If you are a change activist in health and care, this article will resonate with you. Satell challenges the reader to examine concise and powerful examples demonstrating how top-down change can fail. A model of collective behaviour is deconstructed to highlight the benefit of weak and strong ties while trying to instigate change. It is clear that there is a tipping point where majorities influence change.

Challenge top down change is a real-time example of open involvement in healthcare using crowdsourcing methodology and technology. The challenge is being run by NHS Improving Quality, Health Service Journal (HSJ) and Nursing Times (NT). The first stage of the process has seen over five hundred ideas submitted. The ideas submitted with the most support will be taken forward to the next stage and developed, using the wisdom and power of the ‘crowd’.

You can follow the progress of this project in real time, through commentary in the HSJ, NT and Twitter #ChangeChallenge



This contextual piece was written by Carol Read, Transformation Fellow at Horizons Group, NHS Improving Quality @CarolLRead