Helen Bevan, Chief Transformation Officer, Horizons Group

1. @helenbevan
Leading for spread, adoption and
large scale change
Source of image: @voinonen

2. @helenbevan
2
The greatest
danger today is NOT
micro-managing:
it is MACRO-LEADING
Henry Mintzberg

3. @helenbevan
Beware the chasm!

4. @helenbevan
Beware the chasm!

5. @helenbevan
Over the past 20 years there have been more than 100
NHS-wide pioneer/pathfinder/pilot/demonstration sites

6. @helenbevan
It’s an issue of power
Power is one’s
ability to achieve
goals
Bertrand Russell
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7. @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

8. @helenbevan
Connect with the 3%
Just 3% of people in the organisation or
system influence 85% of the other people
Source:
research by
Innovisor

9. @helenbevan
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

10. @helenbevan
WHO will make the change happen?
List A
• The Delivery Board
• The programme sponsors
• The Programme
Management Office
• The Delivery Board work
streams
• The Clinical Leads
• The Directors of
participating organisations
• The Change Facilitators
Source: adapted by Helen Bevan
from Leandro Herrera

11. @helenbevan
WHO will make the change happen?
List A
• The Delivery Board
• The programme sponsors
• The Programme
Management Office
• The Delivery Board work
streams
• The Clinical Leads
• The Directors of
participating organisations
• The Change Facilitators
List B
• The mavericks and rebels
• The deviants (positive). Who do
things differently and succeed
• The nonconformists who see
things through glasses no one else
has
• The hyper-connected who 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
onesSource: adapted by Helen Bevan
from Leandro Herrera

12. @helenbevan
WHO will make the change happen?
List A
• The Delivery Board
• The programme sponsors
• The Programme
Management Office
• The Delivery Board work
streams
• The Clinical Leads
• The Directors of
participating organisations
• The Change Facilitators
List B
• The mavericks and rebels
• The deviants (positive). Who do
things differently and succeed
• The nonconformists who see
things through glasses no one else
has
• The hyper-connected who 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

13. @helenbevan
Do you remember that 3% of people in an
organisation influence 85% of other
people?
Most of them are NOT people on list A
Formal leaders typically make up 12% of an
organisation and drive conversations with
55% of other people
Source: Innovisor

14. @helenbevan
Mark Jaben on the science behind resistance
What NOT to do
But what we do do
Engage
people here

15. @helenbevan
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

16. @helenbevan
Emerging themes in spread
• Increasing attention to the demand side, to
better understand the adopter’s point of view
• Coalition building (social movements and social
media)
• Increasing attention to system conditions
• Acknowledgement of context sensitivity
• The importance of co-design for subsequent
scaling (investors not buyers)
Source: David Albury