On the 12th of September, altstrat was kindly asked to join in a twitter conversation with Helen Bevan (@HelenBevan) and Steve Fairman (@stevefairman1) to discuss the new white paper; The new era of thinking and practice in change and transformation. This whitepaper, published in July 2014, is a call to action for leaders of health and care. It calls for clinicians to challenge the status quo through thinking and action to serve the NHS of the future.
In examining leading trends in change and transformation across multiple industries worldwide, this paper offers us the opportunity to see the profound implications and opportunities for leaders of health and care. We are also enabled to rethink organisational and system change in terms of:
- Who does it (many change agents, not just a few)
- Where it happens (increasingly 'at the edge' of organisations and systems)
- The skills and mindsets that change agents need.
As our students are challenged to think critically to solve wicked problems and discover new ways to innovate in the clinical workplace, we were eager to take part and encouraged our students to do the same in the classroom, on our Facebook page and our Twitter platform.
Many people from UK universities, worldwide enthusiasts and NHS organizations joined the twitter chat, eager to discuss innovation and change. This in itself was a great motivation, the desire for change is out there! Our founder, Trevor Dolan was keen to get involved as he chaired our account for us during the session.
The overriding theme of the conversation was that of putting the white papers initiatives into practise. Yet people were wary of what barriers to this may be overcome.
“Has lack of support for rebels and ideas been a barrier to innovation in the past?” Iain Smith (@nhslean)
“Not only lack of support, but lack of awareness of the very existence of radicals” Jodi Brown (@JodiMBrown)
Good support structures and coaching were put forward as sensible solutions, but is this all talk? Are Mavericks and Rebels given the freedom and support they need to try? Fail? Make mistakes?
“A key principle for emergent leadership is that change must start with 'me'.” -- Steve Fairman (@stevefairman1)
Is working through networks, not hierarchy the answer? We certainly think so, but the barriers we identified during the twitter chat were of other priorities getting in the way, such as hitting targets and data collection.
Being a maverick in the NHS can feel lonely, and some participants of the chat felt that it was easier and quicker to apologise for mistakes made rather than ask for permission to try first, but there are risks involved with doing this. A strong organisational culture that empowers staff & supports innovation could be the answer, because it is always easier when you are moving with likeminded people. If the NHS can build capacity in the system for small groups to develop creative approaches based on local knowledge, innovation and change can occur.
So how do NHS leaders work with the 'liberated'? If they can harness the collective knowledge of the NHS workforce, they can develop best practice & share lessons to reach new successes. But does current leadership support focus upon the dominant rather than emergent behaviours? Emergent behaviours need modelling by those facilitating development, as ‘just’ teaching won’t work.
We heard a lot of great rhetoric and suggestions for putting this white paper into practise, but we are still in search of practical examples and solutions in the NHS workplace. As we continue to encourage our students to innovate through change, we hope to see and share new ideas being put into practise in readiness for future NHS service challenges. We wanted to thank Helen Bevan and Steve Fairman for inviting us to the Twitter chat, and hope to be active in many more online discussions.