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Leading for spread, adoption and large scale change

Source of image: @voinonen

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The greatestdanger today is NOT

micro-managing: it is MACRO-LEADING

Henry Mintzberg

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Beware the chasm!

Source of image: @voinonen

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Beware the chasm!

Source of image: @voinonen

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Over the past 20 years there have been more than 100 NHS-wide pioneer/pathfinder/pilot/demonstration sites

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It’s an issue of power

Power is one’s ability to achieve goals

Bertrand Russell

6

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Jeremy Heimens, Henry TimmsThis is New Power

old power new power

Currency

Held by a few

Pushed down

Commanded

Closed

Transaction

Current

Made by many

Pulled in

Shared

Open

Relationship

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Connect with the 3%

Just 3% of people in the organisation or system influence 85% of the other people

Source: research by

Innovisor

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The 3% rule also appears true for social media

Source: research by Graham MacKenzie using NodeXL

In health and healthcare globally, tweets by 3.3% of

tweeters accounted for 85% of retweets

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WHO will make the change happen?List A

• The Delivery Board

• The programme sponsors

• The Programme Management Office

• The Delivery Board work streams

• The Clinical Leads

• The Directors of participating organisations

• The Change Facilitators

Source: adapted by Helen Bevan from Leandro Herrera

@helenbevan

WHO will make the change happen?List A

• The Delivery Board

• The programme sponsors

• The Programme Management Office

• The Delivery Board work streams

• The Clinical Leads

• The Directors of participating organisations

• The Change Facilitators

List B• The mavericks and rebels

• The deviants (positive). Who do things differently and succeed

• The nonconformists who see things through glasses no one else has

• The hyper-connected who spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on

• The hyper-trusted. Multiple reasons, doesn’t matter which onesSource: adapted by Helen Bevan

from Leandro Herrera

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WHO will make the change happen?List A

• The Delivery Board

• The programme sponsors

• The Programme Management Office

• The Delivery Board work streams

• The Clinical Leads

• The Directors of participating organisations

• The Change Facilitators

List B• The mavericks and rebels

• The deviants (positive). Who do things differently and succeed

• The nonconformists who see things through glasses no one else has

• The hyper-connected who spread behaviours, role model at a scale, set mountains on fire and multiply anything they get their hands on

• The hyper-trusted. Multiple reasons, doesn’t matter which ones

Source: adapted by Helen Bevan from Leandro Herrera

@helenbevan

Do you remember that 3% of people in an organisation influence 85% of other people?

Most of them are NOT people on list A

Formal leaders typically make up 12% of an organisation and drive conversations with

55% of other people

Source: Innovisor

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Mark Jaben on the science behind resistance

What NOT to do

But what we do do

Engage people here

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Mark Jaben on the science behind resistance to change

What NOT to do (but what we usually do)

We don’t need buyers (who “buy-in” to change)We need investors

What TO do

Engage people here

Engage people here

@helenbevan

Emerging themes in spread

• Increasing attention to the demand side, to better understand the adopter’s point of view

• Coalition building (social movements and social media)

• Increasing attention to system conditions

• Acknowledgement of context sensitivity

• The importance of co-design for subsequent scaling (investors not buyers)

Source: David Albury