The power to improve

Helen Bevan
@HelenBevan
#YASLeadership
The
to improve

Source: @NHSChangeDay
2
@helenbevan #YASLeadership

the collective brilliance of people who work in
ambulance services
(with the help of a few critical friends)

Outstanding ideas and creativity
Face
to
face

Brilliant ideas and lots of them

What we are working on now
• Action on responding to people who fall
• Action on responding to people in mental health crisis
and emotional distress
• Action on staff wellbeing
• A directory of good ideas
• Virtual collaboration

Do NHS staff feel they can contribute to improvement?
72 70 71 72
47 47 45
49
0
10
20
30
40
50
60
70
80
2015 2016 2017 2018
Source NHS Staff Survey 2015 to 2018
Question KF7 - Staff feel they can contribute to improvement
Average of all NHS staff

Do ambulance staff feel they can contribute to
improvement?
72 70 71 72
47 47 45
49
0
10
20
30
40
50
60
70
80
2015 2016 2017 2018
Mean score: all NHS staff
Mean score: all
ambulance staff

72 70 71 72
47 47 45 49
41 44 42
48
0
10
20
30
40
50
60
70
80
2015 2016 2017 2018
Do Yorkshire Ambulance staff feel they can
contribute to improvement?
Mean score: all
NHS staff
Mean score: all
ambulance staff
Mean score: all
Yorkshire Ambulance
Service staff

Being able to make a difference is
all about power
Power is the
ability to produce
intended effects
Bertrand Russell

Jeremy Heimens, Henry Timms New Power: How it’s changing the 21st Century and why you need to know (2018)
new power
Current
Made by many
Pulled in
Shared
Open
Relationship
old power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction

Two kinds of people at work
• Feel disconnected from purpose
• Controlled & coordinated through
performance management and
standardised procedures
• Hold back
• Resist change
• Work to a role specification
Adapted from The Emotional Economy
http://emotionaleconomy.com.au/papers-articles/why-the-winners-in-
business-are-taking-the-time-to-build-a-positive-kind-social-culture/
The Compliant

• Feel connected to a higher
purpose
• Direction set through shared goals
& values (“magnetic north”)
• Collaborate
• Embrace change
• Work to who they are
The Contributor
• Hold back
• Resist change
The Compliant

• Feel connected to a higher
purpose
• Direction set through shared goals
& values (“magnetic north”)
• Collaborate
• Embrace change
• Work to who they are
The Contributor
• Hold back
• Resist change
The Compliant
Gallup global research:
• Only 17% of the workforce are
engaged (Contributors)
• Contributors create six times
the value to an organisation
compared to the compliant

The factor that makes the biggest
difference: leadership

What do we know? Studies show:
Sources: The Hidden Potential of Frontline Leaders in the Public Sector
Middle Managers Deserve More Respect
• Frontline leaders and middle managers are often the
key to delivering improvement and performance goals
• They lay the foundations for the truly productive
workplace.
• They directly supervise as much as 90% of the overall
workforce
• Whilst they have an outsize influence on improvement
and performance, only 20% to 30% of a typical
organisation’s leadership development budget targets
them
• Most management training is not designed to prepare
leaders for the daily challenges they will face on the
job.

“We wear too many caps”: role conflict
among ambulance service managers
Joshua Miller, WMAS

If your managers aren’t engaged, your
employees won’t be either
You can’t change a culture without great managers who themselves are
having an exceptional employee experience. This means they need to have
challenging experiences where they, themselves, are engaged and
developing through their strengths. They need to be coached, as they
progressively become more effective coaches themselves.
James Harter
Improvement!

Tomorrow’s management
systems will need to value
diversity, dissent and
divergence as highly as
conformance, consensus
and cohesion.”
Gary Hamel

Change AGENCY definition:
The power, individually and collectively, to make a
positive difference. It is about pushing the boundaries
of what is possible, mobilising others and making
change happen more quickly
Change AGENT definition:
Someone who is actively developing the skills,
confidence, power, relationships and courage to make
a positive difference

After years of intensive analysis,
Google discovered that the key to high performing teams that
deliver change is being nice
Project Aristotle: https://www.youtube.com/watch?v=UfGiCnhdU78&feature=youtu.be&list=PLHEw3ja-
xoaZybvz9f0b1_6bJyG7zZO6L

Systems awareness and systems design are
important for health professionals, but they are not
enough. They are enabling mechanisms only.
…..Ultimately, the secret of quality
is love.
……If you have love, you can
then work backward to monitor
and improve the system.
Aveda's Donabedian

Confronting people with
their freedom may be the
ultimate act of love
Peter Block
Source of quote: Celine Schillinger

72 70 71 72
47 47 45 49
41 44 42
48
0
10
20
30
40
50
60
70
80
2015 2016 2017 2018
What would it take for YAS to have the highest
“contribute to improvement” scores in the NHS?
Mean score: all
NHS staff
Mean score: all
ambulance staff
Mean score: all
Yorkshire Ambulance
Service staff

The power to improve

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The power to improve