Better care fund Helen Bevan

@HelenBevan #NWLBC
The personal leadership
challenge of making
integrated care a reality
12th March 2014
Helen Bevan
@HelenBevan

@HelenBevan #NWLBC
Most large scale change doesn’t fully
deliver its objectives
Source: McKinsey Performance Transformation Survey, 3000 respondents to
global, multi-industry survey
70%
25%
5%
Gets anywhere near
achieving the
change and
delivering the
benefits

@HelenBevan #NWLBC
Most large scale change doesn’t fully
deliver its objectives
Source: McKinsey Performance Transformation Survey, 3000 respondents to
global, multi-industry survey
70%
25%
5% Delivers and
sustains the change

@HelenBevan #NWLBC
Image from: @TheWorldStories

@HelenBevan #NWLBC
Most change efforts are built upon the shaky foundation of
five flawed assumptions; that change can be managed, that
human beings are objective, that there are ‘X’ steps to
change, that we have a neutral starting point for change, and
that change, itself, is the goal
Peter Fuda
http://www.peterfuda.com/wp-content/themes/peterfuda-
bootstrap/content/Why-Change-Efforts-Fail.pdf
Source of image: Whatsthebigideascwartzy.blogspot.com

@HelenBevan #NWLBC
Tensions that change leaders must live with
Dominant
approach
Emerging
direction
Source: @HelenBevan

@HelenBevan #NWLBC
The Network Secrets of Great Change Agents
Julie 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

@helenbevan@HelenBevan
We need to be boatrockers!
• Rock the boat but manage to
stay in it
• Walk the fine line between
difference and fit, inside and
outside
• Able to challenge the status
quo when we see that there
could be a better way
• Conform AND rebel
• Capable of working with others
to create success NOT a
destructive troublemaker
Source: Debra Meyerson

@helenbevan#NHSChangeDay #SHCRchat
Source : Lois Kelly www.foghound.com
There’s a big difference between a rebel
and a troublemaker
Rebel

Reflection
• What are your insights around “radicals” and
“troublemakers”?
• What moves people from being “radical” to
“troublemaker”?
• How do we protect against this?

Valuing radicals
• “New truths begin as heresies” (Huxley, defending
Darwin’s theory of natural selection)
• Big things only happen in organisations and systems
because of heretics and radicals
GALILEO DESCRIBES HIS DISCOVERIES TO THE CHURCH ESTABLISHMENT

Peter Fuda’s Transformational Change Agent
framework
Skills and methods for creating
change
Ability to make sense of, and reshape
perceptions of ‘reality’
Personal characteristics and
qualities

framework: my perspective
“Doing”
• Where most change agents
in health and care put most
of their effort and emphasis
• What others typically judge
us on
• What we often perceive we
need to do to add value
• What most change and
improvement courses focus
on

framework: my perspective
“Seeing ” and “Being”
• We can only do effective
“doing” if we build on strong
foundations of “seeing and
being”
• Change begins with me
• Hopeful futures, creative
opportunities and potential
• Multiple lenses for change
• See myself in the context of
my higher purpose

@helenbevan@HelenBevan @RobertVarnam #IHI25Forum #ChangeAgents
"There’s only one
corner of the
universe you can
be certain of
improving, and
that’s your own
self."
Aldous Huxley
Source of image: timcoffeyart.wordpress.com

‘I do not think you can really deal with
change without a person asking real
questions about who they are and how they
belong in the world’
David Whyte, The Heart Aroused 1994
Source of image: fistfuloftalent.com

1. Driven by conviction and values
2. strong sense of “self-efficacy”
 belief that I am personally able to create the change
3. able to join forces with others to create action
4. able to achieve small wins which create a sense
of hope, self-efficacy and confidence
5. More likely to view obstacles as challenges to
overcome
Five things we know about successful
boat rockers
Source: adapted from Debra E Meyerson
CHANGE
me
BEGINS WITH

Self-efficacy
There is a positive, significant
relationship between the
self-efficacy beliefs of a
change agent and her/his
ability to facilitate change
and get good outcomes
Source of image:www.h3daily.com

What’s the difference between
self efficacy
and
self esteem,
self belief,
self-confidence?

Source: @NHSChangeDay

Source: @NHSChangeDay
What is the issue here?
“permission” ?
(externally generated)
or
Self efficacy ?
(internally generated)

Reflection
What are some ways we can build self-
efficacy?

Building self-efficacy: some tactics
1. Invest in your own change agent development
• create the conditions where success is more likely to happen
2. Create change one small step at a time
3. Reframe your thinking:
• failed attempts are learning opportunities
• uncertainty becomes curiousity
4. Make change (and learning cycles from change) routine
rather than an exceptional activity
5. Get social support
6. Learn from the best
7. Get people whose opinions you value to encourage you
(mentor?)

Lessons for leading change from Peter Fuda
1. In order to create/sustain radical
change we need to move from a
burning platform (fear based
urgency) to a burning ambition
(shared purpose for a better
future)
2. We need to articulate personal
reasons for change as well as
organisational reasons
3. If the fire (the compelling
reason) goes out, all other
factors are redundant
@PeterFuda

Task
Talk to the person next to you
• What is “my burning ambition” for the people we
serve, my service, team and/or family?
• Try to make it personal: tell others why this ambition
connects with your personal motivations

@helenbevan #IQTGOLD#NHSChangeDay
“I have some Key
Performance
Indicators
for you”
or
“I have a
dream”
Source: @RobertVarnam

Three assumptions in leading change
1. Assume that everyone has a noble intention.
2. When people “resist” change is it more likely
to be a result of their interpersonal
interaction with the change process than
their innate character traits (“a bad change
process not a difficult person”).
3. My role as a change agent is about
alignment, not judgement.
Source of image:help.adobe.com

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

References
The School for Health and Care Radicals
www.changday.nhs.uk/healthcareradicals
Bevan H, Plsek P, Winstanley (2011) Leading Large Scale Change - Part 1, A Practical
Guide
Bevan H (2011) Leading Large Scale Change - Part 2, The Postscript
Change Agents Worldwide (2013) Moving forward with social collaboration
SlideShare
Fuda P (2012) 15 qualities of a transformational change agent
Moore I (2013) Diversity is the short cut to building an innovation culture
Schillinger C (2014) Top-Down is a Serious Disease. But It Can Be Treated
Shinners C (2014) New Mindsets for the Workplace Web
Stoddard J (2014)The future of leadership
Williams B (2014) Working Out Loud: When You Do That… I Do This
Verjans S (2013) How social media changes the way we work together SlideShare

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