Transcript of School for Change Agents Session 1 - Change Starts With Me

1. 1
SPEAKER:
Good afternoon, everyone. Welcome to module one of the School for Change Agents 2018. It is
fantastic to see so many of you joining us today from all around the world and I know that many of
you will be watching this as a recording. Many, many more people. Literally thousands of people,
thousands of change agents around the world will be taking part in this module.
My name is Helen and I am part of the Horizons team which is part of the National Health Service in
England. Our focus for module one is change starts with me.
You know, this is the fifth year of the School for Change agents and we have had 14,000 people
taking part from around the world and this year people have signed up from 45 different countries.
What's amazing is that lots of the people that have signed up are in the health and care community.
We have people who work in local government, as coaches, transformation leaders. People that
work in universities, change agents from a variety of different industries, all kinds of people.
Whatever system we come from, I think many of the issues and challenges we face are the same
issues.
It is amazing that so many of us have been able to come together in this way.
The first thing I want to do is just tell you about the roles behind the scenes. As I said, the school the
change agent is brought to you by the Horizons team. We are a very small team. Inside the National
Health Service in England and we help to support change agents across our system.
We run the school for change agents ourselves. Everyone in our team has a role in the school for
change agents. I want to introduce you to everybody that you will be meeting actually behind the
scenes today.
If we start in the top left hand side, there's me, Helen, the main presenter. Here with me I have got
Zoe Lord who is troubleshooting in the room that I am in to make sure everything goes right for the
next hour. Our amazing technical troubleshooter behind the scenes is Olly. His job is to make sure
everything works properly. The person that is actually managing the WebEx today is Pardeep.
We have two colleagues watching the chat room and what we will do a couple of times during the
session today, we will stop and ask them to reflect on what we are seeing in the chat box. Our chat
monitors are Kate and Kathryn.
What also is happening is the Twitter sphere is going crazy for the change agents. We encourage you
to tweet using the hashtag #school for change agents. That means, you can see it there, S4CA. If you
can put that if you tweet then we can pick up the tweets and what we will do is during the session,
we will ask our two Twitter monitors who are Lynette and Liz, what is happening.
Behind the scenes, we have a whole group of people, it is inevitable, particular with the first module,
if you people have problems getting onto the session. We have got Rosie, Val, Caroline looking after
things behind the scenes. Also, because we are also streaming this live on YouTube and we are
making a live YouTube recording, our colleague Dominic is looking after that. A lot of people behind
the scenes and you will hear some of them today.
Let's get going. The first thing we want to do is we have got people with us from all over the world
and I will hand back control to Pardeep, my colleague, what we'll do is, can you see on the top left
hand side? There is an arrow pointer. Can you take that pointer and move it to where ever you are in
the world? Release the arrows.

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That is great. Hopefully you can pick up a narrow and if you can't use your arrow, it is not working
for some reason, do you want to go into the chat box and write where you are.
We are seeing lots of people in the UK but lots of people in North America as well. I know we have a
big New York contingent and a very big Canadian contingent. It is great, welcome, do you want to
tell is where you are? We have got Claudia who is in South America, that is fantastic. I know we have
some Australian and New Zealand colleagues with us. Most of them because of the timescale tends
to watch the recording. This is a bit of a crazy time.
We can see particularly in... People from all over Europe, all over Scandinavia, lots of Brits, lots of
people in North America and we will have most continents. Pardeep, can we go to the second slide?
What we have is where in the UK are you?
Can you move us to that slide?
For those of you in the UK, if you are not, you can join in, if you can put where you are, then that is
fantastic. Wow. What you are seeing is right from lands end to John O'Groats We have people taking
part. That is really amazing.
We have Wales, Northern Ireland, we have got southern Ireland as well. That is really fantastic.
Can you give me back control? We would like to welcome everybody.
Just a few ideas and rules. The whole thing about the school of change agents as it isn't about
listening passively to a lecture, it is about engaging with each other. Please use the chat box,
introduce yourself, ask questions, suggest resources, have conversations with other people. Just one
rule that really helps, because there are so many hundreds of us taking part now, if you are replying
to someone in the chat box, can you start your contribution by their name. If Zoe made a
contribution in the chat box and you want answer, can you start your reply to Zoe with @Zoe? That
way we can make a thread in the conversations rather than a huge barrage of contributions.
We have colleagues on the Horizons team who are keeping an eye on things. If you need support, if
things aren't working, can you see halfway down on the right hand side, there is a little hand symbol.
Can you raise your electronic hand if you need any help and we will pick you up from there. If you
raise your hand, if your issue gets resolved, put your hand down again. That is great. Please, please
join in on Twitter.

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Just a few rules for the school. Everybody is doing their best, particularly with this first session,
sometimes it takes a little while to get used to the tech. Be patient with it. Ask for your you need.
We are keeping an eye on the chat box the whole time, ask questions, be curious, the whole idea is
to share and learn from one another.
Just to say, this is the fifth year that we have run the school for change agents and its predecessors
and we have had the school evaluated formally by the chartered Institute for personnel and
development and they were blown away by the impact of the school because what we found is that
when people took part in all five modules, the school was found to have a positive effect on every
dimension of impact that we looked at. That was at the level of both individual change agents and
the level of their organisation. We hope they will have this impact for you and you will stick with us
through all five modules.
We know it has a positive effect on knowledge of change, our sense of purpose and energy and
motivation to improve practice as change agents. Our ability and confidence to challenge the status
quo and we need to do plenty of that. Our ability to rock the boat and challenge things but stay in it.
We will talk about that more in the module. Most importantly, our ability to connect with others to
build support for change.
A couple more things. The first thing, in terms of, in the UK, you can use the school for change
agents for continuing professional development. Nurses, midwives, allied health professionals in
Britain and other parts of the world probably, you can use this experience as part of your reflective
account for revalidation. If you are a doctor, you should be able to get specific credits. Most
excitingly, everybody who takes part in the school for change agents can apply to become a
certificated change agent. All you need to do to become a certificated change agent is to take part in
all of the school sessions, all five, either in real-time or by watching the recordings. Then I will tell
you about our learning platform, lots of you have signed up already, there are three modules in the
learning platform and if you complete all of those you will become a certificated change agent and
get a badge and you will be able to add this to your professional development portfolio from
wherever you are in the world. To get the certificates and a badge, you just complete all the e-
learning modules. All it is about is watching all the sessions and then to demonstrate that you have
applied what you have learned. Then you get a certificated change agent badge and in previous
years people love their badges and they appear on emails, Twitter accounts, CVs, you too can be a
certificated change agent. We will give you more information about this but basically the way that
you do this is by logging on to our learning management system.
If you are new to the school, this is the first year you have done it, we will send you details of how to
log on, if you have been before and not been certificated and you want to become one now, you will
need to email us at this email address. What I would like to do is ask my colleagues to put that email
address in the chat room now so you can see it as well. We will send you details.

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Let's talk a little bit about what we will do each week. This week, we are going to look at change
starts with me. Being a change agent. What we will then do, there's a problem on my slides, they
have disappeared after slide 11. What I will do, I will stop there a moment. Here they are. They have
come back.
Week two, we will be looking at the power to make a difference and particularly focusing on change
agency which is a power individually and collectively to make a positive difference and that is next
Thursday, the 22nd.
The third week, can you see my slides? I can't see slides on my screen. I have some slides here and I
will work here.
The next week, which is module three, we will focus on being resilient and dealing with resistance to
change. Lots of change agents say to us that it is important to focus on resistance to change and
resilience.
The next week, which is week four, Thursday, 8 March, we will focus on mobilising and organising for
change. What that means is using social movement ideas, community organising, to enable us to
move from the my situation as a change agent to be able to build a we. Week five is about the
change agent of the future. What it means to be a change agent of the future.
I want to stop for a moment because one of the key aspects of the School for Change Agents is not
just focusing on what I know and skills and capabilities I've got.
All of us need these things. We need an understanding of improvement and project management,
analytics and problem-solving, these are key skills. Those are not the skills we teach in the School for
Change Agents. It is about how I think. One of the things we say, you cannot be a change agent on
your own. We have to connect with other people. We need to rely on other people that enable us to
be who we are.
Holding different views at the same time, keeping a short-term view and long-term view. Being
realistic and optimistic. Being comfortable with tensions, issues, paradox, contradictions. Being able
to work with those at the same time and how I think the best of people.
All of those things are important and what we teach in the school is much more, the right hand side,
how I think but we also want to develop the left-hand side about what I know.

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Let's get into the meat of module one. In the next 45 minutes, we'll talk about having the power to
make a positive difference. That's what the school is all about. We will look at a model for power
which is about old power and new power. If we challenge the status quo and do things differently,
we need to be rebels. We need to be the people on the edge that are challenging the current
system.
We will talk about rocking the boat and staying in it. We need to challenge the status quo but not so
we rock the boat and get into trouble.
We are starting from a place of love.
When we have school for change agents and we work with change agents, we work with the
fundamental law that comes from Dave Weiner. "Some of the expertise of the people in the
audience is far greater than some of the expertise of the people on stage", that is the case here
today.
Hundreds and hundreds of you taking part and the wisdom and experience that you bring, we want
to show that with each other.
The school is designed on a learning perch that is called connectivism. We can learn by listening to
experts but the way that we learn best is when we nurture connections. Looking at different
perspectives and experiences we have as a community in the school, how do we learn from each
other?
I thought I'd start the next stage with my own perspective. At the top of the slide, we can see a piece
of installation art. This is from Adam Katz. He took 13,000 orange plastic soldiers and put them on a
shop window. He spelt out all of my good ideas are battles.
I have been a change agent for 30 years. I can't think of a thing I have been involved in that was
easy. I can't think when someone said he was X million pounds or dollars and the team makes the
change. It's never like that. It's always hard. Any of us who are standing up and questioning, some of
us who work in the health and care system, we think about our service users and patients and what
we are aspiring to do in terms of the care that is safe.
To challenge the existing order is never an easy thing. I have quote from Thomas Huxley who was a
Victorian evolutionary biologist. He was defending Darwin's theory of natural selection. He says
"new truths begin with heresies." We are heretics as change agents.

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If you are a rebel, I deviate from the existing order, we don't have an easy life. I hope that being part
of the community of the School of Change Agent can help you to be an effective heretic with pride.
At the base of everything that we think and teach in the School of Change Agents is the issue of
power. The School of Change Agent is focused on building power. The definition of power that we
use is this one. This is Bertrand Russell. "Power is one's ability to achieve goals."
If we think about as as change agents, where we are in the world, we strive to make a difference. We
strive to create positive outcomes for the people we serve. Power is our ability to achieve that goal.
Focusing on power is very important.
Here is an example from a piece of research that my team was involved in. We commissioned the
learning review across the whole of the National Health Service in England.
The most common view we got back from our colleagues from the frontline, doctors, nurses and
support workers, it was I don't feel that I can even make very small changes in my service. I don't
think I can improve things because I don't have permission. So many colleagues felt powerless.
In a sense, what we focus on is how to build power. The school for change agents is about building
agency.
Collectively, we want to build our power to make a difference. Change agency is about having the
power of an individual and collectively with other people to make a positive difference. It's about
pushing the boundaries of what's possible, making change happen more quickly. Over the next five
weeks, it's about building agency.
We are agents. Our definition of a change agent in the School for of Change Agent is somebody who
is actively developing the skills, confidence, building their own power, building relationships with
connections with others and having the courage to make a positive difference.
When we talk about power, this is one of the models that we like the best. It is about making a
contrast between old and new power. This is helpful for change agents.
When we talk about old power, it is like a currency. It is like money. A few people have a lot of it but
most people haven't. Old power is positional authority. It is pushed down in organisations and we
are commanded to do things. You have to do that because it's the emergency department waiting
time target or you have to do that because it's the performance agreement with the buyer or
Commissioner. You have to do that because it's the quality standard.

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Old power ends at the doors of an organisation. If I am the leader of a hospital system and I work
with leaders of the local community, I cannot command them to do anything. Old power is largely
about transactions. It is about holding people to account. It is about governance, systems and
structures.
Many of us live in systems that are about old power. We are also seeing a new kind of power. New
power.
This book is about how we think about power in a new way for a new world. They talk about new
power being a current. It is a surge of energy. When people come together with a common goal,
power grows. It is made by many people coming together. We pull new power into an organisation.
The more people that engage, the more power we have. New power is shared by many.
Largely, new power is about relationships. People engage because they want to and not because
they have to. I am mobilised for change. Old power is that you have to do it because it is a
performance target or a quality standard.
New power is all about relationships and based on trust. If I give my time and effort and energy to
engage in change, if things don't get followed up, I won't engage again.
Those of us who work in the health and care system, some people forecast the demise of old power.
I don't think it will be going away from any health and care system that I know at any time soon. It is
a very strong mechanism.
We are seeing a layer of new power coming on the top that creates all kind of opportunities for us.
For us as change agents, where we need to be in the world is to operate in that difficult zigzag place
between old power and new power.
I've seen lots of examples of people with formal power trying to transform the whole system in a
top-down way. The reality is it doesn't work. It's hard to sustain.
When you push on change people, it's hard to keep it. On the other hand, I've seen local activists
who do amazing things in local settings but they butt up against the wall of old power and it goes no
further. We need to be able to work with both.

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Once you start to work with new power, you can't turn round and go backwards if it doesn't work. I
have a nice quote from Millicent Merchant, if people engaging new power, if they give to a cause
then they are expecting a relationship not a transaction.
If as a leader, I want to go back to old power, it creates a lot of problems.
We as change agents need to be able to mobilise others and work with you power effectively. We
need to be able to do it in an old power world. There's lots of evidence that backs up our ability to
do this. This is Canadian research, shout out to our Canadian colleagues, this research was called, the
article that appeared from it was called the network secrets of change agents. These Canadian
researchers. They went into a very big organisation system and followed 67 change projects around
the system. What they wanted to understand was what makes the biggest difference in terms of
being an effective change agent? First of all, let's look in the chat box, does anybody know who
hasn't seen this before what is the name of the very big organisational system that the Canadian
researchers went around? Anybody want to have a guess in the chat box?
Yes. Some of you know it already. Lots of you. Mandy knows it, Lisa knows it. English National Health
Service. These researchers went around 67 projects in the NHS and what they found was that being
an effective change agent and being able to make change happen was much more about being in the
centre of the informal network and being able to make change happen informally than it was with
having the positional power of being at the top of the formal hierarchy.
Sometimes, we work with students and trainee doctors and newly qualified registered nurses and
they say, I have no power to make a difference. Actually, we have an awful lot of power.
This comes from Herrero who writes about viral change and his study shows that people who are
highly connected in an organisation have twice as much power to influence change as people with
hierarchical power. If we can be the kind of change agents who are highly connected, who can work
in relational ways, be consistent, we can make change happen.
I am just going to give notice to my colleagues that are looking after the chat box and the Twitter to
just say in a couple of minutes I will ask you to give as a bit of an update in what is happening on
Twitter and in the chat box. One more section I want to show you.
What we are finding is as we are moving into a more social world, it is creating all kinds of
opportunities and new knowledge. This is some analysis from (unknown term), organisation network
analysis, they go into lots of different organisations, what they find typically in organisation after
organisation is that about 3% of people in the organisational system influenced about 85% of the
other people.

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If we want to make big change happen in an organisational system, rather than trying to push it
down through the hierarchy, let's find out 3% because they are people who are talking to and
influencing other people all the time.
I guess one of the questions for you is who are your 3%? What's interesting is that it also seems to
apply in terms of social media.
Gwenda Kennedy from Scotland, a public health doctor and a genius as social media analysis, has
looked globally at people tweeting in healthcare. Again, what he is finding is that about 85% of all
the content that gets retweeted originates with just over 3% of people that tweet. The 3% 85%
seems to hold absolutely.
Again, we see that in the school, who is tweeting around the school, there are 3% of people tweeting
that account for 85% of the retweets. It is interesting because, again, we are operating as change
agents in a changing world and people think, oh, that social media is amazing, it gives us the
opportunity to connect with people all over the world and get to new audiences but that is not
actually the reality.
The reality is that most social media operates within an echo chamber. What we mean by that most
people who connect with each other on social media people like us, they are people that already
think the way that we think and actually very little social media goes beyond the echo chamber.
Even though we are in this world where we perceive, we can connect with anybody, we tend to
connect with people like us. Just this idea around the 3%, I want to show you a bit of a complicated
Twitter diagram, bear with me. If you bear with me on that I will have a pause after that for analysis
of chat on Twitter. I want to show you an example, this is (unknown term), what this is about is what
you can see on the left hand side here is a big corporate accounts, a big organisation in the world of
healthcare. It has a lot of followers and put a lot of emphasis, it is waiting all the time.
You can see, on the left hand side, this very big circle here.
That is a lot of activity. If you look beyond that circle, what you can see as there are a lots of material
and tweets being broadcast but a very thin line of people that are receiving it and it isn't going
further. This is a typical corporate health care social media account and what we are doing is
broadcasting, putting material out, all the time. It is being very influential. What is much more
interesting here is this.
What is going on here are what we are calling our medical super connectors. These are a group of
medics, mostly commissioned, some nurses, who are at the centre of informal influence on social

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media. Everything that they put out on social media catches on fire, can you see the concentric
circles going out here? That is a sign of a very influential person. You have a big health care
organisation that has got communication function, lots of followers, putting stuff out but it doesn't
influence but in the middle you can see these medical super connectors who are far more influential,
far better at getting the messages to spread than the big corporate accounts.
We have to learn from this. How can we be this kind of super connector? I will pause there and first
of all I would like to hear from Kate and Catherine about what is happening in the chat box. What
are we hearing?
SPEAKER:
Can you hear me?
SPEAKER:
Loud and clear.
SPEAKER:
There is a whole lot happening in the chat box, we are getting into some interesting discussions
around power and what it means. Firstly I should say people are loving your sketch notes on the
visuals. Also the Huxley quote about heresy.
Three things I have noticed and I'm sure Kate will add to this, connecting most of the people,
commission, people have been saying, yes permission is something that is key. People have become
afraid to ask. Ben says are sometimes we have to remind ourselves that we already have the
permission we need to improve things. People have also been picking up on power and wondering
whether the word has negative connotations.
Somebody suggested that introducing new power into the NHS is actively unwelcome. Zoe made an
interesting point, she said that the CTC forces old power but rightly so and she raised the question of
once we are up to standard, will we then have more freedom to pursue new power? That is a theme
we will come to, how do we balance both of old and new.
SPEAKER:
Thank you. Kate?
SPEAKER:

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I wanted to add that record-breaking news that we have over 750 people on today. That is
something to celebrate. Within that is an amazing community and that is something that is coming
to me today, already people are connecting, before you talked about the most important element is
about creating connective communities, people are already exchanging email addresses and
becoming that connected community. That is something to take home and be happy, glad to see
that happening. The other thing is that there was a great question about how do we find a 3%-ers?
That is really interesting.
Another bit of news via the YouTube, we have people joining already today via YouTube. (inaudible)
SPEAKER:
Fantastic. Thank you so much.
It is really wonderful, to see that connectivity taking place, it warms my heart.
Lee, I think will be my spokesperson enters a twitter. Hi, Lee.
SPEAKER:
Can you hear me?
SPEAKER:
Loud and clear. What is happening on Twitter?
SPEAKER:
Twitter is buzzing. It is incredible. People are really enjoying getting to know people from all over the
world. We have had a picture of some friends in New York, 50 of them, they are listening intently. It
is fantastic. People from England, UK, all over the world, brilliant. They are all getting together in
conversation and talking about the content.
Just as Catherine said, they are loving the content and sharing the slides. There have been lots of
conversation about power and what new power means and about shifts in mindset and reflecting on
how you don't need a formal role in an organisation to be a change agent and you have power.
There was a reflection as well about how can you use a new power mindset not to alienate the old
power and keep them in the community? Also talking about the 3% as well, people reflecting on how
they can find their 3% and how they can engage with them. How they can put it in action already,
thank you everybody for keeping me busy on Twitter. Keep the conversation going there. Thank you.

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SPEAKER:
Thank you so much.
Just to make a couple of reflections. I agree with Zoe that we will never have a world where we don't
have old power. I can't actually think of a single organisation even very flat ones don't have some
kind of hierarchy and for those of us that work in health and care, if we want to keep our patients
and service users safe and well, we have to have some old power mechanisms. Actually, when I think
of the very best senior leaders in the system, the ones that inspire me, what they do, they have old
power authority but they work in fundamentally new power ways. In terms of finding a 3%, there
are many ways we can do this. We can actually do formal analysis where we do organisational
network analysis.
Or we can just go and ask people. If we take the time to talk and find out who'd you talk to? Who
influences you? Very often, senior leaders and organisations are surprised because we don't know
who our 3% are.
Let's move on. We need as change agents to be rebel. We are challenging things in our system that
aren't great. What we mean by rebels? Somebody who is the principal champion of a change
initiative, a cause or an action. The thing about rebels is they don't wait in an old power way for
permission to lead, they get on with it, they innovate, strategise. The thing about rebels is they are
not unguided missiles creating havoc around the organisation, they are responsible, they work from
a place of value and they do the things that are right.
If we actually embrace our rebels in our organisation, we would understand what a powerful role
they play. Are rebels know things that other people don't see. They point to new horizons and new
possibilities. This is probably the last bullet point, my favourite quote about rebels, without rebels,
our storyline never changes and certainly for those of us who work in health and care or local
government or a police service, our storyline has to change. Rebels have to play their role.
We put this picture of a T-shirt here, it says "Raise rebels, not sheep," we have to get a balance, if we
put loads of fences around people you get sheep. When people are saying, I haven't even got
permission to make the tiniest change in my service, that is where we are putting the fences around,
we have to give people the room that they need. It's great, me giving this lecture saying be a radical,
deviant in your organisation.
Often, it feels like we are getting burned at the stake. There's a lot of evidence in neuroscience,
when people feel ostracised from others, we feel it as strongly as pain.

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Sometimes I am in the middle of a room saying we have 20 years experience. We know how to do
this change. We feel like the invisible elephant.
We need to be rebels and boat rockers. This comes from a classic source. Deborah Pearson. We
need to be the people in the organisation who can rock the boat and stay in it. It's a fine line
between being different and being inside and outside.
We are the people who can challenge the status quo when we see a better way of doing things.
When you look at the evidence around people who are able to rock the boat, we learn that these
people are capable of conforming and rebelling at the same time. When I look at my team, the
Horizons team, we strive to do this.
Everybody who works in the Horizons team is a rebel. It is part of what you need to join. In a sense,
we are working at the heart of the NHS. If we just rebelled all the time, we wouldn't last long. As a
team, we try to be good corporate citizens. We try to come forward as part of a bigger directorate
and work really hard and well with other teams.
We try to do reporting very well because we recognise, in order to have the space to rebel, we have
to conform to the things other people think are important. We must do both.
One of the things about being an effective boat rocker is about being able to work with other people
to create success. Number one rule of being a change agent is you cannot do it on your own. You
have to work with others to create success and not the kind of person who is perceived by others as
a disruptive troublemaker.
My colleague Lee on Twitter, she did a sketch note. What's the difference between people who are
successful boat rockers and those who follow? Boat rockers are typically focused and passionate
about the person centred or patient centred mission of the organisation.
They are able to keep perspective even when things are going wrong. They are optimistic
unreasonably. They are able to generate energy and people around them and we will look at energy
next week. They see potential and opportunities and they are able to work together effectively with
other people.
When you look at the characteristics of people that tend to fall out of the boat, often, they are
complaining a lot. The focus of the complaint is around me. My situation, how badly I'm being
treated. People who have fallen out of the boat are angry in a me-focused way.

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Why should they think it's going to be different this time? They are energy sapping and they alienate
people around them so when the positive boat rocker skips along with great new ideas, all they can
see is problems. As a result, the people who have fallen out of the boat are alone.
All of us taking part in the School for Change Agents, we aspire to be boat rockers and not to fall out.
I'm trying to be careful about not putting any judgement on this. I see people in the healthcare
system who start off being boat rockers who are doctors, nurses, social workers who have a real
sense of calling to the kind of work that they do. They find themselves in dysfunctional teams or
toxic organisations.
They end up falling out. I took this quote from Benjamin Zander. "A cynic who has fallen out of the
boat is a passionate person who doesn't want to be disappointed again."
It's about trust. I took this other quote from Marcella Browner - if I choose to distrust it, the world
feels terrible. When I think about myself, when I am feeling energised, I am a boat rocker. If I am
feeling like I'm falling out of the boat, that's not a great place to try to make positive change from.
Those of you who are in a group, here are some questions that you may want to reflect on.
What are some of your insights around boat rocking? What happens that leads to people falling out?
Those are some questions you might want to think about.
I have a question for you. When we look here at this list of the attributes of boat rockers, there are a
few different descriptions. One of those descriptions is far more important than the other seven
when it comes to managing to stay in the boat.
In the chat room, can you put, in terms of those descriptions of boat rockers, which one do you think
is the most important when it comes to staying in the boat? Most of you are getting it right. The
most important one, when it comes to staying in the boat, is - together.
Number one rule of being a change agent is you cannot do it alone. However creative or fabulous we
are, or what great ideas we have, we are in a system that pushes us towards normalisation and
conformity.

15. 15
The system will crash us in the end so we have to connect with other people. I have a slide here. I
tried to put something in for everyone. Some of you will like data and evidence. Some may want to
look at it from a practitioner point of view.
There's a series of other pieces that are reflections.
This idea that change starts with me. I like a quote from Otto Sharman - "When we think about the
success of our actions as changemakers, it does not depend on the things that we do or how we do it
but on the inner place from which we operate". What do we know about successful boat rockers?
1. Able to join forces with others to create action.
2. Important that we achieve small wins. We want to create big transformational change but
sometimes we underestimate the power.
When we make real change happen, it gives credibility, it builds trust. It creates a sense of hope and
possibility and confidence.
3. The topic of the School for Change Agents - a strong sense of agency. What do we mean by that?
It's power. The belief that I am able to create a change.
A lot of it is how I see the world. I am more likely to view the obstacles as challenges to be
overcome. Through the five weeks of the School for Change Agents, we will build on this. The idea
that being a great change agent is not about having the knowledge or skill technically in terms of
improvement. Those things are important but they are not enough. It's about being change, what
each of us does every day and other people understanding that we are change agents through our
work and actions.
This is Donabedian, he is one of my heroes. Anyone who works in quality improvement in healthcare
knows who this is. He was working 40 years ago and was the founding father of quality improvement
in healthcare.
He introduced the initial quality improvement that we know and love. He says, if you want quality,
you have to start from a place of love. If we have love, if we start from that place, we can work
backwards and do all the monitoring and improving systems that we want but we have to start from
that place of love.
One of the most important tactics for us as change agents is to be people who love everyone else.

16. 16
If we look at the history of outlaws, people at the edge, people doing things in different ways, we
see again and again, when people live by a code, Donabedian was an outlaw because what he did 30
or 40 years ago was so different.
He was working with the code. I want to show you another outlaw.
John Perry Barlow was one of my heroes. He was the lyricist of the Grateful Dead. He was also an
activist, an open Internet activist. This idea around living by a code, he died last week at 70. When he
was 30 years old, he wrote a code. He called it 25 Principles of Adult Behaviour.
I put a link in there because it is worth looking at John Perry Barlow's 25 Principles of Adult
Behaviour. They are amazing. For a 30-year-old to have created them is astonishing.
It's a great code for us as change agents. I picked a few of the 25 out. We are running out of time.
Number three, never assume that the motives of other people are to them less noble than yours are
to you. Assume the other person has a noble intent.
Think big. Expect no more of anyone than you yourself can deliver. Tolerate ambiguity. Let's concern
ourselves with what is right, not who is right. What matters is what is right. How can we understand
the needs of the people around us and respect them? We have to listen. How can we reduce our use
of the first person pronoun? How can we please at least as often as we discourage?
We want to be more about joy and less about suspicion. Joy is at the heart of boat rocking. Joy is
what brings us to work to do the things we want to do.
We cannot love anyone else unless we love ourselves. We need to endure. If you are in a group,
think about challenging the system. What is our code?
Really quickly, I'm going to ask our Twitter monitors to say some final things. I want to talk to you
about RCT. What is an RCT? Those of us working in a clinical environment, we think is a randomised
controlled trial. A planned experiment, and a scientific experiment. In the school for change agents,
a randomised coffee trial, we have done this last couple of years and it is magical. What we needed
to do, we have a link there, we will send it in our email newsletter, we want you to sign up to take
part in an RCT and we will randomly pair you up with somebody else and it could be from anywhere
in the world.

17. 17
If you are near each other, you can meet face-to-face but most people do FaceTime or Skype or
phone, we have a virtual cup of coffee together and it is a fantastic way to meet people that you
wouldn't meet otherwise. Very finally, we at the team, we do a series of virtual talks, edge talks. We
are doing some special ones for the school for change agents. What they are is an opportunity to
take part in an interactive conversation. We have a whole programme of them but each of them
only has 25 places.
There is information about those on the website but if you want to sign up, you need to do so quite
quickly and you need to do it via the learning management system which lots of you have signed up
to already.
That brings us nearly to the end of module one. I want to ask Catherine, Kate and Lee to do a few
final things quickly over to you.
SPEAKER:
Hi. Can you hear me?
SPEAKER:
Loud and clear.
SPEAKER:
Loads of chat and a couple of things which are to be continued. One person said "What do I do if I
am a boat rocker but my boss loves falling out?"
SPEAKER:
Okay, carry on with that one!
SPEAKER:
Something about managing our plan and how you get power in others. Boat rockers in our
organisation tend to leave so a question there about perseverance and how we maintain that which
we will pick up in the next module.
SPEAKER:
Great points. Kate, anything to add?

18. 18
SPEAKER:
There was something I put out which was about swimming lessons and those that know me know
that I love teaching swimming. It was about when you fall out, how can... Having a swimming lesson
which we'll link into the future sessions about resilience. It is important to learn how to swim so you
can climb back in the boat.
SPEAKER:
Thank you. Let's carry on with our metaphor and final word goes to Lee looking after Twitter. What
would you like your passing comment to be?
SPEAKER:
So many brilliant comments. I love this tweet from Jansen who says "Change begins with me but
together we can change the world. Use your power to make an impact today right now."
SPEAKER:
Wonderful. That is a wonderful segue to say hope you enjoyed today and we will carry on. We hope
you will become a certificated change agent, do a randomised coffee trial and join our edge talks and
we look forward to seeing you next week when the focus is around agency. The power to make a
difference. Thanks, everybody for taking part. Thanks for your contributions. Let's keep building this
community and hopefully we will see you next week. Goodbye, everybody.