'All of my good ideas are battles'

Imagine going to work on a Monday as ‘Chief Transformation Officer’ for NHS England. Yikes. Dr Helen Bevan OBE doesn’t seem too fazed: ‘All of my good ideas are battles, and new truths begin as heresies’ she said (quoting Adam Katz and Thomas Huxley respectively).

As part of ‘Horizons’, a small group of people within NHS England who support large scale change, Bevan said she would rather be in this country using the health system than anywhere else in the world. The team are moving towards five big things, ‘which we see everywhere’.

Firstly, change is becoming larger scale, more disruptive. IBM told her ‘we rarely see two, three or four-year change projects any more. Now it’s 30-60-90 day change cycles.’ Pilot projects are being replaced by rapid tests and prototypes. There’s no point designing for a world that might be unrecognisable by the time you’re ready to serve it.

Bevan pointed to ‘acceleration of connectedness’, a radical shift in the communication paradigm from top down. Relatedly, hierarchical power is diminishing. Hierarchies are designed for divisions not connectedness; they are slow and risk averse.

The ‘maker movement’ is growing: a renaissance around craft, DIY, and patients as experts and collaborators. Bevan highlighted ‘Maker days’ in Hammersmith and Fulham to address childhood obesity, and the Nightscout Project where diabetic patients, frustrated with the pace of change and availability of solutions, made their own glucose monitors.

Finally, Bevan suggested that ‘change is moving to the edge’. Research and Development takes place ‘with one foot in the organisation, one foot outside’. She cited Ayelet Baron, saying that diversity leads to more disruptive thinking, faster change and better outcomes. ‘New power’ is made by many, pulled in, shared, and open. People can gain more power and control in their own lives through avenues such as Massive Online Open Disease Oriented Communities (there are around 60,000 online for diabetes alone).

Bevan exhorted the audience to make more use of social resources for change – they grow with use rather than diminish. ‘Move to change platforms rather than change programmes. Create the conditions for change and then get out of the way.’ She described the ‘Change Challenge’ – a project with the Health Service Journal and Nursing Times to ‘tap the collective brilliance of the NHS’. 14,000 contributions identified 10 barriers to change. A key one in this context: front line staff can feel overloaded with strategies! Bevan concluded that we should learn from this and similar research such as Google’s Aristotle project: that the key to high performing teams that deliver change is ‘psychological safety’ in the team. 

- More coverage from the Society's Annual Conference will appear here in the coming weeks, and in the July print edition.