Editorial

Editorial – special NHS Transformathon issue 14

Welcome to our NHS Transformathon special issue of The Edge.

On January 27th, The Edge is hosting NHS Transformathon: a free, 24-hour, online event bringing together health and care staff and service users to connect, share and learn from each other.

This edition of The Edge takes a closer look at some of the innovative ideas and thinking that will be shared and discussed at the event.

Like The Edge, NHS Transformathon will showcase the latest innovations, practices and methodologies to inspire you with ways to make change happen. Each session will bring together change leaders, health and care professionals and patients from across the globe to discuss how they are making changes to improve their local health and care services…

Highlights of NHS TransformathonTransformathon include:

  • Roy Lilley and Terri Porrett describe the journey of The Academy of Fabulous NHS Stuff to the point where it has become THE place to go to share all the good things.
  • Nigel Edwards, CEO of health charity Nuffield Trust (UK) and leaders in the crowdsourcing community will debate the potential of designing-by-crowd.
  • Dr. Peter Fuda, one of the world’s leading researchers and practitioners in transformational change will join us from Sydney, Australia with a guide to his best research and insights.

Find out about all the sessions and speakers, add invites to your calendar and watch live or later at http://theedge.nhsiq.nhs.uk/transformathon.

Remember to tweet using the hashtag: #NHSTform.

Issue 13 – Editorial

Welcome to issue 13 of The Edge.

The Edge is a website that brings together the latest ideas and knowledge about change.

It makes sense of this information and presents it to you so you can use it to provide even better health and care services.

We launched the site a year ago and quickly realised that some times things work and some times they don’t. So over the past year, we have been working with our readers to make The Edge even better.

We are trying to make it a place where people can easily connect with others to share their ideas, and experience about making change happen in health and care.

We may not have it quite right yet, but this is a work in progress and we need you to tell us how we can improve it. So get in touch with us by emailing us and let us know what you think.

The focus of this issue is about co-creation, looking at how we can come together to find shared solutions.

We’ve been applying the ideas of co-creation to redesign The Edge and working with other organisations to figure out what works.

In the issue, Kate Pound comments on a TedTalk by Lina Colucci about why we should all hack medicine. She draws links to a recent event that she took part in at Nottingham University Hospitals where 30 staff came together to come up with ways to improve care for older people.

Another highlight for me is a piece from ePatient Dave. He discusses how the internet is changing patients roles. In his short video, he describes his experience of co production between himself and his oncologist. Alison Cameron has provided commentary on this piece and shares her own personal experience about how at times, social media has been a source of support. You can read more about this in the article titled: “E-patient Dave enters the Healthcare Internet Hall of Fame.”

As a team and with our partners, we are exploring how we go about change and how this is changing. We’re looking at different methods of change and speaking to people who have used these in health and care situations.

We are focusing on the outcomes they provide.

In late January, we are running a free 24 hour online event to discuss how change is changing.

WE will bring together people to share their stories about how they have used different or new techniques of change in practice.

Running alongside the broadcast we will have a series of rapid problem solving events called hackathons. The broadcast is called the NHS Transformathon and you can find out more about this on the Transformathon page on The Edge.

 

So please… Take some time to read a few pieces on The Edge and let us know what you think.

Bookmark the NHS Transformathon page and visit it to receive updates about the schedule

And finally follow the #NHSTform to keep in touch about the work that we are going to feature over the upcoming months.

Well this has been my first ever video editorial blog so I hope you enjoyed watching as much as I enjoyed making it.

Happy reading.

Hold onto your hats! Change is changing

We have reached the milestone of ten issues of The Edge. In just eight months, The Edge has attracted 21,000 users. Three quarters of them are from the English National Health Service but others are from more than 100 countries globally.

The Edge is a response to the way in which the world of change is changing.  Even five years ago, we would not have envisaged a platform like The Edge. We set it up so that change activists in health and care could connect around some of the latest thinking and practice in transformational change.

How that word is changing. At the recent 13th annual Change Management Conference in New York, Kinthi Sturtevant of IBM highlighted that they rarely see (large scale) two, three or four year change projects anymore. Now it’s 30-60-90 day change projects. I recently attended LabWorks 2015, a yearly event that brings together innovation teams and labs from around the world that are using design thinking for public service innovation. This is a fast growing movement. Design practice is becoming a mainstream way of engaging with citizens and collaboratively tackling governmental problems. It is also about repositioning change thinking and practice at the edge of organisations so that we can respond at speed, learning from, and collaborating with, the rest of the world.

Another big, related theme at the leading edge of change is the shift from change programmes to change platforms. This has appeared as a frequent topic in The Edge and was the focus of my recent “Edge Talk”: Scrap the programme – this is an era for change platforms. In our increasingly volatile and fast moving environment, leaders are recognising that large scale change programmes driven from the top of the organisation, with multiple, complex workstreams are rarely delivering the outcomes they seek. They are questioning the over focus on process in many programme and project management approaches. There is an alternative. Across the world, people are showing that if they are given the tools to connect and the freedom to create, they will produce outstanding results with an astonishing level of energy and creativity. Change platforms are being established at a quickening rate, in health and care and beyond. A great example is the change platform that the charity Oxfam unveiled recently. The team that brings you The Edge (the Horizons group within NHS Improving Quality) no longer works through change programmes. We only work with platforms.

So hold on to your hats as the velocity of change accelerates. Let’s embrace the inevitable and build the leadership skills, connections, tools and knowledge base for big change in health and care. As Gary Hamel says, we need to focus on the mindsets, motivation, methods and migration of change as much as on strategic ambition. I hope that The Edge and the community that supports it will continue to grow and fulfil its potential in helping to transform the health and care system.

What is the most important thing in the world?

He aha te mea nui o te ao?

He tangata! He tangata! He tangata!

What is the most important thing in the world?
It is people! It is people! It is people!

Our theme for this issue is “our people”.  The concept of people is central to health and care and includes our staff, our patients and our families.  People in their infinite variety, bring different perspectives and experiences and it is this diversity that contributes to innovative solutions to the challenges we face.

It is a privilege to share stories with The Edge readers.  In particular, we hope you will enjoy learning about our indigenous Maaori people:  our tangata whenua (people of the land).  The Maaori philosophy towards health is based on a wellness or holistic health model.  For many Maaori, the major deficiency in modern health services is taha wairua (spiritual dimension).

I am personally delighted that Ko Awatea , on behalf of the Counties Manukau  Health community, has been invited to be the first international guest editor of The Edge.  We are very excited to be part of the expanding Edge community.

The curation of this edition has been a real team effort, coordinated by Dr David Grayson and Dr Lynne Maher who feature later in this edition. We hope that you enjoy our koha (contribution) and our culture so much that you come and visit our wonderful country very soon.

To learn more about how Ko Awatea is leading health system innovation and improvement, visit http://www.koawatea.co.nz

Professor Jonathon Gray
Director
Ko Awatea
@KoAwatea  @graymattrs

Professor Jonathon Gray

Learning from the global health and care community

One of the many ways that social media has enhanced our lives is to give us the ability to connect with, and learn from, people with similar interests and passions from across the globe. There is a richness of knowledge sharing in my life that didn’t exist even four years ago.  It gives me extra confidence that my thinking and practice as a leader of change and transformation is in line with the most leading edge, credible knowledge sources in the world. As soon as new learning becomes available, I receive it.

The Edge epitomised this new connectivity. It has nearly 10,000 subscribers from 98 countries including Norway, USA, Russia, South Africa, Germany, India, Spain, Belgium, Tunisia, China, Brazil and Malaysia. Our learning platforms, such as The School for Health and Care Radicals have attracted people from more than 60 countries. Some people ask “why are you sharing resources with people from outside the English National Health Service? Surely your first concern and priority should be the people in your own system?” It is. AND we, and they, gain greatly from our international collaborations.

Sharing works both ways. We give people access to our knowledge and materials on an “open” basis and in return they collaborate in taking our collective ideas and methods forward. Rather than a narrow, England-centric view of health and care, we get to learn for free from other peoples’ experiences from around the world. We don’t just compare data and experiences that are best in Britain. We can easily hunt out the best learning in the world. Digital connectivity tears down walls and breaks down gates. It takes our level of ambition for our patients, service users and delivery systems to a whole different level.

Recently I talked to a collaborator in Australasia who is a leading expert in healthcare improvement and innovation. She has been acting as a virtual volunteer mentor to a grassroots change activist in the NHS. We linked them up via The School for Health and Care Radicals. Both mentor and mentee have gained from the relationship. As part of the school we set up “randomised coffee trials”, where we randomly allocated people to have a cup of coffee together via Skype. It’s great to see via social media that Melanie the midwife in England and Liz the improvement leader in Qatar are continuing to support each other to be brave and innovative in their change actions.

Later this year, groups from British Columbia, Canada and Auckland, New Zealand will “take over” specific issues of The Edge and provide all the content for that issue. I know from the discussions we have had with them already that they will do an outstanding job and will raise the bar on the standard of content of The Edge. It is likely that every future issue of The Edge will be improved by this voluntary global input.

Breakthrough innovation rarely comes from within organisations. It comes from outside or from the emerging generation. We can gain so much more perspective about our own health and care system by seeing it through the eyes of those who use or provide care in other systems.

So I would like to thank all of our international colleagues for their support and contributions to our change activist community for health and care. We really are changing the world. Together.

You don’t necessarily need to think outside the box, just bring different people into the box

SHCRANZ
Students from our Australian School Group join together for a bake-off & School study session

Back in January, the team that brought you The Edge opened the doors to the School for Health and Care Radicals for the 2nd year running. The School is a free, virtual, modular learning programme that is completely open access and runs over five weeks. What a fun five weeks it was too! Over this year and last, we had nearly 5000 enrollees, including 2234 live participants from over 30 countries joining us to share the learning. We also had a huge impact on social media, with a Twitter reach across the School sessions of an incredible 35.9 million impressions.

Naturally, it follows that we would run a special edition of The Edge for all of those participants (and hopefully many more besides). We are so excited to be able to share so much great content which has been hand-picked by the team, including School for Health and Care Radicals staff and students, so if you were part of the School for Health and Care Radicals, you might see some familiar names.

Shes a rebel

One of the themes that really captured the imaginations of participants in the school was the idea of being Radical, Rebellious or Disruptive. Often these are considered bad words, taboo concepts and certainly not in keeping with traditional organisational bureaucracy. The School explored ways that disruption can lead to great innovation. This is illustrated in some detail through examples in the content of this edition of The Edge. Some of the material explores disruption in a wide-reaching thematic sense, where others identify the small scale incremental changes that can lead to widespread innovation when adopted as a way of working in an organisation. One great piece talks about how Twitter was ‘invented’ through a Hackathon at a failing podcast company – a fabulous example of disruptive innovation and one that I’m sure many Health and Care Radicals appreciate greatly.

Another theme was of self-efficacy. Those of you who attended Module 5 and heard the story I told will know that this is one of my favourite Comfort zonesubjects. I like it because of the a-ha moment that I had when I first attended the School and realised that none of us can hide from the power we have over ourselves, even if we feel powerless over everything else. This idea is explored beautifully by Adam Braun – who starts his story with the idea of getting out of his comfort zone, and ends up achieving something truly incredible. His video is an inspiring example of all of the learning that we went through in Module 1: Being a Health and Care Radical – Change Starts with me. He isn’t even from the world of health and care, but I think his tale of courage and willfulness has a strong link to the potential that we each hold, wherever we work.

The third theme that seems to carry through the School material and the content of this edition of The Edge is Thought Diversity. My favourite description of Thought Diversity is “You don’t necessarily need to think outside the box, just bring different people into the box”. There is a lot that can be improved by listening to other voices and many of the items in this edition of The Edge focus on the power held by those who don’t traditionally hold positional power. When those voices are heard, and those ideas are implemented, great things can happen. Dr. Philip Pearson’s blog as part of the recent Change Challenge series in the HSJ demonstrates with almost barn-door-obvious simplicity how much we stand to gain by embracing the ideas of the incredibly talented and enlightened workforce of the NHS. He explains that if we each had one reasonable idea per month that was implemented, that would be around 10 million improvements per year, cumulatively. With some simple mathematics (that even I could understand) thrown in, he demonstrates how this could save the NHS more money than anything suggested by a man in a suit in Whitehall.

Nothing demonstrates the power of embracing traditionally under-represented voices more than NHS Change Day, which, for the 3rd year running, this month galvanised thousands of stakeholders into action for healthcare improvement. Change Day is a shining example of the benefit of using the huge untapped potential in any organisation for large-scale improvement. One of the most striking elements of the Change Day movement in the NHS and now in other health systems is the inclusiveness of it and the resulting benefit from thought diversity. It is an exampPicture 4le of genuine engagement, not only with the front line, but with students, patients, local businesses, councils and many more.

Thought Diversity will continue to be a theme which gets developed through the School. It is one of the Post-graduate Masterclass modules that will be run over the Spring/Summer period. Look out for more details of how to get involved.

It is an amazing privilege to be part of the community that makes up the School for Health and Care Radicals – and I know that others feel that way too. We have shared a wonderful learning experience and now that our weekly interactions are over, I am pleased to be able to keep the energy and spirit of the School alive on The Edge. As always – look out for free webinars, events and learning content on The Edge website, and use your self-efficacy to keep the energy of the School running all year around.

 

Frogs, battleships and electric monkeys

Do you know the one about the frog in the kettle, the one about the battleship and the lighthouse, or the one about the electric monkey cage?

Surely you do.

According to experts, if you put a frog into a kettle of boiling water, it jumps out, but if you put a frog into a kettle full of cold water and gradually raise the temperature, it will boil to death because it does not notice the change.

According to numerous accounts, a battleship saw a light bearing on its bow, and issued a signal instructing the other ship to change course. The return signal was a refusal. The incensed commander insisted that he was a captain, and that the other should change course. The reply was that the other was a seaman second-class, and recommended that the captain changed course. The commander then replied that he was a battleship, and demanded that the other change course. The reply came back ‘I am a light house — suggest you change course’. The battleship did.

According to many management seminars, a group of monkeys were put into a cage with bananas at the top. However, the bars were electrified, giving the monkeys a shock whenever they tried to climb up. After a while, the monkeys ceased to try, even when the electricity was switched off. Subsequently, the monkeys were replaced one by one with monkeys who had not been part of the original experiment, and the other monkeys savagely attacked them when they tried to climb. Even when all the monkeys had been replaced, the new monkeys did not climb.

These stories indicate, respectively, the dangers of gradual, unnoticed change, the importance of a paradigm shift, and the dangers of accepting culturally learned patterns.

There is, however, a problem. It turns out that no experiment has been conducted in the last fifty years which agrees with the frog in the kettle results. Apparently, around 35 degrees, the frog jumps out, no matter how gradually you raise the temperature. A frog thrown into a boiling kettle dies, and does not jump out.

Likewise, there is no evidence that the story with the battleship and the lighthouse ever happened. You may have read it in Steven Covey’s 7 Habits of Highly Effective People, or you may have read it in one of the more recent Facebook-powered versions. However, as far as can be determined, it never happened, and no credible source has ever been cited to say that it did.

Furthermore, it seems that the monkey cage experiment was never actually conducted.

Feel like you’ve been had? Unlike ordinary urban myths with their lurid tales of deaths and decapitations, these stories are told and retold because they underline lessons that we are sure must be true — or, at least, we are sure once we’ve heard the story. In each case, however, the story originally appeared as a joke or a moral lesson, and the ‘evidence’ was later added to it.

If you’re reading the Edge (which you are) you are already a change radical or interested in becoming one. You’ve almost certainly learned the importance of being willing to question the convenient myths that keep organisations and individuals thinking the way they always thought, and doing the things they always did.

Top Down, Expert-led, Grassroots
Change in the world of care and health is a given: on the one hand, technology advances, working practices improve, problems are solved, on the other, the impact of demographics, pressure on budgets, and an ever more demanding population mean that new problems arise at an ever increasing pace.

Traditionally, Britain’s National Health Service, and many other health and care organisations across the world, have responded with top-down change, and with expert-led change. These two approaches have brought about many benefits over the last sixty-five years, but, on their own, they can never bring about the daily, repeated and iterative changes which truly transform the experiences of patients and clients.

However, these kinds of changes not only often fail to become embedded in front-line practice, but they often grow out of the kettle-frog, lighthouse-battleship, electric-monkey thinking that grows up wherever the people leading the change do not have current, day to day, front-line experience of what they are trying to change.

If you are reading the Edge, this is something that you already know.

Today’s special edition coincides — absolutely deliberately — with NHS Change Day 2015. Change Day is a grass roots movement of hundreds of thousands of people giving themselves permission to make the changes that they know should be made, and which are within their expertise and authority. A cynic might ask — indeed, some have — why such obvious changes were not made years ago, and why an artifice such as Change Day is necessary. However, our old enemies inertia, hierarchy and the tyranny of the urgent often prove too much. It is easier to keep doing what we have always done, it is less likely to get us censured, and it is more convenient given the often frantic pressures under which we are operating. NHS Change Day, and the Change Days it has inspired in the USA, Canada, Jordan, the Netherlands, Australia and Sweden, offers just the impetus which we should not need but which we do need to get on and fix things which have been broken for years.

Grass roots change is not capable of dealing with everything. There are kinds of change which need to be led by experts, and there are kinds of change which need to be led at an organisational or multi-organisational level. However, from the nurse who dramatically reduced the numbers of people who failed to attend appointments by adding a simple hand-written sticky note to their letters, to the painter and decorator who is now repainting an entire hospital in dementia-friendly colours at no additional cost to the health budget, the kinds of change which grass roots, crowd sourced action brings about could seldom be accomplished by other approaches.

Again, if you are reading the Edge, this is something you know.

We offer you this edition in the hope that it will stimulate you to further ask the unasked questions, challenge the comfortable truisms, question the often repeated stories, and be inspired to lead the kind of small changes which together change the world.

Let us say goodbye to the frog kettles, lighthouse battleships, and electric monkeys. May your curiosity never diminish.

References:
http://www.snopes.com/critters/wild/frogboil.asp
http://www.snopes.com/military/lighthouse.asp
http://skeptics.stackexchange.com/questions/6828/was-the-experiment-with-five-monkeys-a-ladder-a-banana-and-a-water-spray-condu

Editorial from Simon Stevens

Like so many other people I joined the NHS – 26 years ago – because I wanted to make a difference to people’s lives. If you chat to any ward sister, junior doctor, therapist or care assistant, you’ll hear the same story.

So NHS Change Day is about harnessing our collective energy, creativity and ideas. It’s about putting power in the hands of those who know better than anyone where change is needed. And it reminds us that the NHS isn’t just a care and repair service, but a social movement that unites the whole country.

Speaking personally, I’m spending today talking to people with learning disabilities and their families about how to overhaul the care they get – by giving them the clout so that their needs and choices really count. And I’ll be getting ‘dementia friendly’ training from Andy Tysoe, a nurse from Chester who has helped lead previous NHS Change Days.

Change Day this year also comes in the week when we’ve just fired the starting gun on the radical grassroots redesign of care for 5 million patients in 29 parts of the country – the first step to implementing the NHS’ own Five Year Forward View. We’ve now got a widely supported plan for a better NHS, and we’re are getting on with it.

So on behalf of your fellow health and care employees, thank you for taking the time today to play your part. Together we can make a multitude of individual changes to care that add up to truly enormous improvements for the patients we’re all here to serve.

By Simon Stevens, Chief Executive of the NHS in England

SS2  SS3

Editorial from Jodi Brown

Welcome to the fifth issue The Edge and my first editorial.

SHCRANZ
One of our Australian groups meet for Module 1 of the School for Health and Care Radicals #SHCRANZ

I’ve been working in the Horizons Team at NHS Improving Quality for just under six months, and I must admit, I feel rather fortunate to be working on some amazing initiatives. My remit includes The Edge, The School for Health and Care Radicals and the crowdsourcing campaign, ‘Challenge Top-Down Change with NHS Improving Quality, the Health Services Journal, Nursing Times and Clever Together. Three incredible, ground-breaking programmes that are all, in their own right, reaching thousands of people across the world who share a common purpose and passion for transformational change in health and care.

The collective passion of change agents, amassing via digital or virtual means, is palpbale and powerful. I was overwhelmed by the response we had to our first module of the School for Health and Care Radicals: ‘Being a health and care radical- change starts with me.’ Not only did we receive over 2000 registrations from people in 36 countries, but witnessed a groundbreaking level of participation in the live WebEx of just short of 500 people. The accompanying Twitter activity made 2.6m impressions, and we attracted 1260 tweets in the 90-minute session.  I urge you to watch the YouTube recording of the WebEx and make full use of the accompanying study guide and slides; these are fantastic resources, freely available to you and your colleagues. You will eventually be able to access the full programme of all five modules from our resources page. It’s not too late to register for the School, with Module 2: ‘Building alliances for change‘ WebEx running on Friday 6th February at 09.00 GMT.

Jodi SHCR 2014 ii
A tweet sent by me during School for Health and Radicals in February 2014 #SHCR

Flashback to a year ago, I was participating in the School for Health and Care Radicals as a student, feeling anxious and dispirited about the state of change and my personal experiences in my NHS Foundation Trust organisation. My leadership energy was flagging, and my self-efficacy was verging on ‘helplessness’. The School was my turning point, helping me to recognise the validity of my beliefs and vision, my ability to bring about change (despite resistance) and to really harness the potent collective shared-experience and wisdom of other likeminded (yet widely diverse) individuals.

Challenge Top-Down Change is yet another record initiative that is just starting its second phase. NHS Improving Quality is working in partnership with the HSJ, Nursing Times and Clever Together to test out crowdsourcing methodologies as a means of ‘tapping the collective brilliance of the NHS’. This isn’t about beating top-down change with a stick, but understanding how bottom-up change can flourish and meet top-down somewhere in the middle. It is about finding new and inspiring ways of challenging change dependency on top-down, change-management approaches and harnessing the energy and wisdom of the whole system to achieve transformational change for the future of our NHS.

An evocative blog by Helen Bevan makes the case to, ‘Scrap the programme: Successful change begins with a change platform‘. This approach has most certainly received support, with the #ChangeChallenge, in only two weeks receiving over 500 ideas and 835 comments with 6162 votes on the barriers and enablers of bottom-up change. Now entering its second phase, the ideas and comments have been coded, analysed and themed, and will be presented back to you to entice ‘hacks’, a call for scalable ideas that have the potential to become tangible solutions. You can find out the latest on this challenge by following the Twitter hashtag #ChangeChallenge, but I do recommend you get involved and make your mark on the way we have traditionally undertaken change in the NHS.

Turning to The Edge, despite being very much in its infancy, there are already over 6000 subscribers with a global reach of 81 countries. Since its launch on 5th November 2014, there have been over 17,500 visits to The Edge website, with over 50,400 page views from over 10,534 separate users. Now, I’m not trying to blind you with statistics! The point is, between the School for Health and Care Radicals, ‘Challenging Top Down Change’ and The Edge we are gathering momentum and energy around change agency, activism and transformational change. You can learn more about energy for change from @RosieLHunt in the classics article, ‘How can we build energy for change in health and care?

I hope you will enjoy reading and commenting on this issue of The Edge. We have hand-picked a variety of blogs, articles and pieces that will spark your imagination and  introduce some ‘out-of-sector’ thinking into health and care transformation. If you are interested in the crowdsourcing methodology of the #ChangeChallenge, you’ll like this blog by @NickKellet on drawing lurkers into crowdsourcing. On the theme of top-down vs bottom-up change, @HelenBevan provides commentary on ‘A new change management concept‘ by @HaraldSchirmer and @DigitalTonto tells us that, ‘Leadership is more important than authority in creating real change.’ I’m really pleased to provide commentary on ‘Leadership lessons from Lego‘ that taps into the creativity and freedom of childhood, which sits nicely alongside this reflection from @DomCushnan on ‘The secret to Pixar’s success: failure’. There is something for everyone in this fifth issue, so please take time to read and digest and do share your thoughts about the pieces we’ve included by voting, or leaving a comment in the box under each article.


Jodi Brown 2

 

 

Jodi Brown @JodiMOlden
Senior Transformation Manager
Horizons Group, NHS Improving Quality

 

Editorial from Helen Bevan

We love seeking out new knowledge for The Edge and making connections between people, ideas and learning. But we are only interested in this knowledge if it has the potential to help make a practical difference; to enable us collectively to make better, faster progress in transforming health and care. That’s why we combine our knowledge hub activities with many actions to mobilise people and build leadership for positive change in health and care.

On 30th January, the team that brings you The Edge is launching the 2015 term of The School for Health and Care Radicals. The School is a free, virtual, modular learning programme, open to anyone, that takes places over five weeks. Our goal is to give people the skills, confidence and networks to challenge the status quo and to play their part in progressive change, in the spirit of the blog by Khurshed Dehnugara that is featured in this edition.

We started the School in 2014 as a response to the many grassroots colleagues who told us that they felt that they didn’t have permission to make even the smallest changes in their workplace or local setting. The reaction was overwhelming. In 2014, 1,900 people registered for the School from over 40 countries. There were 35,000 downloads of the School’s free materials and the social media reach was 2.6 million people a week. We created a thriving, global community of change activists in health and care. We have captured many positive stories of the difference that the School made in people’s lives.

So The School for Health and Care Radicals is back for 2015, with a better learning format based on the learning from last year. You can view the curriculum of the School. Already hundreds of people have signed up. You can sign up too, whether you just want to be able to download the learning materials or you want to do follow up work to become a “Certificated Change Agent” and get Continuing Professional Development points.

One of our big themes at The Edge is the shift that is taking place in the world of change from change programmes to change platforms. This was the topic of one of the knowledge pieces we featured in issue two of The Edge. As part of our commitment to this approach, we have launched a campaign with The Health Service Journal and Nursing Times (based on a change platform) to ignite the collective brilliance of the workforce of the NHS to “challenge top down change”. This campaign is running for ten weeks and will culminate in a free interactive resource on leading change, based on the wisdom and practical experience of NHS colleagues. We hope you will contribute to the campaign. You can sign up here.

Finally, if you are reading The Edge but haven’t subscribed to it yet, we encourage you to subscribe. Just enter your details below and you will receive every issue automatically. At The Edge we operate with high ethical principles; we promise that we won’t spam you or give your email address to anyone else.

Follow Helen Bevan on Twitter @HelenBevan

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