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These are the slides for module 2 of The School for Health and Care Radicals, a five week virtual programme, designed to equip people across the health and care system with the core skills to improve their skills as change agents. It supports NHS Change Day 2014, the grassroots movement in which everyone who values the NHS can make a pledge of action to improve things for patients and the health and care system. Big change only happens in health and care because of heretics and radicals: passionate people who are willing to take responsibility and work with others to make change happen. Being a radical isn't related to hierarchy or position and you don't have to work in the NHS or social care to qualify as one. Registrants to the school so far include patients and carers, students, senior leaders, improvement facilitators and clinical and care staff. Starting on 31 January, there is a live weekly web seminar which will be available to 'listen again', supported by a raft of other opportunities, including coaching and mentoring, virtual discussions and tweet chats, and an ever- expanding portal of useful resources. Programme The programme focuses on five modules over five weeks, 9:30 to 11:00 am GMT Friday 31 January: Being a health and care radical: change starts with me Friday 7 February: Forming communities: building alliances for change Friday 14 February: Rolling with resistance Friday 21 February: Making change happen Friday 28 February: Moving beyond the edge You can view the slides from module 1 at: http://www.slideshare.net/NHSIQ/module-1-being-a-health-and-care-radical-change-starts-with-me You can download the module 1 study guide at: http://changeday.nhs.uk/files/Module%201%20study%20guide%20final%20ph%202.pdf You can view the module 1 recording of the WebEx https://haelo.webex.com/haelo/lsr.php?RCID=cb2534865578962fe574b5ec859da810 The School for Health and Care prospectus is at: http://changeday.nhs.uk/resources#sfhcr More information about The School for Health and Care Radicals http://changeday.nhs.uk/resources#sfhcr Coaching and mentoring film http://changeday.nhs.uk/files/0771pv384r1.mp4 Storify of module 1: http://storify.com/NHSIQ/being-a-health-and-care-radical-change-starts-with Pinterest of module 1: http://www.pinterest.com/nhsiq/school-for-health-and-care-radicals/ You can download the module 2 study guide at: http://changeday.nhs.uk/files/Module%202%20study%20guide%20final%20ph%20V3.pdf Tweetchat We will run a tweetchat each Wednesday from 16:00 to 17:00 GMT, based on the content of the module from the previous Friday. A tweetchat is a facilitated conversation using Twitter. The hashtag we will use for the tweetchats is #SHCRchat. The dates for the tweetchats are: 12 February 19 February 26 February 5 March There is no charge to join the School of Health and Care Radicals and it is open to all, whatever your role or level, and whether or not you work in the NHS.
#NHSChangeDay #SHCRchat
The School for Health and Care Radicals
www.changeday.nhs.uk/healthcareradicals
Module 2: Forming communities:
building alliances for change
Supported by
#NHSChangeDay #SHCRchat
Joining in today and beyond
• Please use the chat box to contribute continuously during the web seminar
• Please tweet using hashtags #NHSChangeDay and #SHCRchat• We will produce summaries of the discussions of today’s module
using Storify.com and Pinterest and put these on the website• The conversation continues on the live chat forum at
www.changeday.nhs.uk/healthcareradicalsforum
#NHSChangeDay #SHCRchat
31st January: Being a health and care radical: change starts with me7th February: Forming communities: building alliances for change14th February: Rolling with resistance21st February: Making change happen28th February: Moving beyond the edge
Modules
#NHSChangeDay #SHCRchat
School statistics
#NHSChangeDay #SHCRchat
Word cloud representation of chat from module 1
#NHSChangeDay #SHCRchat
• Connecting back to module one• Why we can’t be radicals on our own: building
communities for change• What we can learn from leaders of social
movements• Effective framing: telling our stories• Bridging disconnected groups• Building your own community• Questions and call to action
Source of image: www.freshnessmag.com
for today
The truth about leadership
You can make a differenceAND
You can’t do it aloneSource: TED talk by Barry Posner http://workplacepsychology.net/2014/02/01/the-truth-about-leadership-you-make-a-difference-and-you-cant-do-it-alone/
Source of image: jamessamy.com
#NHSChangeDay #SHCRchat
#NHSChangeDay #SHCRchat
Emerging themes in change and transformation
Organisation CommunityPower through hierarchy Power through connectionMission and vision Shared purposeMaking sense through rational argument
Making sense through emotional connection
Leadership-driven (top down) innovation
Viral (grass-roots driven) creativity
Tried and tested, based on experience
“ Open” approaches , sharing ideas & data, co-creating
change
Transactions Relationships
Dominantapproach
Emerging direction
Source: @HelenBevan
From module one
What is community?1. Locality2. Interest or shared purpose3. Sense of belonging: “community spirit”
“There is no power for change greater than a community discovering what it cares about.” ~ Margaret Wheatley
Source of image: rootedincommunity.org
Power in community“Power used to come largely through and from big institutions.Today power can and does come from connected individuals in community.When community invests in an idea, it co-owns its success.
Source of image: orton.org
Instead of trying to achieve scale all by ourselves, we have a new way to have scale. Scale can be in, with and through community.”
Nilofer Merchant
1. Driven by conviction and values2. strong sense of “self-efficacy”
belief that I am personally able to create the change3. able to join forces with others to create action4. able to achieve small wins which create a sense of
hope, self-efficacy and confidence5. More likely to view obstacles as challenges to
overcome
Five things we know about successful boat rockers
Source: adapted from Debra E Meyerson
CHANGE
meBEGINS WITH
From module one
1. Driven by conviction and values2. strong sense of “self-efficacy”
belief that I am personally able to create the change
3. able to join forces with others to create action4. able to achieve small wins which create a sense of
hope, self-efficacy and confidence5. More likely to view obstacles as challenges to
overcome
Five things we know about successful boat rockers
Source: adapted from Debra E Meyerson
CHANGE
meBEGINS WITH
From module one
Source of image: outskirtsbattledome.wikispaces.com
The easiest way to thrive as an outlier
...is to avoid being oneSeth Goodin
“if you want to go fast, go alone. If you want to go far, go together.”African proverb quoted by Al Gore
Learning from social movement leaders
Call to Action
Source: @RobertVarnam
What are the characteristics of people or groups within effective social movements?
• They share a sense of PURPOSE– There is purposefulness about collaborations, discussions, actions, and decisions and a sense
of forward momentum • They are UNITED
– They have learned to manage their differences well enough that they can unite to accomplish the purposes for which they were came together. Differences are openly debated, discussed, and resolved.
• They share UNDERSTANDING– There is a widely shared understanding of what's going on, what the challenges are, what the
strategy is and why what is being done has to be done • People PARTICIPATE
– Lots of people and organisations in the system are active - not just involved in discussions and meetings, but getting the work done.
• They take INITIATIVE– Rather than reacting to whatever happens in their environment, they are proactive, and act
upon their environment. • They ACT
– People do the work they must do to make the things happen that need to happen Source: adapted from Wellstone Action
A social movement isa voluntary collective
of individuals committed to promoting or resisting change through co-ordinated activityto produce a lasting and self generating effect
and creating, as they do a sense of shared identity
What communities have formed since module 1?
• Dorset and Wessex• West Midlands• Herts Radicals Twitter• South west• East Berks Learning and Support Group• The North West• Connections by profession and interest
How do we create change at scale?
Source: Marshall Ganz
Shared understanding leads toAction
Narrativewhy?
Strategywhat?
What is strategy?
Strategy is the process of turning the RESOURCES you have into the POWER you need to win
the CHANGE you wantSource: Marshall Ganz
Resources to improve health and care
Economic resourcesdiminish with use• money• materials• technology
Natural resourcesgrow with use• relationships• commitment• community
Based on principles from Albert Hirschman, Against Parsimony
diminish grow
Framing … is the process by which leaders construct, articulate and put across their message in a powerful and compelling way in order to win people to their cause and call them to action.
Snow D A and Benford R D (1992)
What’s the financial incentive?
Who is performance managing?
What’s the project plan?
Source: @RobertVarnam
The reality“What the leader cares about (and typically bases at
least 80% of his or her message to others on) does not tap into roughly 80% of the workforce’s primary motivators for putting extra energy into the change
programme”Scott Keller and Carolyn Aiken (2009)
The Inconvenient Truth about Change Management
Source of image: swedenbourg-openlearning.org.uk
“I have some Key Performance
Indicatorsfor you”
or
“I have a dream”
Source: @RobertVarnam
Leaders ask their staff to be ready for change, but do not engage enough in sensemaking........
Sensemaking is not done via marketing...or slogans but by emotional connection with employees
Ron Weil
How the world of work is shifting
• The organisation as a collective
• Leaders seek to build the allegiance of the workforce to the goals, culture and ethos of the organisation
• The network as a connective
• We share and identify with a deeper, extra-corporate work culture and the structure is subordinated to that
Source:stoweboyd.com Source of image: www.slideshare.net/mexicanwave/champions-trolls-10-years-of-the-cipd-online-community
If we want people to take action, we have to connect with their emotions through values
action
values
emotion
Source: Marshall Ganz
But not all emotions are equal.........
inertiaurgency
anger apathy
solidarity isolation
you can make a difference
Self-doubt
hope fear
Ove
rcom
es
Action motivatorsAction inhibitors
Source: Marshall Ganz
Effective framing: what do we need to do?
1. Tell a story
Effective framing: what do we need to do?
1. Tell a story2. Make it personal
Effective framing: what do we need to do?
1. Tell a story2. Make it personal3. Be authentic
Effective framing: what do we need to do?
1. Tell a story2. Make it personal3. Be authentic4. Create a sense of “us”
Effective framing: what do we need to do?
1. Tell a story2. Make it personal3. Be authentic4. Create a sense of “us” (and be clear who the “us”
is)5. Build in a call for urgent action
Creating our narrative
• Challenge: What was the challenge? Why was it a challenge?
• Choice: What were the choices? Why did you make the choice you did? Where did you get the courage or hope? How did it feel?
• Outcome: How did the outcome feel? Why did it feel that way? What do you want us to feel?
Source: Marshall Ganz
Vivid details
Source: Marshall Ganz
How do we create a sense of “us” to build momentum for change?
Source of image: studentblognmaestics.blogspot.com
The Network Secrets of Great Change AgentsJulie Battilana &Tiziana Casciaro
1. As a change agent, my centrality in the informal network is more important than my position in the formal hierarchy
2. If you want to create small scale change, work through a cohesive network
If you want to create big change, create bridge networks between disconnected groups
From Module 1
strong ties (cohesive)v.
weak ties (disconnected)
Source of image:brucemacvaresh.com
When we spread change through strong ties:
• we interact with “people like us”, with the same life experiences, beliefs and values
• Change is “peer to peer”; GP to GP, nurse to nurse, gynaecologist to gynaecologist
• Influence is spread through people who are strongly connected to each other, like and trust each other
IT WORKS BECAUSE: people are far more likely to be influenced to adopt new behaviours or ways of working from those with whom they are most strongly tied
The pros and cons of strong ties
Pros Cons
Strong and weak tiesWhen we seek to spread change
through strong ties:• we interact with “people like
us”, with the same life experiences, beliefs and values
• Change is “peer to peer”; GP to GP, nurse to nurse, gynaecologist to gynaecologist
• Influence is spread through people who are strongly connected to each other, like and trust each other
When we seek to spread change through weak ties:
• we build bridges between groups and individuals who were previously different and separate
• we create relationships based not on pre-existing similarities but on common purpose and commitments that people make to each other to take action
• our aim is to mobilise all the resources in our organisation, system or community that can help achieve our goals
Why we need to build weak ties AS WELL AS strong ties
• Weak ties are more likely to lead to change at scale because they enable us to access more people with fewer barriers
Why we need to build weak ties AS WELL AS strong ties
• Weak ties are more likely to lead to change at scale because they enable us to access more people with fewer barriers
• In situations of uncertainty, we have a tendency to revert to our strong tie relationships– yet the evidence tells us that weak ties are much more
important than strong ties when it comes to searching out resources in times of scarcity
Why we need to build weak ties AS WELL AS strong ties
• Weak ties are more likely to lead to change at scale because they enable us to access more people with fewer barriers
• In situations of uncertainty, we have a tendency to revert to our strong tie relationships– yet the evidence tells us that weak ties are much more
important than strong ties when it comes to searching out resources in times of scarcity
• The most breakthrough innovations will come when we tap into our weak ties
Why we need to build weak ties AS WELL AS strong ties
• Weak ties are more likely to lead to change at scale because they enable us to access more people with fewer barriers
• In situations of uncertainty, we have a tendency to revert to our strong tie relationships– yet the evidence tells us that weak ties are much more
important than strong ties when it comes to searching out resources in times of scarcity
• The most breakthrough innovations will come when we tap into our weak tiesHistory suggests that weak ties will probably give us the best
chance to deliver large scale improvements in a challenging timescale
Three components of a great narrative
• Diagnostic – what is the problem that we are addressing? What is the extent of the problem? What is the specific source or sources?
• Prognostic – what could the future look like? What is our “plan of attack” and our strategy for carrying out the plan?
• Motivational – why is this urgent? What is our call for action that connects with the motivational and emotional drivers of the audience?
Source: Benford and Snow
‘If people give to a cause, they expect a relationship, not a transaction.’
Nilofer Merchant
“A cynic, after all, is a passionate person who does not want to be disappointed again.”
Zander R and Zander B (2000) The art of possibility. Harvard Business School Press. As quoted by Steve Onyett
@helenbevan#NHSChangeDay #SHCRchat
Who are your communities?
Source: Celine Schillinger http://weneedsocial.com/blog/2013/8/25/disrupted-disruptors-unite
• In your role: through relationships and social networks
• Through external social networks such as Twitter and LinkedIn
• Through communities of practice and learning groups
@helenbevan#NHSChangeDay #SHCRchat
Building community…..• Why did you feel it mattered for you to from as
a group and come together? • How have you started to form?• What do you plan to do ( meetings etc?)• How do you feel this being part of this
community will help you as a radical? • What reflections do you have on forming
communities that you can share with the group?
@helenbevan#NHSChangeDay #SHCRchat57
http://weneedsocial.com/blog/2013/8/25/disrupted-disruptors-unite
@helenbevan#NHSChangeDay #SHCRchat
Outwitted
He drew a circle that shut me out -Heretic, rebel, a thing to flout.But Love and I had the wit to win:We drew a circle that took him in.
Edward Markham
@helenbevan#NHSChangeDay #SHCRchat
Calls to action campaigns for this weekPost these or similar actions as a pledge on the NHS Change Day pledge wall http://changeday.nhs.uk/campaign• Identify which communities you are currently part of
and how you can utilise your existing communities for change
• Reflect on who else you would like to be part of your community for change and take act to connect with them
• Create your narrative or “call to action” to win other people to your cause
@helenbevan#NHSChangeDay #SHCRchat
Next opportunities for learning
• Sunday 9th February 19:00-20:00 conference call discussion of
module one• Wednesday 12th February
16:00-17:00 Tweet chat #SHCRchat• Next Friday morning 14th February module 3: Rolling with resistance
@helenbevan#NHSChangeDay #SHCRchat
Questions for reflection
1. What learning and inspiration can you take from social movement leaders to help you in your role as an agent of change in health and care?
2. How will you attract the attention of the people you want to call to action?
3. Who are the people who are currently disconnected that you want to unite in order to achieve your goals for change? How can you build a sense of “us” with them?
