Module 3 chat box contents - School for Change Agents

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Module 3 chat box contents – Thursday 2 March 2017
from Helen Bevan to All Participants:
Hi everyone. Welcome to module 3. Where are you, how are you and how is the weather?
from Adrian Woodfield to All Participants:
Hello (at last) from a slightly wet Orkney!
from Sally Davies to All Participants:
Hello from a cloudy Oswestry - looking forward to this session :)
from Naomi Brook to All Participants:
Hello from sunny Coventry! :)
from Oliver Benson to All Participants:
Hello from sunny Warwickshire!
from pramod kumar to All Participants:
Good afternoon , this is Pramod , consultant liaison psychiatrist
from Julie mackie to All Participants:
hello all, Im Julie Mackie from Gloucestershire, England and this is my first live session.
Hello everyone!
from Emma Kelly to All Participants:
Hi everyone - I am Emma and I'm dialing in from sunny Canterbury (East Kent Hospitals)
from Mandy Townsend to All Participants:
hello Everyoe. I am Mandy Townsend from Wirral, England. I work in Wales
Hi Mandy!
from Pip Hardy to All Participants:
Hello Everyone - greetings from Cambridge where it's chilly and a little bit cloudy.

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it's dull and overcast here today too
from Aidan Murphy to All Participants:
Hi. Aidan here from sunny Chorley. UK @aidanfcho
It's great to see so many people in the chat box who I know through Twitter. It's so easy to feel close
to this community
from Charlotte Smith to All Participants:
Good afternoon everyone!
from Beccy Macnamara to All Panelists:
Hi everyone
from Tom de Salis to All Participants:
good afternoon
from Paula Ward to All Participants:
Afternoon everyone
from Victoria Hewitt to All Participants:
Hi Everyone. Looking forward to this module. It's my favourite
from Julie Smith to All Participants:
Hello everyone, esp colleagues from JPUH
from Matilda McCrimmon to All Participants:
Hi everyone .I am very polite today I was Tilda last week :)
from Rebecca Crossley to All Participants:
hellomynameis Rebecca from sunny gorleston #getthenationsigning
from Syeda Akhtar to All Participants:
Afternoon all
I did not make module 1 live.Is it possible to join a breakout room today?

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from Chris Witham to All Participants:
Afternoon everyone. Sorry I couldn't join last week.
from Diana Stewart to All Participants:
Afternoon Sally Drake, Diana Stewart and Lucy Seymour have joined the session today
from Linda D'Arpino to All Participants:
hello!
from Louis Warner to All Participants:
WebEx Assistance: http://theedge.nhsiq.nhs.uk/school/webex-assistance/
from Claire Maggs to All Participants:
Good afternoon, should we be able to hear Oliver speak yet?
from angela gulay to All Participants:
Good morning from Alberta, Canada.
from Maria McGill to All Participants:
Hi Folks REally looking forward to todats session................
@angela - you should be able to hear some music
i do
from Claire Maggs to All Participants:
thank you
:)
from Kathryn Perera to All Participants:
Good afternoon everyone! And hello from sunny London!

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Fantastic to see so many people taking part. If you haven't done so already, we'd love you to put
your name, where you are, how you are, the weather etc in the chat box
from Rachel Volland to All Participants:
Good afternoon from Salford, Manchester
Cold, going to snow like crazy this weekend
from Jo Palmer to All Participants:
Hello everyone; looking forward to module 3 in sunny Dorset
from Leigh Morgan-Jones to All Participants:
Leigh Morgan-Jones - Sunny Staffordshire. Loving life!
from Wendy Johnson to All Participants:
Beautifully sunny day here, near Edinburgh - Wendy :)
Aha in Edinburgh, its glorious, sunny and cold. spring has sprung.
Hi Matilda. We would love you to join a breakout room. Olly will give instructions on how to do it at
4pm
Birmingham UK, weather is lovely but I'm stuck inside!
from Kate Emery to All Participants:
Hello from Gorleston from Kate!
from Kate Pound to All Participants:
Hi Kate
from John Kolodny to All Participants:
John Kolodny- United States- Coalition of Kaiser Unions- Ohio
from Keira Azzopardi to All Participants:

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Good morning from Canada! I'm an student occupational therapist and very excited for the module!
Currently snowy and -10!
from Emma Hill to All Participants:
Hello from Bournemouth
from Elizabeth Beech to All Participants:
Elizabeth Beech Fabulous sun outside - I wish I was in it!
Proper waeather in Alberts #jealous
from Claire Tomkinson to All Participants:
I'm here from Manchester. Missed last week courtesy of Storm Doris! Looking forward to joining in.
Felt very lonely catching up on my own
from Rob Cockburn to All Participants:
Hi from London
from chris malvern to All Participants:
Hello from Birmingham
from Fiona McKenzie to All Participants:
Hi from almost Spring-like Battersea in London! Fiona here.
Hey Chris
Resistance and Resilience - bring it on please
from Caroline Carswell to All Participants:
Hello from Dublin, Ireland = hearing + speech services activist @soundadvice_pro!
from Cheryl Mudge to All Participants:
Good morning from Calgary, Canada.
from Alison Wilson-Shaw to All Participants:
Hi Alison from Keele, Staffordshire

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from Tracy Clifford to All Participants:
hello from Caledon, Ontario, Canada
Got my technology working as well - clearly improving
from Susan Yungblut to All Participants:
Good morning from Ottawa, Canada
from Katy McNeil to All Participants:
Hi I'm Katy from Scottish Government leading improvement team in Edinburgh - my first school for
change agents (same team as Fiona, above)
from Judith Thomson to All Participants:
Hi from Judith at Practice Nurse Development Team in Glasgow
from Laura Wilkes to All Participants:
Hello Everyone, it's Laura from the Library in sunny Suffolk UK
Hi Fiona and Katy - maria from VCCHAS
from madelyn griffiths to All Participants:
Hello from Madelyn at North Bristol Trust
Hi all
from CHAS!
from Alice Gormley to All Participants:
Hello from Alice Gormley ,O.T Manager ,Ireland .Sorry I was not here last week
Fantastic to have so many people joining from across the world.
from John Kolodny to All Participants:

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John from United States supporting Work of The Futurw and Work Force palnning and Development
in Health Care Industry at Kaiser Permanenete
from Martin Sharp to All Participants:
Public Health England ready to go
from Nardia Lloyd-Ashton to All Participants:
Hi Nardia here from Manchester - Skills for Care
from Shelley Cornick to All Participants:
Shelley from Newfoundland, Canada. Hi!
from Angela Rowe to All Participants:
Hi Katy - Angela Rowe here at University Hospital Ayr
from Ashley Burton to All Participants:
test
from Agnes Hardy-Boyer to All Participants:
Hi everyone!
from naomi ledwith to All Participants:
Hi Naomi from manchester
from Karen Perkins to All Participants:
phew finally got my audio sorted!
from Dominic Cushnan to All Participants:
hi everyone :)
from Becky Haines to All Participants:
Hi All: American College of Radiology here in Pacific Conference room in Reston, VA
I can't hear anything but I can see you?
from Jenny Jones to All Participants:
Hi - Jenny Jones here, too, from the American College of Radiology in Reston, VA.

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from Tanya Burchell to All Participants:
Hi from Gloucester
Hi guys!
Lots of folk from America - amazing
from Ann Quinn to All Participants:
Hi Ann here from Dublin, Ireland
from Richard Bessell to All Participants:
hi.....Richard Bessell - Dorset CCG...Anyone around health or social care in dorset on this webinar?
from Ruth Do to All Participants:
Ruth Nottingham here - nice to see everyone
from rianne edinborough to All Participants:
hello from Liverpool
If you can't hear anything, make sure your audio dialog is closed
from Russell Beattie to All Participants:
Hi from University Hospital Crosshouse in Scotland
from helen maitland to All Participants:
hello from Helen in Scotland
Hi I am in very cold and changeable Alexandria (in Scotland)
from Catherine Fleetwood to All Participants:
Hi all, great to be back for week 3
Hello Richard! See you in the breakout later

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Brilliant - lots from scotland too. maybe we should connect??
thanks laura...i'm in vh rm11 if you're around...got on the big screen
how about CPD for social workers?
from Trevor Fossey to All Participants:
Hi from Birmingham UK - Trevor
Clearly its a snow thing
from Aoife Gallagher to All Participants:
Hi from rainy southwest ireland (it really does rain all the time here)
http://revalidation.nmc.org.uk/download-resources/forms-and-templates links for forms for nursing
reval
Love RCTs
Already sorted a chat with my RCT partner in a few weeks :-)
Love Rain! better than snow all the time for sure. :)
from Sally Morgan to All Participants:
looking forward to my RCT - must reply to the email to book a chat!
is the CPD credit for HealthcareScientists too?
from Andrew Marsh to All Participants:

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Hi Andrew Marsh here University of Warwick, Coventry - managed to register properly this week!!
#covmindthegap and getting people active.
need to get on my RCT!
I've got a match! Looking forward to chatting with a change agent in Ireland
Looking forward to my coffee trial - completely new thing for me!
hmmm. still not hearing anything....
from teresa spilsbury to All Participants:
looking foward to coffee trial next weeek - Leicester and Bristol - really exciting to talk to someone in
a trust I know nothing about
Gema and I planning to meet next week
Waiting for my RCT to reply but looking forward to it!
from Muhammad Ali Abid to All Participants:
What was the email again for the RCT?
https://www.slideshare.net/HorizonsCIC/how-to-set-up-a-randomised-coffee-trial some information
on running a local RCT
from Dominic Cushnan to All Participants:
thanks Kate
I'll be honest :) I always think I am right... a huge learning curve for me to get of my high horse and
realise I usally am not

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Helen can you elaborate Campaigner?
Can totally relate Catherine Fleeetwood :-)
good to admit it Catherine!
I've heard all of those!
lol
LOL!
love that quote - heard it so many times ha ha ha
rofl
Have come across the opposite many times - we've done that before and it didn't work so why
should we do it again.'
very true and apt poem
I am currently being too innovative. My Vision seems impossible to achieve to others. But I am not
giving up. These modules will help me deliver the vision... I am sure!
leigh, sounds like you need to gather a group of people...
from Hazel Murgatroyd to All Participants:

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Love that . Perspective is key. Challenging self to take different perspectives is essential to mobilise
others
'my people' are not in my (council) organisation
from Nigel Millar to All Participants:
Dr Who never makes any progress until the Daleks say "Resistance is futile"
"This is really innovative. Unfortunately we can't consider it as it has never been done before."
REALLY resonates with me
from Lisa Bradley to All Participants:
Yes, I'm in. Better late than never! - Will read the transcript later to catch up :-)
My RCT partner just made contact! England linking with Canada.. Hey Erin!
definitely been cast as 'in denial / blocker' before - wasn't true but they didn't bother to find out
Isn't "Resistance is futile" the Borg?
Yep it's the Borg
Love the Dr Who addicts
from Isabella Davis-Fernandez to All Participants:
I must say I still think change should be planned and managed - otherwise you can lose sight of what
you originally set out to achieve
from Maggie Herbert to All Participants:
Resitance is futile - thought it was the Vogons (HitchHikers)

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would this be impossible for the NHS http://www.holacracy.org/
that's star trek!
It was all of them - Just dont be a Marvin
Great slide Helen! Dont tell the PRINCE2 gurus..
Change agents as truth tellers - building trust to tell the truth about resistance where and how it's
shows up.
from Linda Machakaire to All Participants:
Management consultants don't speak same language as clinicians!
from Luis Maldonado to All Participants:
excellent slide
Prince2 - that must be an Italian Prince - Machiavelli
from BARDY Nicolas to All Participants:
Hi Luis. Nice to see you on line
Concerned that there is a suggestion that PMO/Project Managers and the systems they use could be
blockers
Or Clinicians do not speak a language anyone can understand
from Adrian Woodfield to All Panelists:
Management has to have the courage to ask the experts - that is hard to do for some - like giving
away some of their power

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it's about finding the similarities in our difference - whatever role, language etc.
My world is Bizzarre indeed
The old power concept is still embedded in "Stakeholder Management" and moving people from
opposition to neutral
it's just that classic project management isn't really up to the task of mega change making
from Mandy Rudczenko to All Participants:
Love the chaos of a bizarre
If people are being resistant - they are interested
I'm a programme manager and a real challenge and tension between process/governance and
assurance (and external regulation) and organic change.
Both true
project managers can be change agents too! :)
from Sorrel Talbot to All Participants:
I don;t think so Rachel Volland- depends how its rolled out.
Resistance is an indicator of whether the change is relevant to that person - I love this perspective!
Resistance is not futile it is essential - if you get none it means no one is interested
MINDFULLNESS - the new way of lsitening

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I like the bazaar idea. Sometimes though I look and think this is just bizarre so this new word is
helpful
Resistance indicates likelyhood of success - it happens because people beleive the change may
actually happen
agree Nigel - rather resistance than total apathy (speaking from experience :( )
But is there a threshold to diversity where the returns become marginal?
Yese resistance is good
Project Manager here - recognise all the old ways but excited to be driving #red2green and
#endpjparalysis in the new way :)
When you are nearly there you get the most intense resistance - it is a good sign
Yes Catherine!
Agree with Helen - EVERYONE should have a voice - as the people who know - don't be so arrogant
as to think that you everything.
Resistance is not good when it's control-based
*know everything
Resistance is futile

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People change when they connect to peoples stories - patients tell the best ones
This is an awesome article!
from Chris Chambers to All Participants:
Change Process slide had service users in the centre- now there's a radical thought!
Can we have the link for the article in the chat box or with follow up info please
perhaps its the control thats not good not the resistacne?
from Valentina Karas to All Participants:
people don't resist change they resist control....well said Peter Fuda
Process users design the best changes
facts change my mind but I've worked out I'm a bit odd in that respect
interested in reference to better outcomes from collaboration rather than professionals on their
own
I do think clinicians respond well to data and facts.. evidence based change
data/facts theory applies to so much! reinforcing contrary views, opposite of its intent
Sally - just dont think everyone is like you

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and yet data is the currency that clinicans always want !
oooo I am guilty of trying to change resistance with facts and data - I need to read this research
love this.
oh thats interesting. Th number of influential male leaders who tell me I should back up .everything
with facts
People do not change their mind in a meeting or presentation - they do it later - possibly at 3am
Data and facts don't change people's mind?
so have more than one meeting
buy-in vs 'investors. this is great
Robust evidence can underpin change :-)
from Mike Jones to All Participants:
Setting out that story is a powerful way of getting people on board with the change
love the concept of 'investors'
Investors, not buyers - love it!
What not to do....totally NHS!!!!

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Do nto consult - engage people at the beginning
yes - we are often told what we need to choice and end up feeling manipulated rather than engaged
from Si Chun Lam to All Participants:
I think often as change agents, we know this, but (echoing an earlier slide) the organisational
structure in place doesn't support this? e.g. STPs.
from Nazia Ahmad to All Participants:
what to do: is co-production wrapped up differently
not just NHS... it's in human nature and therefore spread across all sectors!
We all talk of getting "buy-in" when need people to be invested in something. Wha't the diference?!
developing a shared understanding - best way.
yes buy in is very council-like!
Yes, I was thinking precisely of STPs
Avoid resisting the change your patients or service users design
hmm...
Bringing in investors mean that you have to give up some of the "pie." Many owners of the change
process. Not just your good idea...
from Emily Latourell to All Participants:

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I love using process maps to bring diverse groups to identify issues, look at desired outcomes
I prefer the cocreation phrase Helen Bevan!
reminds me of involving parents in organisational change - worked much better the earlier they
were involved, much to everyone's suprise
People need to OWN the change - do it themselves and not have it done to them
I don't like the buy-in or investor model
Nursing evidence sometimes come from "controlled" developement sites with additional support
mechanisms which are not reflecteded in everyday practice. Causes "it won't" work here"
Oh, co-creating; difference between buying in and investing
Exactly - mu good idea becomes our great idea.
Suggests that you can passively take part by spending 'money'
Nothing wrong with being a process junkie if it's used as a tool to break down silos, look at a system
level, and get teams to identify issues
not the same as emotinal investoemnt and co-creation
this is happing to me at the moment at work!
from Marie Parish to All Participants:

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This is huge! intent vs impact :)
I ask a lot of questions but am often badged as a 'laggard' whereas actually I just want to better
understand. Anyone else experience this?
@rachel same here. I have read that it means you are processing information on a deeper level.
Yea yeah co-creation is not the same as buy-in *or* investing
So patience it key asset
is
@rachel i am the same too!
Rachel - perhaps they are unable to answer your questions and find them threatening or as a
challenge
Wonder how you can use the 'buy-in' model when the 'change' is externally imposed....value still to
be had with finding solutions together but tough
This is a great question - is my intent impeding my impact. Really helpful! Are there good ways to
reflect on intent -> impact?
'start talking *with* me' surely???
Talking WITH me is better

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@Emily Latoutell and @Nardia - thanks so much good to not be alone
from Bonny Johnson to All Participants:
very true- need to take the time to reflect on ones impact
With me = yes'
'Stop talking at me and start talking WITH me' might be even better
We should practice this with our children so the next generation do not behave like this!
definitely shoudl be start talking with me!!!
great refelction Helen; I often relay intent and think the impact will be a good one!
agreed Wendy
Agree Becky haines patience with yourself as well if change not happening a s quick as you would
like
and ensuring everyone understands your desired impact: do they 'get' it?
intent and impact, never really gien it much thought in terms of awareness. good stuff
Talking to me reflects a rapport, relationship
I like the stuff on intent and impact, not thought in these terms before

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How do you get round management who actively hinder change?
from tom houston to All Participants:
quite a challenge Karen...to talk to teenagers rather than at them
from Stuart Clough to All Participants:
Coproduction requires honesty, not always an easy place to go to, but very worthwhile.
I have to work hard to remember not to be too enthusiatic! Joining Q community allowed me to
experience what a lot of enthusiasm feels like all day long!
listening is as important as talking
Can you get me some statistics to prove that data does not change peoples mind
people are totally disengaged (broadly) with "facts"
i do know that facts dont change minds - but i come from a natural sciences background so that was
hard for me to understand (and still not quite sure what does change minds!)
I think we need to use data more in the NHS to inform our plans for change. Compared other
industries I don't think we do this robustly and then maybe wonder why we can't see or measure
impact?#
from Shelley Huffman to All Participants:
buy in vs investor - still need to be sure people have tools and information to feel they want to invest
- AGREE that need sustainable involvement of many and not just a one time sales pitch to buy in
investor is a powerful concept in achieving sustainable change- will use this

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Helen, at some point it would be great to cover what you do once youve achieved the change - ie
knowing when you have gone as far as you can.
i woudl like some stats/evidence about better outcomes acheivable in groups that are just not
professionals
Think"fake news" make finding facts and trusting them becoming difficult for some
from naomi ledwith to All Panelists:
You need to be a pmo rebel
Yes Isabella, Measure to track impact is so important. How else do you know what difference you
have made?
Agile proejct management needed
Data helps - and put with the patient and or provider stories - brings the data alive to help make
change
data, and statistics, facts, for some people they are very important as they can see change, or the
potential prospect of change, through them, so yes, shouldn't be discounted, but included in a wider
conversation.
from Erin Brown to All Participants:
Hi to my RCT partner Leigh in England from Canada!
I am saying that as head of both pmo and service transformation
How do you get an RCT partner?

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Poor communication causes a lot of resistance.
Follow all the rules but rock the boat to engage
NO data needed.....that's my scientific career over ;-)
People have respect for poor information but good communication
Agree re data, I spoend my life presenting evidence but it doesn't impact in the way I want it to,
stories do better
I have just ordered Prince2 training for my entire management team in order to empower their
abilities to make change using process, not to constrict but to give credibility to their intentions and
actions
from paul bolton to All Participants:
data/facts alone won't change minds - aristotle's three modes of persuasion is all about balance
between ethos/pathos/logic
Karen P - always need data surely??
from Rachel Raw to All Participants:
Simon simeck talks about the limbic brain and the why people do the things they do .really good TED
Talks about
@paulBolton I like that!
ethos,, pathos, logic, very true

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I agree I think data and open forums for discussion are needed. Some people don't work well with
what seems like chaos in the process of debate and sharing points of view. It is a skill to manage
forums so that outcomes and benefits can be identified.
Process doesn't always need to be a dirty word. I think it can bring consistency and measure - but
agree that we need to be agile - and not constrained by it
Thanks Elizabeth...I'll keep working!
Process is a useful tool - but it's only an extension of common sense
thanks Emma, completely agree
PRINCE2 in an agile environment i have found works extremely well..
Lone Wolf - that's me, that is! Embarrassing how apt this description is!
i couldnt agree with this perspective more - i hear this all the time
Love the reference to Aristotle - the philosophical thinking on #S4CA is refreshing and stimulating
so true quote!!!!
Tick box - very apt!
Karen P I find I get great change from using data esp variation in clinical practice

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Change the balance - we should be the token participants
Lone wolfism feeds our egos
Think I am a mobiliser
Sometimes lone wolves become mobilisers as their messaging entrenches
If you have a strong opinion and someone presents you with facts that contradict your opinion, you
will begin to construct an counter argument to defend your belief system - you strengthen the
position you hold.
Agreed! And it keeps you stuck in one place, time for change
provokers and connectors?
Absolutely Elizabeth! We are using data every day to help influence people's behaviour. But also
creatign a good story to relay the evidence by works very well.
being an organiser is not simple or easy. but definitely what lots of people should aspire to!
@cheryl - cognitive dissonance has got a fascinating evidence base on this point
i think im a moblisier too - I just call it being lazy - get a good idea and get people to do all the work!
Dont be a loan wolf - Be Wolfie Smith - "Power to the people"
from Angela Catley to All Participants:

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Think we have some of all of those!
thats where i've been going wrong - too wolfish
And it's very tiring, being a wolf. Seeing that very clearly lately
They may be the least effective kind of change agents, but they are still needed in a system?
How to mobilise the lone wolves?
Its taken me a long time to realise that I needed to move from being a lone wolf - who of course was
right - to being someone who can mobilise and organise and bring others on board
power balance between patient reps and NHSE staff is never equal so can be exhausting - like
pushing boulder up a hill
Like, I can think of a few in my system who we might not necessarily agree with because they ask us
very difficult and challenging questions, but they're essential?
ah but, it is possible to migrate between these types of change agent without noticing it
Zoom out and zoom in to avoid sticking with 'the frame' for change. Eyes and ears to discover
perspectives to build investment now and for the future...
@ julie smith correct
i think there is a time and a place to be all types of change agent. It's just a matter of timing....

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I like the leaders of health and care not being in the trad 'system'
from Masood Darr to All Participants:
Can you explain what a licensed patient is?
from a healthcare prespective this is really interesting to me
from martha murtagh to All Participants:
Sweden are ahead of the game always!
Helen can you reflect about the Occupy movement? Why did it fail?
http://www.holacracy.org/
from ben crane to All Participants:
Should we become better at harnessing lone wolves. We need to bring them in
A licensed patient is one who has becomes skiled in their own health care - most patients i the South
Island of NZ on dialysis do it at home themselves
Rob what made you move from lone wolf to mobiliser?
1 leader makes an easy target for resistance.Multiple leaders gain protection and strength from each
other
thanks @nigel
like the idea of a 'licensed patient'
oh wow, this takes me back to undergrad!

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@nigel - is that common throughout NZ or just in the south island?
wish we could do more of my son's care at home
how does this change model compare to ADKAR?
Models for change are for reference to help us understand what is happening - they are not magic
Airfix kits
takes me back to Katherine Brown's semianr yesterday at CTEHR
Masood - you will need to lead change in your sons (and other peoples )care
true nigel. It's tough but you're right!
also used in drug and alcohol projects - should we think of change resisters as recovering addicts?
Like that Sally
@Sally :)
@masood, you may need to be a lone wolf to start with, until mobilisers show up around you
from Toby Stead to All Participants:
Not sure how this model applies to an organisation rather than an individual

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I like the idea of lone wolves. But, if you put a group of lone wolves together what do you get?
@Toby - it's like sowing the seed....
from Vicki James to All Participants:
pharmacies are great places to go for this support!
from Shawn Volk to All Participants:
@Toby - I think it's more relatable to a collective mindset or organizational values
love the pharmacy plug Vicki
i always fely that model of change misses out a lot.....such as a crisis
Can imagine this in organization...ACR will be at maintenance when budget process matches
strategic plan instead of departmental organization. Does this help?
3
behaviour model makes sense as system change is based on many small individual commitments to
do something differently -- the system level needs to support individuals and team to move along
the model
4 - Action
from Karl Fredrik Westermann to All Participants:
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2/3
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from Jen Quinlan to All Participants:
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2/3
from Adrian Sieff to All Participants:
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from Luke-David Whitmore to All Participants:
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3 preperation
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from Liz Rump to All Participants:
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from Brian Markey to All Participants:
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the biggest challenge for me with this model is trying to get my organisation from precomtemplation
to contemplation
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from Jocelyn Bennett to All Participants:
3-4
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from Lucy Butler to All Participants:
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from Beccy Macnamara to All Participants:
3&4

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@Toby. Does it indicate that someone needs to recognise need for change and become the change
agent who uses narrative and distributed leadership development to go forward
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from Katie Fielding to All Participants:

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from anne brittain to All Participants:
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2
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1 - focus on why
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3 preparation
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from Kate Silvester to All Participants:
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from Mubashir Arain to All Participants:
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from eileen sharp to All Participants:

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2
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skip right to 4
3
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3-4
4, with some 3
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from Philippa Casares to All Participants:
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from Patricia Burns to All Participants:

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2
4 should be earlier?
from Vicki Nash to All Participants:
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from Alan Gately to All Participants:
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from Christine Clarke to All Participants:
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4
almost never 1 precontemplation
from Hazel Runyararo Murwisi to All Participants:
1
from point of view of carer - 2
from Maureen Raine to All Participants:
3-4
from Cathy Caple to All Participants:
2-3
4 - purely reactive
4
2
4
from Steven Amrhein to All Participants:
2

39
should be 1 but is 4
from Susan Yungblut to All Participants:
3
1
from naomi ledwith to All Participants:
1
most people are at 1 ?
from martin hurst to All Participants:
4
from Sajjad Mushtaq to All Participants:
4
from Monisha Gokhale to All Participants:
3
from Louise Utteridge to All Participants:
2
from jacqueline vernooij to All Participants:
4
from Lisa Saminaden to All Participants:
2
from Margaux Brown to All Participants:
2
from Joanne Reay to All Participants:
4
from Michelle Lewis to All Participants:

40
4
from Milne Weir to All Participants:
4 action
from Lisa Stewart to All Participants:
4
from siobhan bonham to All Participants:
3
from Melissa Sullivan to All Participants:
3
from sue hogg to All Participants:
4
4
feels like 3 sometimes
1
1
1
from Liz Oddy to All Participants:
2
1

41
1
2
1
1
pre-1
1
2
1-2
1
from Meredith Waters to All Participants:
4
1
2
1

42
1
1
0
1
1
1
1-2
1
from John Wallace to All Participants:
2
2
1
1
1 is where people are at

43
1-2
1 or 2
3
1
2
1
1-2
-1!
1
1
2
2
1
from Fiona Mac to All Participants:

44
1
1 or 2 reality
from Tom O'Sullivan to All Participants:
3
1-2
2
1
2
2
1
2
1 o 2
1-2
1
from Clare Ibbeson to All Participants:

45
1
1 or 2
1
1 or 2
from Dawn Plimmer to All Participants:
1
2
1-2
1 or 2
3
3
1
1
option 2

46
1 or 2
2
1
2
2
1
2
2
1-2
1
from Vicki Nash to All Participants:
2
1
1 or 2

47
1
1-2
1
from Jane Wilson to All Participants:
2
2
2
2
1-2
1
3
from Tom O'Sullivan to All Participants:
3
3
4

48
2
1
2
from Alan Gately to All Participants:
1
2
1-2
2
1-2
1
3 to 5
2
from Katie Fielding to All Participants:
1
1 or 2
from Jennifer Pollock to All Participants:

49
1-2
from Sarah Lesperance to All Participants:
2
1
1
1-2
2-3
2
2
This is so important - we work in such a complex environment in the NHS where half of the time we
aren't all on the same page (as organisations e.g. CCGs, NHS England, Providers)! It can take a long
time to get to number 4 - action
from Chris Butler to All Participants:
2-3
You should set up a poll for this activity
Good point Helen
hello to fellow pharmacy friends

50
ITs because in healthcare we have a reactive culture where we are primed to act, rather than think
spot on Muhammad
I'm a pharmacy friend
where i work we are constantly already on the back foot
the problem is that people like the "doing" part -stage 4
Dont just do something, sit there!
some people in health services are at -1 = change fatigue!
reactive absolutely in Canada too
exactly Muhammad and we're incented to get them to check a box taht they've made change
this model makse so much sense!
5
5
from Beccy Macnamara to All Participants:
5

51
5
5
5
5
5
5
5
5
5
from Brian Markey to All Participants:
5
5
3
3

52
5
5
5
5
2/5
from Fiona Mac to All Participants:
5
5
from Jennifer Pollock to All Participants:
5
5
2
4
5
5

53
5
5?
5
2
5
5
from Dawn Plimmer to All Participants:
5
3/4
5
5
5
5
5

54
5
5
5
5
2
3
5
5
5
5
3
3
2

55
5
5
1
5
from John Wallace to All Participants:
5
5
3
5
from Sajjad Mushtaq to All Participants:
5
2-5
5
3 or 5
5

56
2
from siobhan bonham to All Participants:
5
5
5
4/5
5
4
2
5
5
5
5
5

57
5
5
4 5
5
5
4
5
2
4
5
4
4
from Jane Wilson to All Participants:
5

58
5
5
5
5
5
5
3
from Victoria Hill to All Participants:
5
5
5
4
1
3-4

59
from Sau Fun Wong to All Participants:
5
4-5
5
3 5
1 an 5
3
BUT we are all differnet
but as a carer I don't see any change
Exactly the same in social care.
how many initiatives fail after starting so well
We are always fighting fires and not planning the prevention
i still thnk that crisis is an important trigger for change
isn't 1 and 2 the 'intent' discussed earlier and 4/5 the impact we dont always consider?

60
We need to think about each individual person
It's because this type of work is a short term project - not par of the bigger picture...
Atul Gwande is my hero!
I'm reading checklist manifesto right now :)
so does data help with getting beyond stage 1 or not?
The cathederal is the Health and care system and change agents are small bizzar stalls within the
cathedral
Everyone in the NHS shoul dbe given his book list at their oreintation day
yes people do the taks and miss the point - love it
Nardia - for some it might but for most I guess it is about heart and minds
Think a lot of tools fail at the missing the point
It's like our STP / Gigital Roadmap - best kept secrets, and wonder why they are not taking off!
tick boxes again....

61
@chris - so very right
Don Berwick - Escape Fire is well worth a read/view
I find organisations and clinicians are very bad at sustaining change through on goping committment
and this is what I am changing in the organisations I work with
escape fire?
and you get a better "chekclist" or process if developed at stage 1 or 2 with the people who are
going to take action - vs silo people with data who can "fix it"
prochaska's 5 stages - it's a great new take on stakeholder management. how to enrouge movement
from one stage to another. interesting.
The key finding from teh check list introduction was that surgical teams started talking to each
other! Amazing!!
unintended consequeces a real problem in healthcare
Introducing the safe surg checklist needs cultural change first
found this with Falls algorythm
intent and impact again!
worked with a fab assistant pyschologist who managed to get a hugely reluctant team from stage
1to stage 5 - a future great leader

62
In all our electronic devices resistors are essential components
i really like this model - it is really resonating with me
Love that!
Atul Gawande - Being Mortal - also worth a read! a surgeon talking about change to improve care at
the end of life.also talks about the surgical checklist.
Stages of change applied to unemployed persons with MDD seeking employment - see Hergenrather
K, Rhodes S, Haase E. Consumers with Major Depressive Disorder and Employment Outcomes:
Application of the Theory of Planned Behavior. Journal Of Rehabilitation. January 2013;79(1):19-29
aligning core beliefs....
totally agree about being mortal fabulous book
ENjoy the conversation - enjoy the disagreements - jsut make sure they are respectful - listen first,
send and third
model is very helpful, and works for the pulic health brief interventions
need to be realistic about how long it takes to make change -- investment in time up front in
listening and understanding will give better long term and sustainable results
Productive conflict and discourse = progress

63
Using facts/data on their own doesn't work but they can be used as part of helping shape
meaning/stories for people to understand
People who resist are not wrong - they jsut see things form a different place
I'm loving some of the suggested reading in these chats - thank you!
@wendy me too!
there is a need to check that what we have heard and our interpetation is correct - it's not just
listening!
love this "model" - move from stage to stage
too often we want to jump to action
Listen and hear and respond
Slight risk we could be waiting around for everyone to be at the action stage! I think sometimes you
have to get going even if not all are on board
@Shelley Huffman - very good point
agreed
Changing your behaviours is essential - behaviour is the only tool of the effective leader

64
Thanks Helen - that feels so true.
sometimes those people are on the top and its a tough journey
@Nigel - agreed
80:20 rule - don't put all your effort into the 20% of cynics. Galvanise the 80%
lol!
we're all in it together
Yes!
Some people need to see the fruits of others labour before trying it themselves
true wendy
hahahahahahhahahhahaha....fw of those horses :)))
What if the horse happens to be your boss?
If your horse dies - thats so hard when yopu keep trying to resuss it
Adrian - lol!

65
Get a donkey! lol
I think being a role model really helps people to invest in change
very helpful module!
Horse DNACPR needed
lol
only if the horse agrees..
Thank you, best session yet.
@Matilda HAHA
poor horse
sometimes hard to know when the "horse is dead" -
from Charlotte Smith to All Participants:
@Matilda:D
from Angela Catley to All Participants:
I have really enjoyed this session but found it much more health (service) focussed than previous
ones - could benefit from a a few care/wellbeing examples. Not a critism though - all transferrable :)
Best session yet

66
great session thank you
excellent session!
Again invaluable information. Thanks Helen :)
thanks Helen
loved today even more than last week - thanks everyone for your engagement, openness, and
passion for change
Really enjoyed this - extremely useful - and great to know that others are in the same place!
thank you - very valuable
I'm afraid I cannot stay for the breakout sessions. A thought provoking session, that has got me
thiniking at a much deeper level about my actions. Thanks Helen
very relatable session -- and reinforces the need to just keep going and really try to build "investors"
and "leaders"
Where do we go to keep in touch??
from Luis Maldonado to All Participants:
Very good session. pick up some tips.
Lots to reflect on, tghanks for a great session

67
Loved that slide . Difficult sometimes to look through others lens
Thanks so much! Always a pleasure to learn/collaborate!
Thank you
Excellent session thank you
Always a pleasure to listen in. Gives a boost to being a change agent.
Please collect the horse comments
Great session. Thanks Helen!
excellent - thank you
the challenges we have offered and shared today have been v constructive
thank you - great session!
Great session. Thanks.
I'm afraid I need to miss the break out sexxions. Great session though and I enjoyed the chat.
Thank you

68
Thanks very much! This a great programme and really inspiring. I can't stay for the breakout
unfortunately. Thanks all!
Great sesh - thanks
Great challenging session :-) thanks!!
thanks Helen, lots of food for thought
Thanks so much!
Thanks folks
Thank you, very thought-provoking this week
brilliant - thanks all but must dash; changes needed!
excellent session thank you
from Chris Butler to All Participants:
thank you
sorry - have to leave now - thanks for this session
excellent session , thank you.

69
great stuff. wish i had time to join a breakout but gotta go.
Thankyou for a great session
I pre-registered but dont know me room number?
Great session - many thanks
just give me a min and I will be there
Thank you for a great session
anyone joining the phone chat?
i cannot attend the breakout session. dispensary calls sorry
I am away from the office this week so I had to "borrow" an office to lead the session. It has standing
up desks so i stood up for the whole lecture. Actually, it has been great. So that is new learning for
me
thanks from the netherlands, really enjoyed the session
Thanks Helen, have you thought of storifying the tweets from each session? (storify.com)
END OF CHAT BOX

Module 3 chat box contents - School for Change Agents

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