The document discusses how healthcare is still organized like in 1917 and how new models of influence are emerging. It notes that 3% of people, called "superconnectors", influence 85% of others through open, shared networks rather than traditional top-down approaches. Trust in experts and institutions is declining globally. Patients and citizens are increasingly using social media and gaining agency. Successful change initiatives empower staff and focus on action, connection, and customization rather than traditional pilots and rollouts. Examples discussed include reducing delayed discharges and increasing community care through social campaigns like #endPJparalysis.

1. Being ready for the
change that’s coming
Source of image: @voinonen
:
Helen Bevan
@HelenBevan
#LeadersHealth18

3. We still organise health and care like the
Tabulating Machine Co. of 1917
Source of image: @corp_rebels@HelenBevan #LeadersHealth18

4. Jeremy Heimens, Henry Timms New Power: How it’s changing the 21st Century and why you
need to know (2018)
new power
Current
Made by many
Pulled in
Shared
Open
Relationship
old power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction

5. Find the superconnectors!
Just 3% of people in the
organisation or system typically
influence 85% of the other people
Source: Organisational Network Analysis by Innovisor

6. Find the 3%:
meet Mandy Carney, Head of
Patient Flow at Yeovil Hospital
• “Knows everyone in the
hospital”
• “Everyone follows Mandy
on Facebook”
• The go-to person for advice
• Mandy makes sense of
things and reduces
ambiguity for people
• Mandy presents her own
monthly award “the Carney
cup”

7. As senior leaders, we are less influential
than we think
If we want to get the same level of influence
through top down change as the 3% get, we
need four times more people
Source : Jeppe Hansgaard

8. The 3% rule also appears true for social
media
Source: research by Graham MacKenzie using NodeXL
In health and
healthcare globally,
tweets by 3.3% of
tweeters accounted
for 85% of retweets
@HelenBevan #LeadersHealth18

9. The powerful medical “superconnectors”
Source: NodeXL analysis @gmacscotland
@HelenBevan #LeadersHealth18

10. Across the world, trust is imploding
Source: http://www.edelman.com/news/2017-edelman-trust-barometer-reveals-global-implosion /
10
Peers are now as credible as experts

11. The inversion of influence
Based on the Edelman Trust Index: the
average of a country’s trust in the institutions
of government, business, media and non-
governmental organisations
@HelenBevan

12. A world of distrust: Edelman Trust Barometer
@HelenBevan

13. Patients, families, citizens & social media
Sources: Benetol et al (2018) How patients’ use of social media impacts their interactions with
healthcare professionals; @RealDoctorMike (2017) Patients trust social media, so be their trusted source
• People living with long term conditions and
with cancer are some of the most engaged
and active audiences on social media
• Research shows:
• Patients and consumers gain agency by using
social media for health-related purposes
• It improves their relationship with their
healthcare professionals
• Overt or tacit opposition from some healthcare
professionals
• Patients trust social media, so be their
trusted source

14. Empower your staff to be the voice of the
organisation. They’ve got audience & credibility
@HelenBevan #LeadersHealth18

15. A big debate in social science
Structure versus Agency
@HelenBevan #LeadersHealth18

16. The predominant approach in recent years has been STRUCTURE
but globally there is a big shift towards AGENCY
The design dilemma at the heart of change
Restructuring
Performance goals
Compliance
Regulation
Competition
Programme
Management
Incentive systems
Activation
Ability to make choices
Capability
Leaders everywhere
Social action
Solidarity
Social movements

17. The power, individually
and collectively, to
make a positive
difference
@HelenBevan #LeadersHealth18

18. Source: @NHSChangeDay
18

19. Source: @NHSChangeDay
19

20. Source: @NHSChangeDay
Problematic:
changing a
“permission
culture” can
take years
The good news:
we can usually
build agency
much more
quickly
20

22. Source: Brian Donohue https://t.co/znqTPXtCANhttps://t.co/znqTPXtCAN

23. Source: Bromford P (2015) What’s the difference between a test and a pilot?

24. #Futurenursing nhs70.crowdicity.com
@HelenBevan #LeadersHealth18

25. Google image
search using the
word ‘nurse’
Google image
search using the
word ‘doctor’

26. Transforming perceptions of nursing
A digital platform was set up to capture ideas on how about
transform perceptions of nursing and midwifery. It was live
for five weeks between December 2017 and January 2018,
supplemented by Twitter chats.
As a result there were:
23,000 interactions
212 original ideas from the
ideas platform
8,520 post views
Nearly 1,000 original tweets
in twitter chat which
generated 40 more ideas

27. Sign up: bit.do/futurenursing

28. Across the globe, researchers and practitioners are
questioning the conventional “spread” model
Pilot project Rolling out
“If we opened our eyes we would see the wonderful irony. Trying
to manage human change through pilot and roll-out has actually
grown something. A proliferation of project managers”.
John Atkinson
@HelenBevan @horizonsnhs

29. 3 principles for spreading change in the new era
ACTIONABLE: The idea is designed to make you
do something. It might start with sharing but it’s a
call to action
CONNECTED: The idea promotes a closer
connection with people you care about or share
values with. It makes you feel part of a community
and the network effect creates further spread
EXTENSIBLE: The idea can be easily customised,
remixed, reshaped by people taking part. It’s
structured with a common stem that encourages
communities to alter and extend it
Jeremy Heimens, Henry Timms New Power: How it’s
changing the 21st Century and why you need to know (2018)
@HelenBevan #LeadersHealth18

30. Making sure that only people who
should be in hospital are in hospital
• The number of hospital beds occupied by
patients whose transfer of care has been delayed
should be reduced to 3.5%
• Less than 15% of assessments [for continuing
care] should take place in an acute hospital
setting;
• a standardised performance dashboard
@HelenBevan #LeadersHealth18

31. #endPJparalysis

32. 70 day challenge:
to give patients
back one million
days of their
precious time that
would otherwise
be wasted in bed
in a hospital or
care home.
@HelenBevan #LeadersHealth18

33. @HelenBevan #LeadersHealth18

34. #endpjparalysis: connected social
communities
@HelenBevan #LeadersHealth18

36. Royal Devon and Exeter Hospital
@HelenBevan #LeadersHealth18

37. @HelenBevan #LeadersHealth18

38. @HelenBevan #LeadersHealth18

40. #ProjectA: the starting point

41. What happened next……
@HelenBevan #LeadersHealth18

42. the collective brilliance of people
who work in ambulance services
(with the help of a few critical friends)

44. Launch Event 28th June

45. Film making in action!

46. Ideas platform 12th July to 5th September
https://projecta.crowdicity.com/

47. 12 ideas were tested in the “innovation burst” 26
& 27 September
1. Response to people in mental health crisis and emotional distress
2. Role of technology
3. Engaging and communicating with the community
4. A review of high volume patient groups
5. An optimal strategy for staff wellbeing
6. Extending make ready teams to other ambulance services
7. A scheme for ambulance staff with health issues to be fast tracked for NHS
services
8. Improvements to the handover process.
9. An improved response to falls.
10.A concept based on “Productive Ambulance Services: Releasing time to care".
11.The concept of rotation of roles
12.A directory of "quick wins" based on the ideas for small scale changes that were
submitted to the ideas platform
*
*
*
*
*
@HelenBevan #LeadersHealth18

48. The process has been 90% virtual

49. Thursday 15 March