2. ENGAGEMENTCOMMITMENT ENERGY
Overview
1. Why start with shared purpose?
2. Case Study: NHS Change Day
3. Lessons in transformation from the largest simultaneous
improvement event in the history of the NHS in England
4. Invite you to think about one thing that you will do differently
from today or what you would pledge to improve what you do
3. ENGAGEMENTCOMMITMENT ENERGY
About me
1. Thirty two years experience in the NHS and social care
2. NHS Improving Quality, national improvement body
3. New national team, Horizons - leading healthcare from the future
4. Previous roles: MH nurse, social care, strategic, operational,
commissioning, Mid Staffordshire hospital, large scale change
5. Leading NHS Change Day
6. I am passionate about what I do
7. I found my purpose by starting with me!
8. Three girls; 27, 23, 13
4. ENGAGEMENTCOMMITMENT ENERGY
The English National Health Service (NHS) – 65 years
1. Free at the point of contact
2. Spend c£110b (USD $170b) on health services – 1st Mental health,
2nd circulatory problems, 3rd cancers and tumours
3. Employs 1.7m staff
4. Fifth largest organisation in the world
5. Serves a population of 54m people
6. Everyday over 1m people use the NHS
7. Improvements in waiting times, hospital acquired infections, cancer
8. It’s a massive complex system, that needs to improve care
5. ENGAGEMENTCOMMITMENT ENERGY
Our challenges in the NHS
1. Unsustainable patterns of growth in expenditure
2. Rising demand and expectation
3. 4% compound reduction, four years running
4. £20b (USD $31b) savings – needs to be made
5. Healthcare needs to be better and cheaper
6. Huge media spotlight
7. Over regulated and fragmented system
8. Delivering higher value through quality improvement
9. How to make the savings and keep quality as an organising
principle
7. ENGAGEMENTCOMMITMENT ENERGY
“For those who hope to
lead today must first tell
their story”
Patients
‘I am the
expert of me’
Change my way
of thinking…
Everyone has a
unique story
Everyday you get up with a
purpose
9. ENGAGEMENTCOMMITMENT ENERGY
Shared purpose vs Organizational purpose
Shared purpose goes way deeper then vision and
mission; it goes right into the gut and taps some
part of our primal self. I believe that if you can bring
people with similar-purposes together and get them
marching in the same direction, amazing things
can be achieved.
Seth Garguilo
10. ENGAGEMENTCOMMITMENT ENERGY
Inspire
Why and why now?
NARRATIVE
Belong
Emotion
Feeling
Values
How and where?
ACTION
Contribute
Create
Connect
Lead
What and Who?
STRATEGY
Know
Think
Understand
Logic
How did the great social movement thinkers change
the world?
11. ENGAGEMENTCOMMITMENT ENERGY
Through our emotions we are more likely to be inspired to
take action
Action
Values
Emotion
For those who are inspired, the motivation to act is deeply personal (Simon Sinek)
Source: Marshall Ganz
13. ENGAGEMENTCOMMITMENT ENERGY
Five reasons to start with shared purpose (why)
1. You cant impose anything on anybody and expect them to
be committed to it. - Edgar Schein
2. Those who start with WHY never manipulate, they inspire.
People follow them not because they have to, but because
they want to. - Simon Sinek
3. We respond differently when we hear stories, rather than
when we see the policy data or financial balance sheets.
4. Purpose helps us to understand what we value in the world
and why the work we do is important to us.
5. Commitment to a common purpose creates energy for
action and great leaders inspire us to act to create
behavioural and cultural change.
18. ENGAGEMENTCOMMITMENT ENERGY
Our strategy for dealing with change sometimes
looks like this….
- Structural change
- Focus on productivity
- Programme management
- System drivers
- Hitting targets
- Reducing costs
- Eliminating waste
- Inspection regimes
19. ENGAGEMENTCOMMITMENT ENERGY
The largest simultaneous improvement
initiative in the history of the NHS
You cant impose anything on anyone and expect them to be committed to it. Edgar Schein
20. ENGAGEMENTCOMMITMENT ENERGY
It started with a tweet!
You cant impose anything on anyone and expect them to be committed to it. Edgar Schein
Young clinical leaders and
improvement leaders
started to talk about how
they could improve care
Damian Roland
Stuart Sutton
Helen Bevan
21. ENGAGEMENTCOMMITMENT ENERGY
Our shared purpose
Creating a mass movement of people working in and with the NHS
demonstrating the difference they can make, by pledging one simple act
big or small to improve patient care.
Our goal: 65,000 pledges, 1000 for every year since the NHS was established
From single
action to…
…collective
action
24. ENGAGEMENTCOMMITMENT ENERGY
“If you want to really understand management,
manage volunteers” – Peter Drucker
It changes how you look at motivation and influence if
you remove the handcuffs of employment from your
view of managing performance
It makes you work harder at aligning your goals and
their goals
Volunteers are doing something because they want
to, not because they need to.
30. ENGAGEMENTCOMMITMENT ENERGY
Example pledge – Jackie’s story
Individual > organizational
By spending a day with frontline
staff I was able to reconnect
with why I do what I do. The
staff were so committed. The
Trust really took the concept of
Change Day to another level by
getting the whole organisation
behind it.
“
Barking, Havering and Redbridge University hospital, London
31. ENGAGEMENTCOMMITMENT ENERGY
Example pledge – Ashley’s story
Patient/Staff champion > to Board
Change Day gave me
permission to use my
energy in the direction that
I wanted to use it
“
32. ENGAGEMENTCOMMITMENT ENERGY
Example pledge – Ellie’s story
Feedback Wednesday – Individual > organisational
“I was able to facilitate changes from feedback quickly, to make great
difference for our patients. Being a part of the core team inspired me even
more and the idea spread to different departments.”
Patient Experience Lead
Birmingham Children’s Hospital
33. ENGAGEMENTCOMMITMENT ENERGY
Example pledge – Damian’s story
Individual
It has prompted myself, and
others to discuss with our
pharmacies methods of
improving the taste of one of
the common medicines for
children.
“
”Damian Roland - Junior Doctor
Dr Rani – Childrens TV Presenter
Stuart Sutton - GP
34. ENGAGEMENTCOMMITMENT ENERGY
Example pledge – Russell’s story
Individual > global Cerner
Our Change Day event
brought together people
driving change in
healthcare. It positioned
Cerner as a partner for
change an
transformation
“
35. ENGAGEMENTCOMMITMENT ENERGY
NHS Change Day survey feedback
MEASUREMENT
BENEFITS
SUSTAINABILITY AND IMPACT
Our patient satisfaction has gone through
the roof. It has been so successful that we
have come from daily complaints to being
nominated to the ‘Outstanding and
Compassionate care Award’ in less than 6
months.
Heart of England Foundation Hospital
“
”
36. ENGAGEMENTCOMMITMENT ENERGY
Measurement, benefits and impact
MEASUREMENT
Year 1
65,000pledges,
creating a ground swell
BENEFITS
•Scale and accelerate the time from an idea to implementation
•Partnerships becomes possible
•Young leaders empowered (check in)
SUSTAINABILITY AND IMPACT
Small sample from a recent survey monkey:
80%
Said they shared what they were doing with others
The majority of people said it caused a change in their personal behaviour
The majority of pledges led to a long term impact in the organisation
Year 2 - 2014 – 500,000 Pledge, share, do, inspire (mobile app)
Year 3 – Continuous cycle of improvement, patient experience, value
38. ENGAGEMENTCOMMITMENT ENERGY
Challenges
1. Many people did not believe it was possible to build a grassroots
improvement movement inside a hierarchy like the NHS
2. Seek forgiveness rather than permission, frontline staff believing they
could lead change without being told what to do
3. Leaders and managers mind set need to change with new ways of
improvement thinking
4. How do we ignite the fire of NHS Change Day at Scale and enable it to go
viral. Social media still novel or patchy across healthcare
5. Maintaining momentum and our own energy up. Attract new supporters
6. Copious amounts of courage and belief (took a leap of faith)
40. ENGAGEMENTCOMMITMENT ENERGY
We worked with the hierarchy…..
You’ve got to see people like me
saying… we’re here to help you do your
job better... to take away the obstacles
that stop you doing it. And if we see
our job like that, it’s a completely
different way of thinking about how
the system operates
“
”
Sir David Nicholson
CEO – NHS England
Dementia pledge
Leadership cannot rely on a presumed monopoly of ideas
43. ENGAGEMENTCOMMITMENT ENERGY
Organisational radicalsWhat do boat rockers do……
• Able to challenge the status quo
when they see that there could be
a better way
• Walk the fine line between
difference and fit, inside and
outside, rock the boat but manage
to stay in it
• Capable of working with others to
create success NOT a destructive
troublemaker
46. ENGAGEMENTCOMMITMENT ENERGY
Summary
1. Change start with self – Its starts with me!
2. Everyone has a story – they are all unique
3. Start with shared purpose, but find your purpose
4. Connect through the head, heart and hands
5. We need to work/lead differently – courageous. If you don’t
believe in it yourself then don’t expect others to
6. Real power – comes from giving away power to others
7. Push the boundaries and hierarchy in pursuit of the goal – the
goal is the goal
8. When we use natural resources, the more we use them, the
more they grow
48. ENGAGEMENTCOMMITMENT ENERGY
What will you do differently after today?
I invite you to pledge to make a difference….
I pledge to………It starts with
you.....
49. ENGAGEMENTCOMMITMENT ENERGY
Thank you for listening
Questions?
www.nhschangemodel/nhschangeday
#nhschangeday
Jackie Lynton
@jackielynton
Jackie.lynton@nhsiq.nhs.uk
Russell Mayne
@russellmayne
russell.mayne@cerner.com
ENGAGEMENTCOMMITMENT ENERGY
