Do We Have the Three Types of People Needed for Scale and Spread in the NHS?

Posted by: Diane Ketley - Posted on:

Recently Helen Bevan shared on Twitter a blog on how to spread and scale change: ‘Scaling Businesses as a Team’, by James Allen. The tweet resulted in lots of activity. 

On first glance the similarities in how ‘great companies bring innovative ideas to customers at industrial scale’ and the challenges we face in spreading and scaling improvements in health and social care may not be obvious; certainly some of the terminology used is different. However, the main messages I took from the blog have great resonance with our current thinking in NHS Horizons on how to support spread and scale.

The three types of people or communities described in the blog are similar to the roles, rather than people, that need to exist to enable spread and scale at pace in the NHS. 

The roles of disrupter and executor as described in the blog post appear similar to those of innovator and adopter as we in the NHS call them. 

The third type, described in the blog post as the ‘scaler’ is of particular interest. The scaler is a rarer entity in the NHS and their absence may contribute to the frequent ‘chasm’ that is seen in spread initiatives. 

The scaler bears some resemblance to the role of system convener. We at NHS Horizons are developing this role – it means being a bridge or broker between innovators and adopters.  The system convener coordinates activities, enables others and helps create the conditions to increase scale and spread through creating an ‘adaptive space’ for collaboration in the complex setting of the NHS.

The importance of the different communities or roles working and communicating well together and of leadership to encourage communication and to support shared learning is highlighted in both the blog and in our current thinking.

We will be writing more on system convening and spread in a future blog and in the Spread White Paper later this year.

You may also be interested in The School for Change Agents. The virtual global community is free to join; this year’s webinars start on 16 May.

If you’re interested in how to spread innovation in healthcare, there are further blogs to follow. Please do subscribe to this blog, and follow @DianeKetley @horizonsnhs#nhsspread.

…. every organization implicitly comprises three types of people. We call these groups the three communities.…