1. #NHSChangeDay #SHCRchat ‘Dis*ruption - an agent of constructive change' Jackie Lynton: Head of Transformation @jackielynton Dominic Cushnan: Actionable Knowledge Manager @dominiccushnan Horizons Group, NHSIQ

2. #NHSChangeDay #SHCRchat Operate at the edge of current thinking and change Share the disruptive power of connecting, leading edge knowledge, transformation and innovation Connect people to empower them, to help health and care to think differently about the rules of change and make sense of it in their own context Horizons Group Small team

3. @HelenBevan Our new White Paper - Five enabling themes www.nhsiq.nhs.uk/ whitepaper

4. #NHSChangeDay #SHCRchat

5. @HelenBevan Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey Gets anywhere near achieving the change and delivering the benefits Most large scale change doesn’t fully deliver its objectives

6. @HelenBevan Most large scale change doesn’t fully deliver its objectives Source: McKinsey Performance Transformation Survey, 3000 respondents to global, multi-industry survey Delivers and sustains the change

7. ENGAGEMENT COMMITMENT ENERGY 100% of all projects evaluated as “Successful” had a good technical solution or approach 100%

8. ENGAGEMENT COMMITMENT ENERGY Over 98% of all projects evaluated as “Unsuccessful” also had a good technical solution or approach 98%

9. @HelenBevan Most change efforts are built upon the shaky foundation of five flawed assumptions; 1.That change can be managed 2.That human beings are objective 3.That there are ‘X’ steps to change 4.That we have a neutral starting point for change 5.That change, itself, is the goal Peter Fuda http://www.peterfuda.com/wp-content/themes/peterfuda- bootstrap/content/Why-Change-Efforts-Fail.pdf

10. #NHSChangeDay #SHCRchat Why is change needed and what needs to change?

11. @HelenBevan Leading change in a new era Dominant approach Emerging direction

12. @HelenBevan Leading change in a new era Most healthcare transformation efforts are driven from this side

13. Using disruptive methods in change Source of image: www.slideshare.net/mexicanwave/champions-trolls-10-years-of-the-cipd-online-community

14. Facebook didn’t exist Twitter was still a sound The cloud was still in the sky 4G was a parking place LinkedIn was a prison Applications were what you sent to college Skype was a typo Thomas Friedman, World Economic Forum, Quoted by http://ayeletbaron.comhttp://ayeletbaron.com

15. Disruptive innovations already available for healthcare professionals and patients

16. Its about people not technology! If the ‘change’ were a patient and the symptoms were found to be persisting despite intensive therapy, the diagnosis should be questioned and new interventions considered. Technology is not the goal – the goal is the goal!

17. Disrupting the status quo 1. History tells us that, innovation flourishes no matter how difficult the environment 2. Disruptive attackers thrive in downturns by taking advantage of ‘disruptive opportunity’ 3. Today's tough times in healthcare can lead to seminal changes in the world of disruptive innovation/technology; because it throws us into finding a different way What's Next for Innovation?: Disruptive Developments to Watch through the Downturn

18. @HelenBevan is the new normal! “By questioning existing ideas, by opening new fields for action, change agents actually help organisations survive and adapt to the 21 st Century.” Céline Schillinger Image by neilperkin.typepad.com

19. Innovation is not a mystical state “It's a natural state - a human birthright. The people in your organisation, in fact, already are innovative. The only thing is: their natural ability to be innovative is being obscured by their own habits of mind and a variety of bothersome organisational constraints.” Source and picture: Name: The heart of innovation: How we spark innovation, Oct 24, 2013. Ideas champions.com

20. Source: Helen Bevan Compliance States a minimum performance standard that everyone must achieve Uses hierarchy, systems and standard procedures for co- ordination and control Threat of penalties/ sanctions/ shame creates momentum for delivery Changing our mindset about change? Commitment States a collective goal that everyone can aspire to Based on shared goals, values and sense of purpose for co- ordination and control Commitment to a common purpose creates energy for delivery

21. @HelenBevan @HelenBevan #APACForum Probably the largest simultaneous improvement initiative in the history of healthcare A disruptive case study @HelenBevan #Quality2014 #f1

22. www.changeday.nhs.uk NHS Change Day is supported and coordinated by NHS Improving Quality. NHS Change Day is a grassroots movement with the purpose of empowering each other to take action to improve health and care. It connects people, bringing them together to in turn do something better together. It celebrates and shares every improvement we make better together. Date March What is NHS Change Day?

23. @HelenBevan @HelenBevan #APACForum NHS Change Day Aim: Our shared purpose for NHS Change Day is to ignite thousands of actions that will improve care for people. If you are inspired, then join us in delivering actions that make a difference.

24. #NHSChangeDay #SHCRchat@HelenBevan @BoelGare @JackieLynton #Quality 2014 #M5 Resources to improve health and care Economic resources diminish with use money materials technology Natural resources grow with use relationships commitment community Based on principles from Albert Hirschman, Against Parsimony diminish grow

25. Simple Rules Commitment vs Compliance How can we innovate in a complex system and how can we make innovation everyday business? Underlying principles: Small inputs can make big change, collective action, holding yourself and each other to account, intrinsic motivation, large-scale change, social movement principles. Call to action 1.Make a pledge, publically, website 2.Chose a pledge that means something to you 3.Pledge (action), share, do, inspire (improvement cycle) 4.Goal: 1 st year 65,000 pledges, 2 nd year 802,000 pledges 3 rd pledge to action 5.Date

26. @HelenBevan @HelenBevan #APACForum NHS Change Day 2014 More than 800,000 pledges to take action 81 separate Campaigns 86 million twitter impressions 35,400 video views 95,000 daily reach on Facebook More than 98% of the activity through volunteers

27. ENGAGEMENT COMMITMENT ENERGY Example pledge – Jeharna’s story Member of the public The way my brother was looked after by the NHS staff was just brilliant and I wanted to say thank you. “ ”

28. ENGAGEMENT COMMITMENT ENERGY Example pledge – Damian’s story Individual It has prompted myself, and others to discuss with our pharmacies methods of improving the taste of one of the common medicines for children. “ ”

29. ENGAGEMENT COMMITMENT ENERGY Louise's Story 2 nd year student nurse – York University Louise carrying out her change day pledge ‘Mock ward’ 2013

30. ENGAGEMENT COMMITMENT ENERGY Example pledge – Ashley’s story – Barking Havering and Redbridge Trust Change Day gave me permission to use my energy in the direction that I wanted to use it “ ” Main Trust wide pledge for NHS Change day in 2013 Guardian Service Informal way of raising concerns

31. BHRUT & THE GUARDIAN SERVICE Total2012Total2013TotalAll* Would you feel safe raising your concern? Yes75258%107280%45,02571% No19215%26920%6,99911% Would you feel confident your Trust would address your concern? Yes51640%93270%3420054% Staff Feedback: The following responses in the 2013 NHS Staff Survey in the Health, Wellbeing and Safety at Work category had the largest overall shifts in the Trust when compared to 2012:

32. Harvard Business Review McKinsey M-Prize Leaders Everywhere Challenge Nesta and Observer 50 New Radicals

33. @HelenBevan Our new White Paper - Five enabling themes www.nhsiq.nhs.uk/ whitepaper

34. Getting information off the internet is like taking a drink from a fire hydrant Mitchell Kapor

35. What is The Edge A platform for change activists in health and care to learn, connect and grow Mobilising and organising and connecting with other change activists Curation vs Content creation Seek, Sense, Share what does it mean Why curation?

36. Curating knowledge Finding things out and keeping up to date “pulling” information, but also having it “pushed” to us by trusted sources Making sense and meaning of information Reflecting and putting into practice what we have learned Plugging information into our own mental models and turning it into knowledge Connecting and collaborating Sharing complex knowledge with our own work teams Testing new ideas with our own networks Increasing connections through social networks Source: Harold Jarche

37. #NHSChangeDay #SHCRchat Friends of the Edge theedge.nhsiq.nhs.uk @jackielynton @dominiccushnan