Greater Manchester Future Leaders

@HelenBevan #LeadingGM
How to be a GREAT change agent
Dr Helen Bevan, OBE
Chief Transformation Officer
NHS England
@HelenBevan
ANDSTAYINGINIT:

“New truths begin as heresies”
(Huxley, defending Darwin’s theory of natural selection)
Source of image:
installation by the
artist Adam Katz
www.thisiscolossal.com
Via @NeilPerkin

WHO makes change happen?
Source: adapted by Helen Bevan
from Leandro Herrera
List A
• The Transformation
Programme Board
• The programme sponsor
• The Programme Management
Office
• The leads of the [insert
number] transformation work
streams
• The Clinical Director
• The Team Leader /Unit
Manager
• The Change Facilitator

List A
Programme Board
Office
streams
• The Clinical Director
Manager
List B
• The mavericks and rebels
• The deviants (positive). Who do
things differently and succeed
• The contrarians, because they can
• The nonconformists who see
things through glasses no one else
has
• The hyper-connected. Good or
bad, they 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

List A
Programme Board
Office
streams
• The Project Manager
Manager
List B
• The mavericks and rebels
• The deviants (positive). Who do
things differently and succeed
• The contrarians, because they can
• The nonconformists who see
things through glasses no one else
has
• The hyper-connected. Good or
bad, they 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

Change is changing

Kinthi Sturtevant, IBM
13th annual Change Management
Conference June 2015
We rarely see two, three or four
year change projects anymore.
Now it’s 30-60-90 day change
projects

Source: Bromford P (2015), ”What’s the difference between a test and a pilot?”
Pilots are being replaced by rapid tests and
prototypes

Change is changing
Change from the edge

An example from the
Cabinet Office
http://www.slideshare.net/Openpolicymaking/060715-change-cardscollated?next_slideshow=1

@HelenBevan #LeadingGM#FabChangeDay
Why go to the edge?
“ Leading from the edge brings us
into contact with a far wider range
of relationships, and in turn, this
increases our potential for diversity
in terms of thought, experience
and background. Diversity leads to
more disruptive thinking, faster
change and better outcomes
Aylet Baron

Jeremy Heimens TED talk “What new power looks like”
https://www.youtube.com/watch?v=j-S03JfgHEA
old power new power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction
Current
Made by many
Pulled in
Shared
Open
Relationship

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

People who are highly connected
have twice as much power to
influence change as people with
hierarchical power
Leandro Herrero
http://t.co/Du6zCbrDBC

“I have some Key
Performance
Indicators
for you”
or
“I have a
dream”
Source: @RobertVarnam

“Tomorrow’s management systems
will need to value diversity, dissent
and divergence as highly as
conformance, consensus and
cohesion.”
Gary Hamel
Image by neilperkin.typepad.com
is the new normal!

“Tomorrow’s management systems
will need to value diversity, dissent
and divergence as highly as
conformance, consensus and
cohesion.”
Gary Hamel
Image by neilperkin.typepad.com
“The single biggest mistake to
avoid? Creating disruption at work.
Focus on developing relationships,
not disrupting and alienating
people. Peter Vander Awera on
learning from setbacks and failures
is the new normal!
##FabChangeDay

#SHCR @HelenBevan#@HelenBevan #LeadingGM
What happens to
heretics/radicals/rebels/mavericks
in organisations?

#SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevanSource: Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out

We need rebels!
•The principal champion of a change initiative, cause
or action
•Rebels don’t wait for permission to lead, innovate,
strategise
•They are responsible; they do what is right
•They name things that others don’t
see yet
•They point to new horizons
•Without rebels, the storyline never
changes
Source : @PeterVan http://t.co/6CQtA4wUv1

If you put fences around people, you
get sheep. Give people the room they
need
William L McKnight

We need to create more boat rockers!
• Rock the boat but manage to
stay in it
• Walk the fine line between
difference and fit, inside and
outside
• Conform AND rebel
• Capable of working with
others to create success NOT
a destructive troublemaker
Source: Debra Meyerson

#SHCR @HelenBevan
Source : Lois Kelly www.foghound.com
There’s a big difference between a rebel and
a troublemaker
Rebel

Reflection
• What are your insights around “rebels” and
“troublemakers”?
• What moves people from being “rebel” to
“troublemaker”?
• How do we protect against this?

#SHCR @HelenBevan
Source : Lois Kelly www.rebelsatwork.com
There’s a big difference between a
rebel and a troublemaker
Rebel

Change starts with me
Source of image: jasonkeath.com

‘I do not think you can really deal with
change without a person asking real
questions about who they are and how they
belong in the world’
David Whyte, The Heart Aroused 1994
Source of image: fistfuloftalent.com

1. able to join forces with others to create action
2. able to achieve small wins which create a sense
of hope, possibility and confidence
3. More likely to view obstacles as challenges to
overcome
4. strong sense of “self-efficacy”
 belief that I am personally able to create the change
Four things we know about successful
boat rockers
Source: adapted from Debra E Meyerson
CHANGE
me
BEGINS WITH

Self-efficacy
There is a positive, significant
relationship between the
self-efficacy beliefs of a
change agent and her/his
ability to facilitate change
and get good outcomes
Source of image:www.h3daily.com

Source: @NHSChangeDay

Source: @NHSChangeDay
What is the issue here?
“permission” ?
(externally generated)
or
Self efficacy ?
(internally generated)

Building self-efficacy: some tactics
1. Create change one small step at a time
2. Reframe your thinking:
• failed attempts are learning opportunities
• uncertainty becomes curiousity
3. Make change routine rather than an exceptional
activity
4. Get social support
5. Learn from the best

#SHCR @HelenBevanImage copyright: http://13c4.wordpress.com/2007/02/24/50-reasons-not-to-change/

#SHCR @HelenBevan#@HelenBevan #LeadingGMSource: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively

#SHCR @HelenBevan#@HelenBevan #LeadingGMSource: http://www.slideshare.net/AndreaWaltz/gfn-slidesharegfnhandling-rejectionpositively
Make it a personal
PERFORMANCE target.

Research from the sales industry:
How many NOs should we be seeking to get?
• 2% of sales are made on the first contact
• 3% of sales are made on the second contact
• 5% of sales are made on the third contact
• 10% of sales are made on the fourth contact
• 80% of sales are made on the fifth to twelfth
contact
Source: http://www.slideshare.net/bryandaly/go-for-no

“Papers that are more likely to contend against
the status quo are more likely to find an
opponent in the review system—and thus be
rejected —but those papers are also more
likely to have an impact on people across the
system, earning them more citations when
finally published”
V. Calcagno et al., “Flows of research manuscripts among
scientific journals reveal hidden submission patterns,”
Science, doi:10.1126/science.1227833, 2012.
—

Being a great change agent is about knowing, doing,
living and being improvement

Avedis Donabedian
“Ultimately, the secret of
quality is love.
…… If you have love, you
can then work backward
to monitor and improve
the system”.

Project Aristotle: http://qz.com/625870/after-years-of-intensive-
analysis-google-discovers-the-key-to-good-teamwork-is-being-nice/
After years of intensive analysis, Google
discovers that the key to high performing,
innovative teams is being nice

Key tactic :
Out-love everyone else
Source of image: Bradley Burgess

Four ways to connect!
1. Follow us on Twitter
@HelenBevan
@School4Radicals
2. Subscribe to
theedge.nhsiq.nhs.uk
3. Get materials from
theedge.nhsiq.nhs.uk/school
…and sign up for our monthly #EdgeTalks
theedge.nhsiq.nhs.uk/edgetalks

#SHCR @HelenBevan#IQTGOLD#SCHR @HelenBevan

#SHCR @HelenBevan
For our break, we will
have a RCT

• Randomised Coffee Trial!
• Randomised Coffee Trial!
Randomised Coffee Trial!

#SHCR @HelenBevan
fabnhsstuff.net/fabchangeday/rct/ or google “Fab stuff RCT”

utcomes of Randomised Coffee Trials

#SHCR @HelenBevan
Join in one of our national Randomised Coffee Trials
fabnhsstuff.net/fabchangeday/rct/ or google “Fab stuff RCT”
Mental health – for anyone interested in mental health issues
Dementia – for anyone interested in dementia issues
Staff wellbeing – for anyone interested in how staff are cared for
Patient Safety – for anyone with an interest in ensuring patient
safety across the health and social care system
Home First – looking at the issues around how people who have
long-term health conditions receive care outside of hospital
Learning and Leading Together – for anyone interested in how
patients and healthcare staff can work together in genuine
partnership
MatExp – for anyone interested in improving maternity experience
– women and families as well as professionals

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