10 years an NHS change agent: Learning #1 – Success is possible

Ian Railton

Ian Railton

Ian Railton is leaving the NHS after 10 years as a change agent. In his eight-part blog series, Ian gives an overview of his key learning during this time. This second installment focuses on the inevitability of success and improving capability.

  • It’s not whether it’s possible, it’s whether we’re capable
  • Most change efforts fail yet people keep doing the same thing
  • Do something different
  • Learn and apply: Kotter, Large Scale Change, social movement, lean
  • Make this the ‘way you think’ – the ‘way you do’
  • Let go, be passionate, put away self-doubt

I lie awake for two hours most nights. It can be frustrating, but often it’s a time when my mind brims with ideas of how to solve problems. It might be the design of a workshop, a persuasive argument, a mathematical calculation or a handy gadget. The trouble is, even my most original and exciting ideas have had a common flaw – they have not actually been original! For all my inventiveness, someone else has always had the idea before me.

And so it is with our NHS. For all the problems that people and organisations face in advancing quality with diminishing resource, the solutions to those problems almost certainly already exist. For the most part they are glaringly obvious – just listen to patients, carers, families, front line staff – they know it inside out.

And I suggest even our most complicated and complex problems, those super-wicked problems we all struggle with, well they too are not really that insurmountable. They can’t be, because we can all lie awake at night and imagine a health and social care system that works the way it needs to work and costs what is affordable.

So, perhaps we should dispel any lingering thoughts that this can’t be done, because it can and will be done, it’s inevitable. It is simply our collective capability that will ultimately determine how long it is going to take, how easy it will prove to be, and what damage we will cause along the way.

Maybe if we view our capability as the thing we need to improve, and address this with gusto, perhaps the transformation of health and social care will become more tangible and less difficult than it appears currently. So, how could we become more capable? Well, as always, the solutions are already out there – here’s two of many:

  1. Firstly, we ‘know’ from Einstein that doing the same thing over and over will get the same result, so if we want to change the result we must do something different.
  1. Secondly, despite most change programmes failing, successful change happens all over the world, all of the time. What makes it successful has already been neatly captured in knowledge we have at our fingertips: Kotter; social movement; lean thinking. Apply it.

So, that’s straightforward then. We accept that everything becomes achievable if we are more capable, and we do something different in properly applying all of this great knowledge we have at our disposal. Sorted!

I am reminded of Paul Plsek’s words – “People don’t have a USB port in their head where you download new thinking and in the morning they’re transformed.”

Well, maybe the head-mounted USB port is some way off full production, but the concept of the download sounds right. We have to re-programme mindsets; people need to see that they have to change for everything else to change, that they have to think and act differently to achieve future success.

And as change agents it follows that we too must recognise we have to change, that we have to become more capable. If people are struggling to see and do things differently, then perhaps we need to help and support them differently. If we get to the point of ‘they just don’t get it’, words I admit to using far too often in the past, there must be something we are not getting.

So, break free of those shackles, put away self-doubt and do something wonderfully different.

Can we become more capable?  Sure we can!

Is it possible?  Without doubt!

Next time:  Purpose, and the importance of Why?

Related posts:

Subscribe to NHS Improving Quality’s blog to get the remaining posts in Ian’s series direct to your inbox. You can also connect to Ian on LinkedIn or on Twitter @verandernltd.


2 thoughts on “10 years an NHS change agent: Learning #1 – Success is possible

  1. Pingback: 10 years an NHS change agent: what I have learned | NHS Improving Quality

  2. Pingback: 10 years an NHS change agent: Learning #2 – Purpose and the importance of Why? | NHS Improving Quality

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