looking back, looking forward, look around

Looking back, Looking forward, look again

Looking Back Looking Forward Look Around

Kate Pound - Horizons Team NHS England

Horizons Group @KateSlater2 @School4Radicals @theedgeNHS

This talk is bought to you by the Horizons team

A small team of people within NHS England who support improvement and change We tune into and engage with the best change thinking and practice in healthcare and other industries around the world and seek to translate this learning into practical approaches to change

The team has emerged through years of supporting change in the NHS and wider health and care system

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSIn this session we will Take a look back over our journey

Look forward to consider new era change

Look around to understand our role as leaders of change and connecting with each other


3

Look back




Change is changing?7

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSIn 2005Facebook didnt widely existTwitter was still a soundThe cloud was still in the sky4G was a parking place LinkedIn was a prisonApplications were what you sent to collegeSkype was a typo8

Source: Thomas Friedman, World Economic Forum. Quoted by: http://aveletbaron.com

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSLeading change in a new era

Dominant approach

Emerging direction


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Leading change in a new era

Dominant approach

Emerging direction

Most healthcare transformation efforts are driven from this side

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSJohn Kotter, the most influential thought leader globally, recognises new approaches are needed

FROM

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSDoes this work? More than 70% of all major transformation efforts fail. Why?

Because organizations do not take a consistent, holistic approach to changing themselves, nor do they engage their workforces effectively. John Kotter

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSJohn Kotter: Accelerate! We wont create big change through hierarchy on its ownWe need hierarchy AND networkMany change agents, not just a few, with many acts of leadershipAt least 50% buy-in requiredChanging our mindsetFrom have to to want to

TO


Image copyright: http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/


Must doWant to do

Kotter: From have to to want to


I have some Key Performance Indicatorsfor you

orI have a dream

Source: @RobertVarnam

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSLink below

http://www.bbc.co.uk/news/magazine-23790147

http://www.bbc.co.uk/learningzone/clips/martin-luther-king-i-have-a-dream-pt-1-2/1293.html

With the brooding statue of Abraham Lincoln peering down at him, King began by telling protesters that their presence in the symbolic shadow of the "great emancipator" offered proof of the marvellous new militancy sweeping the country. For too long, he complained, black Americans had been exiles in their own land, "crippled by the manacles of segregation and the chains of discrimination".The whirlwinds of revolt would continue to shake the very foundations of the country: "And those who hope that the Negro needed to blow off steam and will now be content will have a rude awakening if the nation returns to business as normal," King said. It would be fatal for the nation "to overlook the urgency of the moment and to underestimate the determination of the Negro".He's good - he's damned goodKennedy on KingWearied by the suffocating heat, the crowd's initial response was muted. The speech was not going well. "Tell 'em about the dream, Martin," shouted Mahalia Jackson, referring to a rhetorical riff that King had used several times before, but which had not made it into his prepared speech because aides insisted he needed fresh material. But King decided to cast aside his prepared notes, and launched extemporaneously into the refrain for which he will forever be remembered."I have a dream that one day this nation will rise up and live out the true meaning of its creed," he shouted, his out-stretched right arm reaching towards the sky. Soon he was hitting his rhythm, invigorated by the chants and cries of the crowd. "Dream on!" they shouted. "Dream on!"With his voice thundering down the Mall, King imagined a future in which his children could "live in a nation where they will not be judged by the colour of their skin but by the content of their character". Then he reached his impassioned finale.King asked the crowd to yell so it was heard the world overWatching at the White House, the president was riveted. Like so many Americans, it was the first time he had heard the 34-year-old preacher deliver a speech in its entirety - the first time he had taken its measure, listened to its cadence. "He's good," Kennedy told one of his advisors. "He's damned good." The aide was struck, however, that the president seemed impressed more by the quality of King's performance rather than the power of his message.

The biggest-ever digital campaign for EMAP (Health Service Journal and Nursing Times)

14,000 contributors to the joint campaign to challenge top down change

Ground-breaking: the first-ever crowd-sourced theory of change in the NHS

Horizons Group @KateSlater2 @School4Radicals @theedgeNHS14,000 contributions identified 10 barriers to change:

Confusing strategies

Over controlling leadership

Perverse incentivesStifling innovationPoor workforce planningOne way communication

Inhibiting environmentUndervaluing staffPoor project managementPlaying it safe

Source: Health Service Journal, Nursing Times, NHS Improving Quality, Change Challenge March 2015


14,000 contributions identified 11 building blocks for change:

Inspiring & supportive leadershipCollaborative workingThought diversityAutonomy & trustSmart use of resourcesFlexibility & adaptabilityLong term thinkingNurturing our peopleFostering an open cultureA call to actionSource: Health Service Journal, Nursing Times, NHS Improving Quality, Change Challenge March 2015

Challenging the status quo

Horizons Group @KateSlater2 @School4Radicals @theedgeNHS is the new normal!

By questioning existing ideas, by opening new fields for action, change agents actually help organisations survive and adapt to the 21stCentury.Cline Schillinger

Image by neilperkin.typepad.com


None of us can change the past but we all have the ability to change the way we perceive the future


21

Look forward


Seismic shifts23

DIGITALCONNECTION

Hierarchical power

Work complexity

Change from the edge

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSLooking forward to an new era for change Five enabling themes in change and transformation www.nhsiq.nhs.uk/whitepaper

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSWhat does it mean to be a rebel or a radical?

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSWe need rebels!

The principal champion of a change initiative, cause or actionRebels dont wait for permission to lead, innovate, strategiseThey are responsible; they do what is rightThey name things that others dont see yetThey point to new horizonsWithout rebels, the storyline never changesSource : @PeterVan http://t.co/6CQtA4wUv1

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSWhat happens to heretics/radicals/rebels/mavericks in organisations?



Source : Lois Kelly www.foghound.com

Theres a big difference between a rebel and a troublemakerRebel

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSWhat led you in to your role?

We asked via twitter the question what led you into nursing?

The responses were around the rebel values.


Remain connected to our inner rebel Source: Rebelsatwork.com

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSWe need to be boatrockers!Walk the fine line between difference and fit, inside and outside, rock the boat but manage to stay in itAble to challenge the status quo when we see that there could be a better wayConform AND rebelCapable of working with others to create success NOT a destructive troublemaker

Source: Debra Meyerson

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSWhat are the risks for a boat rocker?Our experiences of being different can be fundamentally disempowering. This can lead us to conform because we see no other choicewe surrender a part of ourselves, and silence our commitment, in order to surviveLeave the organisationwe cannot find a way to be true to our values and commitments and still surviveStridently challenge the status quo in a manner which is increasingly radical and self-defeatingthis just confirms what we already know that we dont belong

Source: adapted from Debra E Meyerson


Source: @NHSChangeDay

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSJenny the Mhttps://www.youtube.com/watch?v=TmVfVBN0gnQ


Often as radicals, we feel different to other people


Look around

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSLeading change in a new era

Dominant approach

Emerging direction

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSThe Network Secrets of Great Change Agents

As a change agent, my centrality in the informal network is more important than my position in the formal hierarchyIf you want to create small scale change, work through a cohesive network If you want to create big change, create bridge networks between disconnected groups

Horizons Group @KateSlater2 @School4Radicals @theedgeNHS40People who are highly connected have twice as much power to influence change as people with positional power

Leandro Herrero

Source: http://t.co/Du6zCbrDBC


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When we spread change through strong ties:

We interact with people like us, with the same life experiences, beliefs and valuesChange is peer to peer; GP to GP, social worker to social worker, nurse to nurse, community leader to community leaderInfluence is spread through people who are strongly connected to each other, like and trust each other

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSWhen we seek to spread change through weak ties

we build bridges between groups and individuals who were previously different and separatewe create relationships based not on pre-existing similarities but on common purpose and commitments that people make to each other to take action

We can mobilise all the assets in our organisation, system or community to help achieve our goals


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Sources of weak ties

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSYou cant be a rebel alone Stay close to where you started Remain focused on the goal Understand the story Strengthen and widen your network and ties Believe in yourself Be not be afraid

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSConnect and understand othersAs you walk your daily walk as a leader think aboutKnow your flock Care for your flock Find any missing members of your flock Lead your flock andProtect your flock

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSRemember the story and you remember the reason

Hello my name is Doris

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSLast words are from a transformational leader, we can all be leaders https://www.youtube.com/watch?v=P0zVPZBykSE

Horizons Group @KateSlater2 @School4Radicals @theedgeNHSFollow us on Twitter@KateSlater2 @Helen Bevan @TheEdgeNHS @School4RadicalsSubscribe to theedge.nhsiq.nhs.ukGet materials from theedge.nhsiq.nhs.uk/school and sign up for our monthly #EdgeTalkstheedge.nhsiq.nhs.uk/edgetalksView the sessions from the #NHSTForm theedge.nhsiq.nhs.uk/transformathon

Four ways to connect!


Slides adapted from 2016 School for Health and Care Radicals, Helen Bevan http://theedge.nhsiq.nhs.uk/school/


looking back, looking forward, look around

Healthcare