What’s the evidence?The failure of large scale

transformational change projects is rarely due to the content or

structure of the plans that are put into action

To make transformational change happen we need to connect networks

of people who ‘want’ to contribute

http://iedp.com/articles/vertical-leadership/?utm_source=Sign-Up.to&utm_medium=email&utm_campaign=13787-257163-Campaign+-+01%2F09%2F2016

Source: David Dinwoodie (2015)

It’s much more about the role of informal networks in the

organisations/systems affected by change

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The essential flaw of quality improvement approaches

The essential flaw of [quality improvement ] is that, when

implemented, it tends to reinforce the mechanistic and hierarchical

models that are consistent with the mental maps of most managers Chris Argyris, Flawed advice and

the management trap Source of image:

www.biblicalcreation.org.uk Read more at: http://www.slideshare.net/jurgenappelo/management-30-workout

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Is your change process a cathedral or a bazaar?

http://www.unterstein.net/su/docs/CathBaz.pdf

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We have a lot of cathedrals

Source: Sewell (2015) : Stop training our project managers to be process junkies

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The power of the platform“Facebook, YouTube, Twitter and their lesser cousins have proved the power of the platform. They have shown that if

your average 21st century citizen is given the tools to connect and the freedom to create, they will do so with

enthusiasm, and often with an originality that blindsides the so-called creative industries. …..

Good leadership is no longer about ‘taking charge’ or imposing a strategic vision but about creating the

platforms that allow others to flourish and create” Ashoka

http://www.virgin.com/unite/entrepreneurship/what-does-leadership-mean-in-the-21st-century

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“Change comes naturally when

individuals have a platform that allows

them to identify shared interests and

to brainstorm solutions.”

Gary Hamel & Michele Zanini, 2014

Build a change platform not a change program

@HelenBevan #HQT2016

• systematic “change management”

• too often, leaders prescribe outcome and method of change in a top-down way

• change is experienced by people at the front line as “have to” (imposed) rather than “want to” (embraced)

Change Programmes

• everyone (including service users and families) can help tackle the most challenging issues

• value diversity of thought• connect people, ideas and

learning• Role of formal leaders is to

create the conditions and get out of the way

Change Platforms

“Tear down the walls”

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Why platforms?“Platforms today power learning and innovation

at the speed of change by providing collaborative and sometimes exponentially

productive spaces for people to create value”John Hagel

Source of image: Pinipa

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Evolving kinds of change platforms:

They overlap!

1. Connecting platforms

2. Mobilising platforms

3. Learning platforms

4. Knowledge platforms

5. Crowdsourcing platforms

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Example platforms

Source of image: @JenniferClemo

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http://biggerboat.org/exploring-moodocs/

MOODOCs(Massive, Online, Open, Disease Oriented Communities)

60,000 online diabetes communities and

around 80 million online patient communities

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The Academy of Fabulous Stuff• Half a million page views • Over 700 fab shares• 1,500 to 4,000 page views

a day• Nottingham Safe staffing

app: 2,500 views• Dovetailing vaccinations

Scheme: 160 direct queries

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@HelenBevan #HQT2016

https://youtu.be/eUApgJBZU8M

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Source: OpenIdeo https://challenges.openideo.com/challenge/end-of-life/refinement

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@HelenBevan #HQT2016

Our Sli.do change platform

What one thing would make the biggest difference in improving the healthcare system?

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Adding your idea about “one thing”

• Go to Sli.do• Add the event code #7674 and click “join

event” • In the space that says add

your tip• Don’t forget to add your name before you click • Vote for the answers you like best by clicking

on the thumbs up

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The prize

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A collaboration maturity model

We aspire to get to the “innovate” (platform) level

Source: Simonterry.com

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Organisations that are nearing the innovate (platform) level

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Source: @NHSChangeDay

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@HelenBevan #HQT2016

Source: http://www.slideshare.net/alwynlau/learning-theories-learner-needs

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10,000Nearly

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The School was formally evaluated by the Chartered Institute for Personnel & Development

#EdgeTalks WebEx

http://theedge.nhsiq.nhs.uk/expert/how-has-the-school-for-health-and-care-radicals-made-a-difference/

How has the School for Health and Care Radicals made a difference?

@HelenBevan #HQT2016

The School was formally evaluated by the Chartered Institute for Personnel & Development

• Change knowledge• Sense of purpose & motivation to improve practice• Ability to challenge the status quo• Rocking the boat & staying in it• Connecting with others to build support for change

Statistically significant positive effect on at both individual and organisational level

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Nearly 100,000

connections(defined as a viewing, a

download of material or an original tweet)

• Latest no-cost solutions

• 150 speakers• 28 topics

• Live broadcast and on-demand

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@HelenBevan #HQT2016

The People’s Transformathon

#CoPro16 “A new relationship with patients

and communities”  

Global online event co-created by patients, caregivers, the voluntary

sector & NHS England Horizons team.

Showcasing the range of innovation and improvement initiatives in which citizens

are involved as equal partners in the UK & worldwide. #EveryoneIncluded

Join us on 28th November. 12-8pm GMT

@HelenBevan #HQT2016

@HelenBevan #HQT2016

Should we undertake routine radiology investigations overnight for all our inpatients?

How to build a change

platform in an hour

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Some lessons

1. You can’t control the outputs of the crowd2. People want a relationship3. Always, always, follow up

@HelenBevan #HQT2016

The Natural Environment Research Council asked the crowd to name its new £200 million polar research vessel

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TEN TIMES as many

votes as the next most popular answer

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Some lessons

1. You can’t control the outputs of the crowd2. People want a relationship3. Always, always, follow up

@HelenBevan #HQT2016

”If people give to a cause, they expect a relationship, not a transaction”

Nilofer Merchant

Once you start down this path, you have to follow up and continue

@HelenBevan #HQT2016

1. Frame the issues in ways that will engage and mobilise the imagination, energy and will of diverse stakeholders

2. Take steps to be more social leaders, invest in digital skills & social connections & lead through networks as well as formal leadership systems

3. Find your B-list people & give them important tasks

4. Consider what/where your equivalent of ‘the edge’ is, so that you incubate radical & disruptive ideas & lead healthcare from the future

5. Build change platforms for important issues – create bazaars alongside the cathedrals

6. Adopt emergent approaches to planning & design, based on monitoring progress, learning & adapting as you go

SIX

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Four ways to connect!

1. Follow us on Twitter@HelenBevan@School4Radicals

2. Subscribe to theedge.nhsiq.nhs.uk

3. Get materials from theedge.nhsiq.nhs.uk/school

…and sign up for our monthly #EdgeTalks

theedge.nhsiq.nhs.uk/edgetalks

@HelenBevan #HQT2016

Ashoka (2014) What does leadership mean in the 21st century?Berg O (2014) The Collaboration Pyramid revisitedBevan H (2015) From change programmes to platformsBriggs D (2015) The elements of council as a platformBromford P (2015) What’s the difference between a test and a pilot?Chesbrough H et al (2016) Why does open innovation work?Choudray P (2015) The platform manifesto: 16 principles for digital transformationDawson R (2015) The future of work and organisations Deloitte University Press (2014) A movement in the makingDeloitte University Press (2015) Business ecosystems come of ageHagel J (2015) The power of platformsHagel J (2015) John Hagel at SXSW 2015: Narratives, platforms and movementsHagel J (2014) Platforms are not created equal: harnessing the full potential of platformsHamel G, Zanini J (2014) Build a change platform not a change programHealth Services Journal, Nursing Times, NHS Improving Quality (2015) ‘Change Challenge’ interactive toolkitHeimans J (2014) What new power looks like [YouTube]

References cited in the slide deck (1/2)

@HelenBevan #HQT2016

Heimens J, Timms J (2014) Understanding “New Power”Innovations- Kontor Väst (2013) Open innovation – a handbook for Researchers Little J (2016) Change management is deadMilton N (2014) Why knowledge transfer through discussion is 14 times more effective than writingO’Reilly T (2010) Government as a platformPearce D (2013) Social business discussions are the new documentationRaymond E S (2001) The Cathedral and the BazaarSatell G (2015) 4 things you should know about platformsSatell G (2012) How power is shifting from corporations to platformsSatell G (2015) Leaders must do more than inspire – we must shape networksSchillinger C (2015) Forget social networks, think social impact [YouTube]Scrivens J (2015) Enabling the experience of wholeness within enterprise social networksSewell S (2015) Stop training our project managers to be process junkiesShaw K (2015) Placing a digital platform at the heart of organisational change with OxfamSimon P (2011) The Age of the PlatformVan Alstyne et al (2016) Pipelines, platforms, and the new rules of strategy

References cited in the slide deck (2/2)