Editorial

Editorial from Jackie Lynton

Welcome to the third issue of The Edge. The response to the second issue has grown and your feedback on the articles are really inspiring conversations across the world. We welcome your comments that are helping to shape how we develop The Edge. So, please keep them coming.

In the last issue we invited you to join the Webinar on; Thought Diversity – ‘What does it mean to us?’ The response was fantastic, over 200 people signed up.

As a change activist with over 30 years’ experience in the NHS I have led numerous change programmes. I have used lots of traditional methods for change and seen some successful change and lots of change that has failed at the first hurdle. So it was great to hear the conversation not just focussing on the ‘what’ and the ‘why’ of the benefits of thought diversity but as one participant put it; how do we get leaders to make and honour commitment to diverse thinking?

Leaders don’t transform overnight but there was an explicit agreement that the power of diversity of thought is critical to helping us deliver the transformation needed in the ‘Five Year Forward View’.

There is a difference between ‘thinking differently’ and ‘thought diversity’. Thinking differently invites anyone to apply creative thinking to a solution. Thought diversity helps leaders understand how people think and be their authentic selves. Leaders and communities negotiate the world around them through the lens of their own experience, knowledge, background and identity which allows an opportunity to harness a more powerful and nuanced kind of diversity to spur practical and grounded change.

We have a tendency to overdesign, add complexity, and go for high tech solutions. Some people are hard wired to think very differently to others, large organisations tend to standardise thought and practice rather than encourage diversity, and can miss this point. They try to change the way people think, but ignore that fact that their people and communities have many different ways of thinking.

As another participant put it,

“It’s about bringing in diverse views to uncover different ways of thinking and exploring understanding what we don’t know.”

The challenge for us is to support leaders in the ability to reflect deeply on their own mind set for innovation and change and use ideas, divergent approaches, and people in advancing service improvement and exploring what the practical implications that individuals and organisations need to take to make it happen. We hope that The Edge is helping you to do that.

It is only by making explicit our mental models that we collectively learn about its potential to improve services and transform the way we work locally. This means letting go of a narrow view of the world and opening up a deeper relationship to diverse perspectives.

You can watch the webinar video here and experience the thought diversity conversation first hand, or follow the conversation on Storify


This editorial was written by Jackie Lynton, Head of Transformation, Horizons Group, NHS Improving Quality @jackielynton

Jackie-Lynton

Editorial from Jackie Lynton

Welcome to the third issue of The Edge. The response to the second issue has grown and your feedback on the articles are really inspiring conversations across the world. We welcome your comments that are helping to shape how we develop The Edge. So, please keep them coming.

In the last issue we invited you to join the Webinar on; Thought Diversity – ‘What does it mean to us?’ The response was fantastic, over 200 people signed up.

As a change activist with over 30 years’ experience in the NHS I have led numerous change programmes. I have used lots of traditional methods for change and seen some successful change and lots of change that has failed at the first hurdle. So it was great to hear the conversation not just focussing on the ‘what’ and the ‘why’ of the benefits of thought diversity but as one participant put it; how do we get leaders to make and honour commitment to diverse thinking?

Leaders don’t transform overnight but there was an explicit agreement that the power of diversity of thought is critical to helping us deliver the transformation needed in the ‘Five Year Forward View’.

There is a difference between ‘thinking differently’ and ‘thought diversity’. Thinking differently invites anyone to apply creative thinking to a solution. Thought diversity helps leaders understand how people think and be their authentic selves. Leaders and communities negotiate the world around them through the lens of their own experience, knowledge, background and identity which allows an opportunity to harness a more powerful and nuanced kind of diversity to spur practical and grounded change.

We have a tendency to overdesign, add complexity, and go for high tech solutions. Some people are hard wired to think very differently to others, large organisations tend to standardise thought and practice rather than encourage diversity, and can miss this point. They try to change the way people think, but ignore that fact that their people and communities have many different ways of thinking.

As another participant put it,

“It’s about bringing in diverse views to uncover different ways of thinking and exploring understanding what we don’t know.”

The challenge for us is to support leaders in the ability to reflect deeply on their own mind set for innovation and change and use ideas, divergent approaches, and people in advancing service improvement and exploring what the practical implications that individuals and organisations need to take to make it happen. We hope that The Edge is helping you to do that.

It is only by making explicit our mental models that we collectively learn about its potential to improve services and transform the way we work locally. This means letting go of a narrow view of the world and opening up a deeper relationship to diverse perspectives.

You can watch the webinar video here and experience the thought diversity conversation first hand, or follow the conversation on Storify


This editorial was written by Jackie Lynton, Head of Transformation, Horizons Group, NHS Improving Quality @jackielynton

Editorial from Helen Bevan

Welcome to the second issue of The Edge. We have had such a fantastic response to the first issue with nearly 4000 subscribers and visits by people from over 59 countries! In response to your feedback, we have slightly reduced the number of curated articles and built on the length and nature of the accompanying comments that we post alongside each of the articles. We will develop this over time, and hope to see more of you submitting your links to articles and pieces that would be of interest to other health and care activists, along with your own comments, insight and questions. The Edge will continue to grow and evolve with your feedback and support, so please do keep it coming by contacting us.


In this second issue of The Edge, I will be focussing on the topic of ‘Social movement thinking: a set of ideas whose time has come for change in health and care?’

“When we talk of social change, we talk about movements, a word that suggests vast groups of people walking together, leaving one way behind and travelling in another” (Rebecca Solnit)

The second “classics” section contains extensive resources for applying social movement thinking to improve health and care services. Across our sector globally, we have seen a massive growth in improvement programmes and projects, as leaders recognise that the way we deliver services at present isn’t going to achieve the results we need for the future. Many of these projects and programmes have delivered impressive results but on their own, projects and programmes are unlikely to deliver the far-reaching changes required to transform the health and care system. In addition to changing care delivery processes and structures, we need some new and additional thinking and practice. One of the biggest gaps is in our understanding of motivation for undertaking improvement activities; how do we move our focus from people who “have to” change to people who “want to” change? How can we create change efforts that surge with energy, that are an unstoppable force for positive change? How do we mobilise all the people who could and should contribute to our change efforts: people who use services, their carers and families, partners in the wider community, our entire health and care workforce, the leadership community?

A social movements perspective may help us to think about our transformation efforts in a new light, offering fresh but complementary approaches to existing improvement thinking and practice. In addition to the extrinsic drivers of the programmatic approach to change, social movement thinking is about connecting with peoples’ core values and motivations and mobilising their own internal energies and drivers for change. This is underpinned by evidence from the change management field that people change what they do less because they are given analysis that shifts their thinking than because they are shown a truth that influences their feelings. Read through the links in the classics section and consider these questions:

  1. What learning and inspiration can you take from social movement leaders to help you in your role as an agent of change in health and care?
  2. How could you attract the attention of the people you want to mobilise for action?
  3. Who are the people who are currently disconnected that you want to unite in order to achieve your goals for change? How can you build a sense of “us” with them?

Given the significant challenges facing our health and care systems (and us as change activists) perhaps social movement thinking is a set of ideas for the health and care system whose time has finally come.

As a final note, I’d like to urge you all to sign-up to our forthcoming webinar, in conjunction with NHS Confederation. Thought Diversity: what does it mean for us? will be held on Wednesday 3rd December 2014, 15.00-16.30 GMT. The webinar is an opportunity to develop a new lens for health and care becoming more intentional about leveraging diversity of thought to spur practical and grounded change. Thought diversity has potential to contribute to the key challenges facing the NHS, in light of the NHS Five Year Forward View for leaders and frontline staff. The webinar will give participants the opportunity to reflect deeply on their own mind set for innovation and change, exploring the practical implications that individuals and organisations need to take to make thought diversity happen. I really look forward to joining with as many of you as possible on 3rd December.

Editorial from Helen Bevan

Welcome to this first edition of The Edge, brought to you by the Horizons Group, part of NHS Improving Quality, the national improvement body for the National Health Service in England. We are a small team operating at the brink of current thinking and practice of change and transformation in health and care. We are proud to be part of the NHS system and everything it stands for but we are deliberately positioned at the very edge of the system. We have one foot inside the NHS, connecting with leaders of change and transformation across England. Our other foot is outside the system, bringing new knowledge back to the NHS from leading practitioners, researchers, disruptive innovators and opinion formers across the globe. We hope that these new connections and the injection of additional thinking will both assist and disrupt conventional change practice and lead to better health and care outcomes for patients and the public.

The Horizons Group, NHS Improving Quality
The Horizons Group, NHS Improving Quality

The Horizons Group and The Edge are part of a global trend for creative processes (including organisational development and change management) to move to the edges of organisations. Futurists predict that in the near future, the edges will be where almost all high-value work will be done in organisations. The Edge is where those who want to challenge are able to unite, share, support and grow together as change activists. Leading from the edge brings you 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.

This first edition of The Edge contains curated articles, blogs, resources and inspiration that are hand-picked to appeal to a wide range of change leaders in health and care. We want to stimulate discussion, challenge pre-conceptions, widen the view and build knowledge about a number of the key themes that emerged from our white paper, The new era of thinking and practice in change and transformation. You will soon find that this is not your usual healthcare bulletin; this is purposefully designed and curated to flip traditional thinking and mental models.

We hope you will be able to move your change thinking and practice closer to the edge, so that your ideas are more radical and your change processes more transformational. At the same time, we need the edge to co-exist with and influence mainstream ways of organising for change. That is our ultimately our goal for our work in the Horizons Group and we hope it will be your goal as a change leader too. The Edge is evolving and will be shaped by your collaboration, insight and energy. Please join in, comment, Tweet, share and tell us what you think. The Edge will only be as good or useful as the connectivity it helps create.

Helen Bevan, November 2014

Rocking the boat without falling out

This issue of The Edge appears at a time when the formal evaluation of The School for Health and Care Radicals, undertaken by the research team from the Chartered Institute of Personnel and Development, is about to be published. You can download the preliminary materials about the evaluation of the school from The Edge website.

What strikes me is how many parallel themes there are between the outcomes of the evaluation and the pieces that have been selected for this edition of The Edge.

Nearly 7,000 local change activists signed up for The School for Health and Care Radicals in 2014 and 2015. The school is based on principles of social learning; i.e., we learn more about actionable change by connecting with other people with a similar mission than we do from so-called change experts. And the evaluation suggests that the school was very social; 49% of people participated in the network of learners and 52% took part in the online tweet chats during the modules.

The evaluation survey showed that the school experience had a positive effect on every dimension of impact tested, covering both individual and organisation-level metrics. Often, learning programmes will show a positive effect on some impact measures but it is very unusual to show a positive score on EVERY measure. The impact areas fit with many of the themes in this issue of The Edge:

Theme one: building knowledge about change. This is about developing our own skills and wisdom as leaders of change so that we get better outcomes from our change efforts. This is a strong theme amongst the collection of pieces in this issue of The Edge. See A new way of defining the workplace: everyone can be a changemaker. An interview with Adam Lent of Ashoka by Stephanie van de Werve, Supporting clinicians to drive improvements and delivery of new models of care in the NHS by Felix Mukoro, The Quantified Organisation: people-powered digital transformation by Lee Bryant and 5 Design Principles for Life by Phuong Mai.

Theme two: Building a sense of purpose to drive action. This is about supporting people to connect with their higher purpose and values and to be motivated to change and improve things. In this edition of The Edge you can get advice from How Petr Švancara created a movement by Adi Gaskell, How Reddit the business lost touch with Reddit the culture by Adrienne Debigare and David Weinberger, How to motivate your team by Bear Grylls, Seven Things Only Weak Managers Say by Liz Ryan and The epidemic of managing without soul by Henry Mintzberg.

Theme three: ability to challenge the status quo. This is about having the skills and confidence to make a difference. In this edition of The Edge read How speaking up can save lives by Rona Flin and Superheroes and change agents by Simon Terry for inspiration.

Theme four: managing to thrive survive as an agent of change and improvement. It’s tough being a “boat rocker. This is about the ability to keep paddling and not fall out of the boat. There is sound advice in Confounded by the unknown: without a paddle by Julian Stodd and Everyday leadership by Drew Dudley.

Theme five: connecting with others to take collective action for change. As we have said constantly as part of the school, “the number one rule of being a health and care radical is that you can’t do it on your own”; we have to join forces with other people. These pieces in this issue of The Edge will help: The revolution will not be centralized by Greg Satell and How Twitter users can generate better ideas by Salvatore Parise and colleagues.

We will continue to use content from The Edge to improve the curriculum of The School for Health and Care Radicals. We will continue to co-create the content for The Edge with the learning community of the school. Please keep your ideas and experience as part of both flowing. It is the most connected, capable people who will change the world.

This editorial was written by Helen Bevan, Chief Transformation Officer of NHS Improving Quality. Follow her on Twitter at @HelenBevan.

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