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@helenbevan
Making transformation happen:
creating the conditions
@HelenBevan
@helenbevan
The Horizons team:
Change agents and change agency
• A small, diverse team of people within
the NHS that supports change agents
and builds change agency
• We tune into the latest change thinking and
practice in healthcare and other industries
around the world –translating this learning
into practical approaches to change
• The team has emerged through years of supporting
change in the NHS and the wider health and care system
@helenbevan
Change is changing
@helenbevan
Kinthi Sturtevant, IBM
13th annual Change Management
Conference
We rarely see two, three or
four year change projects any
more. Now it’s 30-60-90 day
change projects
@helenbevan
Change is changing
@helenbevan
@helenbevan #HEAconf17
To stay in touch, connect with the 3%
Just 3% of people
in the organisation
or system typically
drive
conversations with
85% of the other
people
Source: research by Innovisor
@helenbevan
What is the best way to spread new
knowledge?
Source of data: Nick
Milton
http://www.nickmilton.com/2014/1
0/why-knowledge-transfer-
Social connection/discussion is
14 times more effective
than
written word/best practice
databases/toolkits etc.
Source of image: www.happiness-one-quote-time.blogspot.com
@helenbevan
http://www.nancydixonblog.com/2017/07/the-
hidden-knowledge-problem-in-organizations.html
@helenbevan
Change is changing
@helenbevan
We still organise health and care like the
Tabulating Machine Co. of 1917
Source of image: @corp_rebels
@helenbevan
Source: Innovisor
@helenbevan
Jeremy Heimens, Henry Timms
This is New Power
old power new power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction
Current
Made by many
Pulled in
Shared
Open
Relationship
@helenbevan #HEAconf17
The Network Secrets of Great Change
Agents
Julie Battilana &Tiziana Casciaro
As a change agent, my centrality in the
informal network is more important
than my position in the formal
hierarchy
@helenbevan
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 and systems
affected by change
@helenbevan #HEAconf17
Mark Jaben on the science behind resistance
What NOT to do
But what we do do
Engage
people here
@helenbevan #HEAconf17
Mark Jaben on the science behind resistance to change
What NOT to do
(but what we usually do)
We don’t need buyers (who “buy-in” to change)
We need investors
What TO do
Engage
people here
Engage
people here
@helenbevan
The predominant approach in recent years has been STRUCTURE
but globally there is a big shift towards AGENCY
The dilemma at the heart of change
@helenbevan
AGENCY is about power
• The capacity of individuals to make their own
choices and to take action in a given environment
• Words that are connected to agency:
• Action
• Activity
• Effect
• Influence
• Power
• Choice
@helenbevan
Source: @NHSChangeDay
@helenbevan
Source: @NHSChangeDay
@helenbevan
Source: @NHSChangeDay
Problematic:
changing a
“permission
culture” can
take years
The good news:
we can usually
build agency
much more
quickly
@helenbevan
Individual AND collective agency
Individual agency:
People get more power
and control in their own
lives: patient activation,
shared decision-making
and self-care
Collective agency:
People act together,
united by a common
cause, harnessing the
power and influence of
the group and building
mutual trust
@helenbevan
Building agency for large scale change
We do not become transformed alone, we
become transformed when we’re in relationship
with others
Hahrie Han
Source of image: Idahoc Community Action
@helenbevan
http://biggerboat.org/exploring-moodocs/
MOODOCs
(Massive, Online, Open, Disease Oriented Communities)
@helenbevan
New Public
Passion:
a growing
global
movement
@helenbevan
Big drive to bring social movement thinking
and practice into delivery
@helenbevan #HEAconf17
The Change Challenge
Tapping the collective brilliance
of the NHS
14,000 contributions identified
10 barriers to change:
Confusing strategies
Over controlling
leadership
Perverse incentivesStifling innovation
Poor workforce
planning
One way
communication
Inhibiting
environment
Undervaluing staff
Poor project
management
Playing it safe
14,000 contributions identified
11 building blocks for change:
Inspiring & supportive
leadership
Collaborative working
Thought diversityAutonomy & trust
Smart use of resources
Flexibility &
adaptability
Long term thinking
Nurturing our people
Fostering an open
culture
A call to action
Source: Health Service Journal, Nursing Times, NHS Improving
Quality, “Change Challenge” March 2015
Challenging the
status quo
@helenbevan
After years of intensive analysis,
Google discovered that the key to high
performing teams that deliver change is
psychological safety (being nice)
Project Aristotle:
https://www.youtube.com/watch?v=UfGiCnhdU78&feature=youtu.be&list=PLHEw3ja-
xoaZybvz9f0b1_6bJyG7zZO6L
@helenbevan
... the last era of management was about how
much performance we could extract from
people
... the next is all about how much humanity we
can inspire
Dov Seidman
A changing world
@helenbevan
Free five week virtual learning programme
for change agents in public service
•Shown to make a significant improvement in individual &
organisational change agency
•A module a week for five weeks
•Handbook and study guides
•Guided social learning
Join more than 10,000 people who have taken part
from 44 countries globally
How to rock the boat and stay in it!
Join
the
Starts 15th
February
2018
Join here:
http://theedge.nhsiq.nhs.u
k/school/

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