Health leaders and activists (the very embodiment of old and new power!) gathered in London on the afternoon of August 24, 2017 for a seminar about new power in health and care. Horizons’ team member Sasha Karakusevic has written about his reflections about this event, full of energy and optimism about health and care transformation:

Helen Bevan’s introduction reminded us of Bertrand Russell’s famous saying: “Power is one’s ability to achieve goals”.  The saying remains true, but the environment and context has changed.  This means the nature of power and how to exercise it is changing, and needs to be developed.

We were extremely lucky to be able to bring together members of our network to spend time with Jeremy Heimans and Henry Timms, who are leading thinkers in this area.  Their focus is on old and new power. Following their Harvard Business Review article in 2014 they have been researching the topic; our seminar was a great opportunity to explore emerging themes ahead of the publication of their book next year.

What struck me early in the session is the great strength of people working in our field to manage complexity, nuance and the politics of change.  When we looked at where we were on old and new power values and approaches the consensus was towards new power values and new power approaches. The rate of progress is governed by our ability to work with old power values and models. People in the room were clearly leaders and shapers of change, recognising and responding to what is happening in the world today.

Jeremy and Henry highlighted different approaches to using new power, in particular the importance of ‘shape shifters’ – people with the knowledge and experience to understand the present and use this to create the future.  They compared this to ‘disruptors’ who understand where they want to get to, but do not have the connections and subtlety needed to consistently achieve their goals.




As we all know, being a leader isn’t always a comfortable experience! Themes that resonated in the room and on Twitter were the power of relationships and the need to build connections to get things done.  This is one of the biggest challenges…being nice to people works!

Another interesting theme from the discussion was that REMOVING structure to create more creative space is likely to be more effective than adding more structure.  This highlights one of the biggest challenges in transformation – if the structures are designed from the perspective of the current world view they may block our ability to see and create the future.  This is one of the reasons that we increasingly use ‘unconference’ techniques to allow new ideas and approaches to surface.

Our unconference surfaced four key areas to focus on for those working on transformation:

  • Message
  • Movement
  • Measurement
  • Method

We identified that old and new power approaches will use the same tools but in different ways.  So the final thing to highlight in this blog is the need for transparency as one of the key levers for building trust.  I highlighted the Edelman Trust Barometer results showing the loss of trust in many traditional institutions.  Rather than seeking to define the ‘what’, senior leaders may well be most effective developing the ‘how’, so more people can be involved in creating the future we want.

We will be sharing more thinking on these topics in the forthcoming update of the Guide to Large Scale Change (developed with the Sustainable Improvement Team) and look forward to developing out thinking and practice of new power approaches with Jeremy, Henry and the Horizons community.


Slides from the day can be seen below;