Change is changing - how to lead large scale change

Leading Large Scale Change

Steve Fairman, Managing Director (interim)Helen Bevan, Chief Transformation Officer, Horizons groupCharlie Keeney, Programme Director

Transformational

Transformational

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

Capability for radical change: HIGH stakes

All industrialised countries face profound and defining health

care choices over the coming decade… It’s not just funding that

will shape the future success of the NHS. As important will be our capacity for improvement and

change

Simon Stevens Chief Executive NHS England

The NHS. . . needs toturbo-charge changes in the

way healthcare is delivered to patients

David Bennett Chief Executive

Monitor

We need to up the pace of radical change if we are to truly

respond to the lessons of Mid Staffordshire, Winterbourne View and the needs of our

population.

Jane CummingsChief Nurse

NHS England

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Introducing NHS Improving QualityCore purpose: helping the NHS to develop to face and meet the critical challenges ahead

Future success of the NHS will rest on all in and who use it having the capability to transform the way we think and work

A new lean, impactful, relevant, inspiring organisation, focused on patient benefit

Our approach

Developing evidence-based products and programmes supporting delivery of the Outcomes Framework and NHS priorities

Active development pipeline for the things that the NHS’ improvement body should do at a national level. Partnerships critical for development and delivery

Being at the leading edge of thinking and skills about radical, transformational change and translating this into action for the service

Our new White Paper• Examines leading trends in

change and transformation globally

• How to make change happen at a faster rate and be more disruptive

• join the new breed of leaders across the world, rewriting the rules of change and leading change from the future to get different results

• Release date: 4th July 2014 (celebration day for NHS Change Day)

Today’s session

1. Positioning the Horizons group to be at the ‘edge’ – hear from Helen Bevan shortly…

2. …and then a flavour of NHS IQ support on the ground from Charlie Keeney, leading the Clinical Commissioning Group transformational change capability programme

3. Questions and Answers

The remainder of weekVisit our stand A34, to:•hear more about our work supporting improvement at scale, •senior team ‘listening clinics’ as we further build our offer, and •details of our upcoming White Paper

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

SEISMIC SHIFTS

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

SEISMIC SHIFTS

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

SEISMIC SHIFTS

DIGITALCONNECTION

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

SEISMIC SHIFTS

DIGITALCONNECTION

Hierarchical

power

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

SEISMIC SHIFTS

DIGITALCONNECTION

Hierarchical

powerWork complexity

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

SEISMIC SHIFTS

DIGITALCONNECTION

Hierarchical

powerWork complexity

Change from the edge

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

Whilst back in the world of health and care...

Many of the ways we go about improving health and care were designed

in a different mindset for a different set of

circumstances Source of image:www.lifecompassblog.com

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

Some warnings‘‘The organizations that survive the future will be those that are capable of changing as fast as change itself

Gary Hamel’’

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

Leading change in a new era

Dominant approach Emerging direction

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

John Kotter: “Accelerate!”

• We won’t create big change through hierarchy on its own

• We need hierarchy AND network• Many change agents, many acts of leadership• At least 50% buy-in• Changing our mindset

• From “have to” to “want to”

Source of image:www.slideshare.net/mexicanwave/champions-trolls-10-years-of-the-cipd-online-community

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

5 ways to lead from the edge - and thrive

1. Embrace disruption2. Curate knowledge3. Build bridges to

connect the disconnected

4. Roll with resistance5. It starts with me

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

@corprebelscorporaterebelsunited.com

Across the world, the change agent movement Is exploding!

@rebelsatworkrebelsatwork.com

@chagwwchangeagentsworldwide.com

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

And it’s happening in healthcare!

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

is the new normal!

“By questioning existing ideas, by opening new fields for action, change agents actually help

organisations survive and adapt to the 21st Century.”

Céline Schillinger

Image by neilperkin.typepad.com

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

The 90/30 conundrum

of senior leaders say that to create more

innovation, they need to activate the

radicals/rebels/heretics/mavericks in their

organisations or systems

of senior leaders are very satisfied that

radicals/rebels can provide this value in their organisations or

systemsSource: rebelsatwork.com

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

5 ways to lead from the edge - and thrive

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

An “overcoming resistance” mindset

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

“The most basic not-so-secret formula for building an innovation culture is pretty simple - embrace diversity and start to attract, retain

and promote a diverse workforce that looks differently, works differently, dress differently, speaks differently and is inclusive of the

full spectrum of human sexual orientation and gender identities.”

Source of image: idsgn.org

Diversity: critical to innovation

“Do this before you start hiring consultants and rethinking your innovation process; there is no process that works without true diversity.”

Idris Moore

@HelenBevan @CharlieKeeney @nhsiq #confed2014@stevefairman1

Supporting CCGs and local systems to get their ambitions for patient-centredtransformation off to the best possible start

@HelenBevan @CharlieKeeney @nhsiq #confed2014

Our learning…

Collaboration and broad partnership Commitment -v- compliance Impact of shared purpose Loose – tight properties Learning through doing Wider yield

@HelenBevan @CharlieKeeney @nhsiq #confed2014