Trust, Purpose, Power, and a Paradox Reflections on Module 3 of The School for Change Agents

Posted by: NHS Horizons - Posted on:

Originally published by Leigh Kendall – 12th June 2019

If you’ve been following The School for Change Agents since week 1, you’ll know that it’s all about connectivism. 

You can’t be a change agent on your own…and to bring people together, you need a shared purpose. This was the focus of the third module, Purpose and Power.

This quote by Seth Carguilo sums up why shared purpose is so important:

“[Shared] purpose goes way deeper than vision and mission; it goes right into your gut and taps some part of your primal self. I believe that if you can bring people with similar primal-purposes together and get them all marching in the same direction, amazing things can be achieved.”

As Helen Bevan said, improvement is anchored in purpose. You’ll probably be familiar with improvement models such as ‘Plan, Do, Study, Act’ (PDSA) – the models are really helpful for giving us structure and a methodology. To make sure your efforts are successful, and to avoid ‘de facto’ purpose (which is when the focus is purely on targets and compliance) you need to work with people to create a shared purpose first – before you get started on methodologies. 

Understanding the difference between aim and purpose is crucial to appreciating why this is important. A lot of improvement programmes focus on the aim – setting a determined course in order to achieve a set goal within a specific timescale, rather than the purpose which seeks to make explicit the reason behind something that is being done. 

Purpose defines WHY we are doing what we are doing, and WHAT we hope to achieve from it.

To express it another way, purpose gives us the ‘so what, and who cares’. Targets and compliance are essential of course; understanding why those targets matter is what inspires us to get out of bed in the morning, so we can go to work and make a difference, and also go the extra mile.

Here’s a template you’re welcome to steal with pride to create your own shared purpose:

If you need a bit of extra inspiration, in the spirit of Blue Peter here’s one we made earlier…the shared purpose for The School for Change Agents. 

A point from the webinar I found fascinating was the Noble Purpose Paradox. This quote from Philip Hadridge explains what it is:

“Why is it that the more compelling the mission, the more tricky it can be to get the best collaborative behaviours and the necessary focused action?

“And how can some places that are trying to achieve the most crucial and needed changes to the world we live in be riven with petty politics and driven by individuals sometimes ruthlessly pursing their own agendas?”

This is how the paradox manifests itself:

• We question the motivations and actions of co-workers or other leaders and amplify differences in point of view

• Personal interpretations of right and wrong come to the fore

• We find it hard to present alternative points of view without arguments or undercurrents of resistance

• We find that raising some of the issues at work about power or ambition is almost impossible.

This connects with some other new learning from the module that I also found fascinating, about trust. Mutual trust is important in any team and working environment.  Below are details about the different types of trust when we’re working in ‘new power ways’ (new power meaning that which is shared and distributed, rather than traditional hierarchical ‘old power’).

Relational trust relates to how we treat one another: “I will treat you with respect for your dignity and basic human compassion and hear your voice.” 

Functional trust relates to how we get things done together: “I will do my best to work supportively and reliably with you, regardless of our relative roles.”

Flow-of-value trust is about understanding that people have very different levels of power or privilege: “I won’t benefit personally from your involvement or our connection without ensuring that you benefit too.” 

This is particularly important when it comes to relationships between patients and professionals and between senior leaders and staff at the point of care where traditionally there is a power imbalance.

We know how challenging life and work can be when trust in any relationship is eroded, so it’s well worth taking the time to create that shared purpose so that you know what you’re working towards, and why. The shared purpose can be useful to refer back to when you come up against inevitable challenges as we discussed in Resilience is an Act of Defiance , to remind yourselves what is the point of it all.

It’s also worth considering how, as a leader, (and we are all leaders in some form) we are ‘signal generators’. Some questions to ask yourself in how you communicate: Are you setting a clear direction? Are you being authentic? Are you being inclusive? 

Because we all have the power to make change happen.

This post gives just a small taster of the content of module 3 of The School for Change Agents. For even more learning, please see the recording and the slide deck, and the online modules on FutureLearn.

You can also read the Outputs and Outcomes from Hugh McCaughey’s #Improve4Patients tweet chat – for further information about the case study that is mentioned during the module.

The live webinar for module 4 – Moving to Action presented by Kathryn Perera will be broadcast on Thursday 13 June at 3pm UK time. Joining details are here. It will also be broadcast live on our YouTube channel – the recording will be available at the same place.