disruption an agent of constructive - nhs confederation/media/confederation/files/public...

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Disruption: an Agent of Constructive ChangeAflonyddu: Asiant ar Gyfer Newid Adeiladol

Jackie LyntonHead of Transformation, NHS Horizons, NHS Improving QualityPennaeth Trawsnewid, GIG Gorwelion, GIG Gwella Ansawdd

@welshconfed#wnhsreality15

Jackie Lynton – Head of Transformation

@jackielynton

Disruption an agent of constructive

…..

Stepping up to reality

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#NHSChangeDay #SHCRchat

Operate at the edge of current thinking and change

Share the disruptive power of connecting, leading edge knowledge, transformation and innovation

Connect people to people, to help health and care to think differently about the rules of change and make sense of it in their own context

Horizons Group

Small team

@HelenBevan

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

different mindset

for a different set of circumstances

We are operating with 20th century change practice in a 21st

century world

:

Source of images : http://www.slideshare.net/dachisgroup/dave‐gray‐the‐connected‐company@jackielynton

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@HelenBevan

Five enabling themes in change and transformation www.nhsiq.nhs.uk/whitepaper

@jackielynton

@HelenBevan @JackieLynton #mixmashup

Four ways to connect with us!

1. Follow on Twitter@Jackie Lynton

2. Subscribe to

3. Enrol for The School for Health and Care Radicals: next term starts 30th January 2015

4. Engage with NHS Change Day 2015: 11th March www.ChangeDay.nhs.uk

TheEdge.nhsiq.nhs.uk

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Why do we need to change and what needs to change?

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Why is change needed and what needs to change?

@HelenBevan Source of image: Whatsthebigideascwartzy.blogspot.com@jackielynton

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@HelenBevan

Most large scale change doesn’t fullydeliver its objectives

Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi‐industry survey

70%

25%

5%

Gets anywhere near achieving the change and delivering the

benefits

@HelenBevan@jackielynton

@HelenBevan

Most large scale change doesn’t fullydeliver its objectives

Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi‐industry survey

70%

25%

5% Delivers and sustains the change

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@HelenBevan

Most change efforts are built upon the shaky foundation of five flawed assumptions; that change can be managed, that human beings are objective, that there are ‘X’ steps to change, that we have a neutral starting point for change, and that change, itself, is the goalPeter Fuda http://www.peterfuda.com/wp‐content/themes/peterfuda‐bootstrap/content/Why‐Change‐Efforts‐Fail.pdf

Source of image: Whatsthebigideascwartzy.blogspot.com@jackielynton

@HelenBevan

Front line teams get inundated with high priority messages from leaders each day, making it difficult for them to know what to focus on

Increasing number of messages as information cascade through

the organisation

Source: adapted from http://businessjournal.gallup.com/content/162707/change‐initiatives‐fail‐don.aspx

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@HelenBevan

Front line teams get inundated with high priority messages from leaders each day, making it difficult for them to know what to focus on

Increasing number of messages as information cascade through

the organisation

Source: adapted from http://businessjournal.gallup.com/content/162707/change‐initiatives‐fail‐don.aspx

Buy in from front line staff is critical for improvements in quality and safety . Don’t overload them

Buy in from front line staff is critical for improvements in quality and safety

Don’t overload themhttp://healthaffairs.org/blog/2014/03/07/the‐

dangers‐of‐quality‐improvement‐overload‐insights‐from‐the‐field/

My first experience of being in large scale change in the NHS 1986

The story of Fredrick……

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#NHSChangeDay #SHCRchat@HelenBevan @BoelGare @JackieLynton #Quality 2014 #M5

Emerging themes in change and transformation

Source: @HelenBevan

@HelenBevan@jackielynton

Leading change in a new era

Dominant approach Emerging direction

Most healthcare transformation efforts are driven from this side

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@HelenBevan

John Kotter: “Accelerate!” most influential thought leader globally, recognises new approaches are needed

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

• We need hierarchy AND network

• Many change agents, not just a few, with many acts of leadership

• Changing our mindsetTO

FROM

@jackielynton

Must do

Want to do

Kotter: From “have to” to “want to”

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Must do

Want to do

Kotter: From “have to” to “want to”


Innovation/ideas is not reserved for someone sitting at the top of a hierarchy, but driven down to unleash new

levels of engagement

Nurse

Doctor ManagerSocial worker

Patient

Carer maker Cleaner

Pharmacist

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What lights the ‘fire in your belly’ and makes you feel passionate and determined to make change happen?

Unleashing the energy

The more you do what you love the more energy you have. Leadership Freak

Vs

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Here have some of mine!

MyPower

Power

Shifting positional power to relational


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

@jackielynton

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“Tomorrow’s management systems will need to value

diversity, dissent and divergence as highly as conformance, consensus

and cohesion.”Gary Hamel

Our underpinning themeEmbracing difference to change the conversation

@HelenBevan @BoelGare @JackieLynton #Quality 2014 #M5

Why am I a radical?

@jackielynton

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Source : Lois Kelly www.rebelsatwork.com

Sometimes other people see radicals/rebels as troublemakers

Rebel

#NHSChangeDay #SHCRchat@HelenBevan @BoelGare @JackieLynton #Quality 2014 #M5Source: Rebelsatwork.com

Rebels learn how to tell their story

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Me at 22 years old

#NHSChangeDay #SHCRchat#NHSChangeDay #SHCRchatImage from: @TheWorldStories

Change the world

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ENGAGEMENTCOMMITMENT ENERGY

• Creating a space for getting ready for change

• Invitation to thinking differently about change

• Share the collective wisdom of people in the room – 5 minutes of wisdom

Overview


1987

1. I did not feel heard, supported

2. Let down by my profession, shame

3. I was part of a system that didn’t protect vulnerable people

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33 years on

1. My experience2. Staff who ‘checked out’3. Compliance over

commitment4. Staff not feeling

‘permission’ to make to make changes

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‘Can I really make the change?’

Will ‘the system’ really ALLOW me?

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When you hit up against this wall, how do you feel?


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Now I don’t!Now I bring my authentic self to work

I had to be someone one else to fit in


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NHS Change Day 2015

Wednesday 11 March

Making a change for better together.

Disruptive Case Study

Do something better together….

Audacity to think we could mobilise the 1.5m people in the NHS

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Must do

Want to do

Shared purposeGoal – 65,000 (500k)

pledgesCore leadership team

Personal pledgeSet a dateWebsite

Social media Took risks

Courage & belief Kept it simple!

Holding each other to account rather than performance management

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Change Day pledges and stories

‘…the floodgates of change open’from front line to senior leaders

My pledge…..Not let hierarchy get in the way of patient care

What I didWorked with the hierarchy at an early stage. Seeking their support with an explicit understanding that they respected the grassroots nature of Change Day.

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Bottom up approach with top down support

I urge as many people as possible to give their support“

"NHS Change Day is a fantastic opportunity to join a movement of young leaders who want to make a

difference in the NHS

Jeremy Hunt Health Secretary

Chief Nursing Officer ‐ England

Professor Sir Bruce Keogh National Medical Director

It's especially an opportunity for the next generation of junior doctors to effect change

in a practical and sustainable way"

151

With the patronage and support of Her Royal Highness Princess Muna Al-Hussein who was the first to pledge

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Fun day for children Support group with a stomas

NHS CEO personal National pledge campaign

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30% shift in staff survey:‘Would you feel confident your hospital

would address your concern?’

Ashley Brooks Patient Champion

‘Change Day gave me the permission to use my energy in the direction I wanted to use it’

Students swap places with patients in mock ward

Change in University nursing curriculum

Louise Trowse – Second year student

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Tasting common medicine for children

Discussing pharmacy methods of improving the taste

Dr Damian Roland

“The single most important skill I learned from improvement leaders was narrative. It connects us to the reasons we were called to work forthe NHS. It will stay with me the rest of my career.”

Jeharna sings forchildren’s ward tosay thank you

‘I wanted to say thank you to NHS staff for the way my brother was looked after when he got knocked over,’

Staff feel appreciated

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Smile Feedback Wednesday

Ellie Milner

@HelenBevan @JackieLynton #mixmashup

• We must activate the mavericks, radicals, rebels and heretics

• From the top of the hierarchy:

You CAN support and enable a social movement

You CAN join forces to achieve shared purpose

You CAN utilise movement principles

BUT you CANNOT lead or drive it

• It’s not enough to mobilise, we have to organise

• There is a massive untapped reservoir of energy and talent out there and the potential is outstanding

What have we learnt?

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Now I don’t!

Now I believe it starts with me

Change had to start from the top with a change programme

It starts with me….

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More information

For more information visit

changeday.nhs.uk

@jackielynton

http://youtu.be/HvGOYmpOZI4

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http://youtu.be/HvGOYmpOZI4

disruption an agent of constructive - nhs confederation/media/confederation/files/public...

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