Module 2 of the School for Health and Care Radicals ran on Thursday 11th February from 14:30-16:00 GMT and was led by Helen Bevan, Chief Transformation Officer, Horizons Group, NHS England. A recording of this module can be found at: http://theedge.nhsiq.nhs.uk/school/module-2/#resources The golden rule for change activists is: ‘You can’t be a radical on your own’. This module gives us an understanding of the power of working together by exploring communities of practice and social movements. We identify techniques for connecting with our own and others’ values and emotions to create a call for action. To find out more about the School for Health and Care Radicals, click and paste this link into your address bar: http://theedge.nhsiq.nhs.uk/school

1. #SHCR @School4Radicals
Module 2
From me to we: Creating connections
and building communities
Supported by:
theedge.nhsiq.nhs.uk/school
Module

2. #SHCR @School4Radicals
• Please use the chat box to contribute continuously during the
web seminar
• Please tweet using hashtag #SHCR and the handle
@School4Radicals
• Request to join our Facebook group School for Health and
Care Radicals
• We will produce summaries of each module discussion using
Steller and put it on the website
• Join in the #SHCR Tweetchat each Tuesday at 1900 (GMT)
Joining in today…and beyond

3. #SHCR @School4Radicals
Get certificated!
• Complete a change
• Reflect on it
• Complete the change agent application form
and submit
School for Health and Radical Change
Agents

4. #SHCR @School4Radicals
The first 30 day change challenge guide
This is our first 30 Day Change
Challenge we would like you to:-
• form a team
• agree a change to undertake as
a team
• complete the change
• review and learn
• and celebrate.

5. #SHCR @School4Radicals
What is your attitude to the change that
you are currently involved in?
Bring it on.
It makes me
nervous.
It’s my job!

6. #SHCR @School4Radicals
#My3Words reflections from last week

7. #SHCR @School4Radicals
Programme Study Guide:
www.slideshare.net/TheEdgeNHS/school-
for-health-and-care-radicals-iii-study-
guide-2016?related=2
Module 2 Study Guide:
www.slideshare.net/secret/2xYuwk
e1PQaPpn
Study guides

8. #SHCR @School4Radicals
Session lead:
Helen Bevan
@HelenBevan
Learning lead:
Pip Hardy
@PilgrimPip
Session chair:
Kate Pound
@kateslater2
Twitter monitor:
Zoe Lord
@zoelord1
Chat monitor:
Dominic Cushnan
@domcushnan
Storyteller:
Mark Davis
@markdavis275
Storyteller:
Graham Mackenzie
@gmacscotland
The team today

9. #SHCR @School4Radicals
11th February: From me to we: Creating
connections and
building communities
18th February: Rolling with resistance
25th February: Making change happen
3rd March: Moving beyond the edge
Modules

10. #SHCR @School4Radicals
• Connecting back to Module 1
• 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
• How we build a sense of “us and us”
• Questions and call to action
Sourceofimage:www.freshnessmag.com
Today

11. #SHCR @School4Radicals
YOU can make a difference
AND
You can’t do it ALONE
Source: 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
Learning from module 1

12. #SHCR @School4Radicals
Jeremy Heimens TED talk “What new power looks like”
https://www.youtube.com/watch?v=j-S03JfgHEA
old power new power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction
Current
Made by many
Pulled in
Shared
Open
Relationship
From

13. #SHCR @School4Radicals
Source : Lois Kelly www.rebelsatwork.com
Rebel
From
There’s a big difference between
a rebel and a troublemaker

14. #SHCR @School4RadicalsSource: Lois Kelly http://www.slideshare.net/Foghound/rocking-the-boat-without-falling-out
Often as radicals, we feel different to other
people
From

15. #SHCR @School4Radicals
Often as radicals, we feel different to other people

16. #SHCR @School4Radicals
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

17. #SHCR @School4Radicals
"Communities are characterized by three things: common
interests, frequent interaction, and identification.“
Wally Block
“There is no power for change greater than a
community discovering what it cares about.”
Margaret Wheatley
Source of image:
rootedincommunity.org
What is community?

18. #SHCR @School4Radicals
“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
Power in community

19. #SHCR @School4Radicals

20. #SHCR @School4Radicals
Example school communities since
module 1
• Mental Health Group
#SHCRmh
• Person Centred Care
#SHCRPCC
• 6Cs #SHCR6Cs
• Value Makers
• Nottingham University and
Hospitals
• Adam Mileusnic
@Chasquicomms
(comms group)
• North West
• Papworth, Cambridge
• USA – Jim Rawson
• Western Australia
• Melbourne, Caulfield team
• Police group
• @BCPFT
• NHS England
Have we missed you off? Tell
us in the chat box or on #SHCR

21. #SHCR @School4Radicals
@CCNetworkCom
@CaremakersUK
@TheEdgeNHS
@WeNurses
(& all WeCommunities)
@FabNHSStuff
#MatExp
@HSCVoices @NHSChangeDay
#FOAMed
Free Open Access
Meducation
Expanding our communities

22. #SHCR @School4Radicals
“When we talk of social change, we talk of
movements, a word that suggest vast
groups of people walking together, leaving
behind one way and travelling towards
another”
Rebecca Solnit

23. #SHCR @School4Radicals
Source: Hahrie Han (2014) How organisations develop activists
Lone wolves
Mobilisers
Organisers
What’s different about activist organisations/
communities with high participation rates?

24. #SHCR @School4Radicals
“Great social movements get their
energy by growing a distributed
leadership”
Joe Simpson
Focus on the “We”

25. #SHCR @School4Radicals

26. #SHCR @School4Radicals
http://www.slideshare.net/NHSIQ/the-power-of-one-the-power-of-
many?qid=97bb3464-07c2-4883-9531-c3d436a66aa1&v=qf1&b=&from_search=2
Learning from social movement leaders

27. #SHCR @School4Radicals
Calls to Action

28. #SHCR @School4Radicals
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)

29. #SHCR @School4Radicals
What’s the
financial incentive?
Who is
performance
managing?
What’s the
project plan?
Source: @RobertVarnam

30. #SHCR @School4Radicals
“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
The reality

31. #SHCR @School4Radicals
1. People speak intellectually but engage
emotionally
2. Facts are hard to remember and easy to
challenge
3. If we only talk about our success people won’t
believe us
4. People don’t want more communication; they
want meaningful communication
http://www.peterfuda.com/2014/10/30/traditional-comms-fail-engage/
Four gaps between
how we
communicate
change
how people
engage with that
communication

32. #SHCR @School4Radicals
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

33. #SHCR @School4Radicals
“I have some Key
Performance
Indicators
for you”
or
“I have a
dream”
Source: @RobertVarnam

34. #SHCR @School4Radicals
If we want people to take action, we have to
connect with their emotions through values
action
values
emotion
Source: Marshall Ganz

35. #SHCR @School4Radicals

36. #SHCR @School4Radicals

37. #SHCR @School4Radicals
But not all emotions are equal.........
inertiaurgency
anger apathy
solidarity isolation
you can make a
difference
Self-doubt
hope fear
Overcomes
Action motivators Action inhibitors
Source: Marshall Ganz

38. #SHCR @School4Radicals
Posts on social media with a higher emotional
content get more shares
Source: Advanced marketing Institute: http://coschedule.com/blog/emotional-headlines/

39. #SHCR @School4Radicals
‘‘Leaders must wake people out of inertia.
They must get people excited about
something they’ve never seen before,
something that does not yet exist”
Rosa Beth Moss Kanter
Source of image: www.linkedin.com/company/activate-brand-agency

40. #SHCR @School4Radicals
1. Tell a story
Source of image: woccdoc.org
Effective framing:
what do we need to do?

41. #SHCR @School4Radicals
http://www.slideshare.net/amitkaps/fifth-elephant-2014-talk-
crafting-visual-stories-with-data?sf3881865=1

42. #SHCR @School4Radicals
1. Tell a story
2. Make it personal
Source of image: woccdoc.org
Effective framing:
what do we need to do?

43. #SHCR @School4Radicals
1. Tell a story
2. Make it personal
3. Be authentic
Source of image: woccdoc.org
Effective framing:
what do we need to do?

44. #SHCR @School4Radicals
1. Tell a story
2. Make it personal
3. Be authentic
4. Create a sense of “us” (and be clear who the “us”
is)
Source of image: woccdoc.org
Effective framing:
what do we need to do?

45. #SHCR @School4Radicals
Effective framing:
what do we need to do?
1. Tell a story
2. Make it personal
3. Be authentic
4. Create a sense of “us” (and be clear who the “us”
is)
5. Build in a call for urgent action
Source of image: woccdoc.org

46. #SHCR @School4Radicals
How do we create a sense of
“us” to build momentum for
change?
Source of image: www.tannerfriedman.com

47. #SHCR @School4Radicals
Mark Davis
@markdavis275
Telling his story

48. #SHCR @School4Radicals
strong ties vs. weak ties
Source of image: http://www.forbes.com/fdc/welcome_mjx.shtml

49. #SHCR @School4Radicals
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,
social worker to social worker, nurse to
nurse, community leader to
community leader
• Influence is spread through people
who are strongly connected to each
other, like and trust each other

50. #SHCR @School4Radicals
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,
social worker to social worker, nurse to
nurse, community leader to
community leader
• 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

51. #SHCR @School4Radicals
The pros and cons of strong ties
Pros Cons

52. #SHCR @School4Radicals
• 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
• We can mobilise all the assets in our
organisation, system or community to help
achieve our goals
When we seek to spread change through weak
ties

53. #SHCR @School4Radicals
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
More on weak ties: https://www.youtube.com/watch?v=w7AzRVxhEXA#t=45

54. #SHCR @School4Radicals
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

55. #SHCR @School4Radicals
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 and most radical
change will come when we tap into our weak ties

56. #SHCR @School4Radicals
Sources of weak ties

57. #SHCR @School4Radicals
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 our audience?
Source: Benford and Snow
Source of image: www.ecommercedefense.com

58. #SHCR @School4Radicals
Four keys to collaboration
• Lean into your discomfort
• Listen as an ally
• State your intent
• Share your “street corner”
Source: Judith Katz and Fred Miller

59. #SHCR @School4Radicals

60. #SHCR @School4Radicals
60
http://weneeds
ocial.com/blog/
2013/8/25/disr
upted-
disruptors-unite

61. #SHCR @School4Radicals
…the art of mobilising others
to want to struggle for shared
aspirations
Jim Kouzes
Source of image: environmentvictoria.org.au
Leadership is….

62. #SHCR @School4Radicals
“You don’t need an engine when you have
wind in your sails”
Source of image: emmyck.wordpress.com

63. #SHCR @School4Radicals
Graham Mackenzie
@gmacscotland
Telling his story

64. Healthy Start & welfare rights advice
Leith Early Years Collaborative
Pioneer site
Graham Mackenzie
Consultant in Public Health
0131 465 5438
Twitter: @gmacscotland
graham.mackenzie@nhslothian.scot.nhs.uk
Today’s materials at
www.scotpublichealth.com/healthystart
Also see www.Facebook.com/gethealthystart

65. Healthy Start
• Food and vitamin vouchers
• Low income families
• Pregnant women (from 10 weeks
gestation) and children under 4
• £3.10 per week food vouchers
Twitter: @gmacscotland

66. Overview of our work
1) We worked with one midwife to
understand the process of signing a
woman up for Healthy Start by week
10 of pregnancy (Mar 2014)
2) Once we had identified a simpler
and faster process to sign up we
surveyed other midwives in the same
team, neighbouring team then the
whole of Lothian (Apr – May 2014)
4) We shared the recommendations and data with team
leads, for cascade, and started visiting the other teams (May
to Nov 2014).
3) We put the lessons into a simple recommendation sheet
and flow chart for pregnant women and their midwife (May
2014).
5) We kept testing – e.g. reaching new populations, support
for women to complete the form, other services and beyond
pregnancy…. work that continues…
Twitter: @gmacscotland

67. Voucher receipt by women
Full paper shows data at team level too
Source: Department of Health Jan 14 – Dec 15
PLEASE DO
NOT TWEET/
SHARE THIS –
WAIT FOR BMJ
QIR PAPER

68. Voucher receipt by women
Full paper shows data at team level too
Source: Department of Health Jan 14 – Dec 15
PLEASE DO
NOT TWEET/
SHARE THIS –
WAIT FOR BMJ
QIR PAPER

69. Staff and service
factors (e.g.
midwives and
welfare rights
adviser (WRA)). Do
students know about
Healthy Start and
welfare rights? Is
WRA accessible?
Family factors (e.g. language,
beliefs around claiming benefits,
literacy)
Community factors (e.g. does
local shop accept Healthy Start,
local transport links)
DWP/ HMRC (e.g. if no
response 3 weeks after
Healthy Start
application, reapply).
Keep rejection letters to
discuss with WRA.
Points to consider when discussing results with team
Starting point: e.g. a
team with a higher
baseline figure may not
expect much of an
increase.
Twitter: @gmacscotland

70. Referrers Welfare rights advice Families
Granton
Information
Centre
89 clients attended
appointment at Granton
Information Centre Mar –
Sep 2015
£404k financial gain
projected for these families
during 2015/16
Average £4,500/ family
Scottish Legal Aid Board
funding until Oct 2016Twitter: @gmacscotland

71. #SHCR @School4Radicals
To conclude
• Institute for Healthcare Improvement "high
impact" leadership behaviours
• Person-centredness (1:1)
• Front Line Engagement (with teams)
• Relentless Focus (keep testing)
• Transparency (share data)
• Boundarilessness (all partners)
Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact
Leadership: Improve Care, Improve the Health of
Populations, and Reduce Costs. IHI White Paper. Cambridge,
Massachusetts: Institute for Healthcare Improvement; 2013.
(Available at ihi.org)

72. #SHCR @School4Radicals
• Next Tuesday, 16th February
1900-2000 GMT: Tweet chat #SHCR
(Basic tips on how to join in a tweetchat)
• Next Thursday 18th February
1430-1600 GMT - Module 3:
Rolling with resistance
• Catch up on all sessions via the SHCR website
http://theedge.nhsiq.nhs.uk/school/resources/
Next opportunities for learning

73. #SHCR @School4Radicals
This week’s #SHCR twitter chat
‘can’t be a rebel alone’

74. #SHCR @School4Radicals
Questions for reflection
• What learning and inspiration can I take from
social movement leaders to help me in my
role as an agent of change?
• How can I connect with new individuals and
groups to achieve my goal/s for change?
• How can I promote co-production in my
communities?
Questions for reflection

75. #SHCR @School4Radicals
Questions for reflection
• Let others know what’s happening in my own
change community
• Identify opportunities for co-production
• Create my own story/narrative to win other
people to my cause
Call to action

76. #SHCR @School4Radicals
Goodbye and good luck!
‘Coming together
is a beginning.
Keeping together
is progress.
Working together
is success.’
Henry Ford
Goodbye and good luck!
Source of image:
http://switchandshift.com/transactional-or-
transformational-which-leadership-style-is-best