Module 5 - Moving beyond the edge

The School for Health and Care
Radicals
www.changeday.nhs.uk/healthcareradicals

Module 5:
Moving beyond the edge
Supported by
#NHSChangeDay #SHCRchat

www.changeday.nhs.uk

#1mintobein


Joining in today and beyond
• Please use the chat box to contribute continuously during
the web seminar
• Please tweet using hashtags #NHSChangeDay and
#SHCRchat
• We will produce summaries of the discussions of today’s
module using Storify.com and Pinterest and put these on
the website
• The conversation continues on the live chat forum at
www.changeday.nhs.uk/healthcareradicalsforum


Modules
31st January:

Being a health and care radical:
change starts with me
7th February: Forming communities: building
alliances for change
14th February: Rolling with resistance
21st February: Making change happen
28th February: Moving beyond the edge

Almost:
1,300 learners
8,000 Slideshare views
1,500 study guide views
850 Storify views

And over…
4,500 tweets #SHCRchat
A weekly potential reach of 2.6M!

for
today
• Review of what we have learnt so far; characteristics of a
transformational change agent
• Panel discussion - How are radicals are going to move forward
with making change based on what they have learnt?

• “From the edge” – views about the emerging directions for
change and change agents
• Panel stories - Inspirational stories of how people have gone
beyond the edge
• Reflections and key messages about the school
• Panel discussion – What groups have formed and what has come
out of the mentorship programme?

• What next for the school?

Source of image: www.freshnessmag.com

Pulling it all together:
the characteristics of a radical
change agent

Peter Fuda’s Transformational Change Agent
framework
Skills and methods for creating
change

Ability to make sense of, and reshape
perceptions of ‘reality’
Personal characteristics and
qualities


framework: my commentary
“Doing”

• Where most change
agents in health and care
put most of their effort
and emphasis
• What others typically
judge us on
• What we often perceive
we need to do to add
value
• What most change and
improvement courses
focus on
• The “de facto” purpose of
a health and care radical

framework: my commentary
“Seeing ” and “Being”
• We can only do effective
“doing” if we build on strong
foundations of “seeing and
being”
• Give us the potential for:
• better outcomes
• more engagement
• self-fufillment and
connection with our
bigger purpose as an
agent of change


“Being” as a health and care radical

Personal characteristics and
qualities


“Being an effective Change Agent
involves demonstrating what you
teach as much as pontificating from the
mountaintops. Any behaviour we ask
others to adopt, we must consistently
represent in our own work, and share the
positive outcomes.”
Bryce Williams
Working Out Loud


• Living my conviction and values
• Strong sense of “self-efficacy”
 belief that I am personally able to create the
change

•
•
•
•
•

Shared purpose, not de facto purpose
A role model and signal generator
Stepping outside my comfort zone
A “rebel” rather than a “troublemaker”
Learning not judging
CHANGE
BEGINS WITH


me

 belief that I am personally able to
create the change

•
•
•
•

A “rebel” rather than a
“troublemaker”
CHANGE
BEGINS WITH
• Learning not judging

me

Rebel

Source : Lois Kelly www.foghound.com

 belief that I am personally able to create
the change

•
•
•
•
•

A “rebel” rather than a “troublemaker”
Learning not judging
CHANGE
BEGINS WITH


me

“Seeing” as a health and care radical
Ability to make sense of,
and reshape perceptions of
‘reality’


‘En este muno traidor
No hay verdad ni mentira,
Que todo esta en el color
Del cristal con que se mira’
In this world of many mazes
There is nothing false or true:
All depends upon the hue
Of the glass through which one gazes
(Sixteenth-century Spanish quatrain)


Seeing
“Seeing, looking, monitoring, listening,
perceiving and especially the indefinite concept
of intuitive feeling ”
Aubrey Jango


‘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

“Seeing” as a health and care radical
•
•
•
•

The big picture
Multiple perspectives
The positive intentions of others
Possibility of bad change processes rather than
resistors, blockers and laggards
• Hopeful futures, creative opportunities and
potential
• Multiple paradigms for change (eg, diagnostic and
dialogic)
• See myself in the context of my higher purpose

“Doing” as a health and care radical

Skills and methods for
creating change


“Doing” as a health and care radical
• Create the conditions where everyone can
contribute and do their best
• Join forces with others to create action
• Achieve small wins which create a sense of hope, selfefficacy and confidence
• Appeal to both the head (logic/planning/data) and the
heart (shared values/purpose, framing, relationships)
• Make change (and learning cycles from change)
routine rather than an exceptional activity
• Use models, theories and frameworks effectively

Use models, theories and frameworks
effectively


Conclusions for health and
care radicals?


Panel discussion #1
Learning journeys…


Facilitator – Jenny Price
Time – 10 minutes

Lana Nicholson
My key learning:
They’re not laggards,
they’re just
Precontemplative!
How I am moving beyond
the edge:
Best Quality together


Susan Wighton
My key learning:
The NHS is embracing a
fundamental change of
perspective, returning to its
social movement roots.
How I am moving beyond
the edge:
I have founded Health-Hum*,
focussing on health literacy
using grassroots networking
(*seeking charitable status)


“From
the edge”


Source of image:hoodlinghole.blogspot.com

What do we mean by “the edge”?
• Working at the edge of organisations
so we can see the potential and
make connections that we couldn’t
do if we were at the centre
• At the edge of current practice and
knowledge about change
• Taking risks and demonstrating
courage to think and do things in
new ways
• On the edge of ?

On the edge of glory?


Source of image: panchecco.deviantart.com

What is happening with change?
• Change is happening at a faster rate and is becoming
more disruptive
• Many of the ways we go about change were designed
for a different era and different set of circumstances
• Complex work is getting more complex and that makes
it difficult to replicate and copy; creative work is
changing more quickly
 both require more tacit knowledge which is best
developed through conversation and social
relationships rather than instruction manuals and
best practice databases

Source: Change Agents Worldwide and Steven Verjans

Emerging themes in change & transformation?
Dominant
approach
Organisation
Power through hierarchy
Mission and vision
Making sense through
rational argument
Leadership-driven (top
down) innovation
Tried and tested,
based on experience

From module one
Transactions

Emerging
direction
Community
Power through connection
Shared purpose
Making sense through
emotional connection
Viral (grass-roots
driven) creativity
“ Open” approaches , sharing
ideas & data, co-creating
change
Relationships
Source: @HelenBevan

Tacit knowledge is where the
action is….

It’s the people with tacit
knowledge who deliver the
results
But
The only way tacit knowledge can be broadly shared…
…is to turn it into explicit knowledge
VERY difficult
Few organisations succeed

Gray D (2012) The Connected Company

“Tacit knowledge is best
developed through conversations
and social relationships”
Harold Jarche


Source of image: northcentralcollege.edu

Two of the biggest future opportunities for
health and care radicals
• As bridge builders between disconnected
groups
• As curators and sharers of knowledge


Potential to share on a massive scale


Role of the Horizons Group
To stimulate new and ‘disruptive’ approaches in
support of health and care transformation,
operating at the edge of current thinking and
practice:
• skip a generation of thinking about how to create
large scale change
• skip a generation in new people to connect with:
emerging leaders, clinical trainees, students
• Skip a generation of methods for change: open
innovation, social media, crowdsourcing, hackathons

What next for The School for Health
and Care Radicals?


Panel discussion #2

Some inspirational stories of how people have
gone beyond the edge…


Facilitator – Pip Hardy
Time – 10 minutes

Nick Graham


Carol Read, Innovation Lead

Salisbury NHS Foundation Trust

Change starts with me
• Inspirational network #SHCR Chat
• NHS Change Model –
Spread of innovation
• NHS Change Day started
with a tweet
• My pledge & Twitter
experiment 22/23 Feb


Making change happen -www.mytrusty.co.uk
• NHS Innovation – Based
on original sunflower
cream formula used at
hospital for over 20
years
• First moisturising cream
with the NHS logo
• 100% profits back into
NHS patient care


Right Here – Right Now
Innovation in partnership
with diverse communities
• Salisbury Hospital Staff
& volunteers
• Other hospitals, GP
Surgeries, Walk in
Clinics, other clinics,
Independent retailers,
Hotels
• Wessex AHSN


Media interest
• The BBC One Show – My
Trusty® tested by Alex
Jones, Matt Baker &
Paddy McGuinness
• The Independent, Mail on
Sunday, Style magazine,
Radio 3, BBC South Today
• Glossy box, Blogs,
YouTube


#SHCR - Be part of the story…
• Join my pledge - “I pledge to connect with others and develop a network
that can fast-track innovative ideas to improve patient care”
• Find out more from www.mytrusty.co.uk, FB & @My_Trusty or
@CarolLRead
• Try out the cream on NHS Change day @WessexAHSN Stand @NHSExpo
• Email contact :- sunflowercream@salisbury.nhs.uk


Some reflections…


8 things I have learnt from this experience of
The School for Health and Care Radicals
1. There is a massive untapped reservoir of energy
and talent out there and the potential is
outstanding

2. The core audience is different to what we
anticipated:
 more expert
 more specialist


8 things I have learnt from this experience of
The School for Health and Care Radicals
3. The most important need is for connection and
community
4. How to build the relationship between tacit and explicit
knowledge
5. The best experience seems to be synchronous in time,
asynchronous in location
6. We benefit greatly from our global connections
7. All teach, all learn
8. We need to move forward to:
a. Glory
b. the next phase of The School for Health and Care Radicals

Panel discussion #3

Our developing communities


Facilitator – Liz Carter
Time – 10 minutes

Ibukun and Helen


Ibukun and Helen
• Ibukun said that she wanted motivation and inspiration from
the relationship
• Helen ‘I am keen to learn from others and to be able to share
my experiences of change and supporting others (teams and
individuals)’
• Ibukun has made links with people, to start gathering stories to
help build the ‘case for change’ and identify opportunities for
improvement.
• She also agreed to speak at a conference about being a radical
and several people gave feedback about how inspiring she was,
providing hope.

• The materials from the School have helped provide a starting
point for our conversations with each other and others. We
have established a way of maintaining the relationship as we
continue our journey, via e-mail and skype.

Radicals from Down Under
NZ - Learning Group


Meet the team
Priyesh Tiwari
Alex
Nicholas

Lynne
Maher

Alex Twigg

Eman
Radwan

Katrina
Wahanui

Margaret
Aimer

Alison
Schneller
Natalie
Leger


Purpose of group
• Improve personal practice of community organising skills
• Develop a group of community organising learners, leaders
and practitioners within Counties Manukau Health (and
partnering organisations)
• Contextualise the learning from the programme within our
roles, work and community here in NZ
• Increase the awareness for community organising approaches
in our respective services, departments, teams and
organisations


What we’ve learnt together
“As a group we have been able to talk about the concepts, share each of our own
learning and put it into our own context here in Auckland.”
“The experience has helped to reaffirm some of our existing learning, challenge some
of our current thinking and helped us to develop plans for sharing the learning
more widely.”

“We have learnt that what’s required for effective & sustainable change – the
investment of time in relational conversations to build shared purpose and
meaning - is not always valued by organisations managing pressing political and
economic pressures.”
“We are beginning to appreciate the importance of a community of radicals to sustain
and encourage each other as we articulate organisational heresies!”


Susan and Loy

Susan and Loy


Susan and Loy – our learning
• We can both learn from each other
• These connections need to survive beyond
the duration of the modules
• Creating a thriving network of radicals could
exert a significant force for change.


Feedback from CMCSU
• Loved the quote from flash dance about passion

• We have uploaded the radicals school content and narrative
onto the organisations electronic shared space
• Inspirational, sharing with people with similar mind set which
doesn’t happen across normal organisation life

• Offers potential for what we can do next
• Massive enabler
• Opens up thinking around what’s possible

• Our ambition for next year is to provide health and care case
studies for next years programme


Shucong and Lynne


Emerging themes and feedback:
• Pace of work is making it difficult to prioritise
• I am still here for anything that you need
• I am keeping on top of the education through
the power points and enjoying what I am
reading
• Thank you for your matchmaking skills. I am
positive that I will have a beneficial (and
radical) experience


Gain a certificate as a health and care change
agent AND claim your continuing professional
development points – Clinics coming soon…
Take some actions to demonstrate your learning from the school
and become a “certified change agent”. If you complete the
learning process you will:
• Be recognised as a “certified change agent” by the school and
NHS Improving Quality
• Be awarded a virtual badge that you can used on your email
signature, personal website, etc
• Be invited to take part in one of our virtual graduation
ceremonies
• Receive a framed certificate (UK residents only)
More details can be found here:
http://changeday.nhs.uk/resources#sfhcr

Some example pledges…
• To do at least one thing every week of the year that is "not in my job
description”

• To listen and hear the unspoken
• To reflect on every day by having a ‘best moment’
• To set up a Paired Learning programme for Doctors and Managers to work
together and learn from each other

• To donate platelets, raise awareness of the need for more platelet donors, and
encourage friends and family to join me.
• I pledge to speak the truth, even if my voice shakes
• I pledge to (attempt to!) set up a choir or series of choirs for NHS Change Day
• To say thank you for pledging
• I pledge to "connect the dots" supporting Clinical Leadership and Team
Engagement


Calls to action campaigns for this week
Post these or similar actions as a pledge on the NHS
Change Day pledge wall
http://changeday.nhs.uk/campaign
• What effort would be required on your part to action
your pledge for Change Day and do the follow up
work for certification??

• Why would it be beneficial for you to be a certified
Change agent?
• Who can help you with this process?

Questions for reflection
1. How can I move in the direction of change in
ways that will help me bring about the
changes I want to see?
2. How will I build on my experiences of the
School for Health and Care Radicals?
3. How will I build networks and communities in
support of the changes I want to see?


Module 5 - Moving beyond the edge

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