10 years an NHS change agent: Learning #2 – Purpose and the importance of Why?

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 installment focuses on purpose and the importance of ‘Why’.

Ours not to reason why, Ours but to do and die.  Tennyson’s tweaked quote from The Charge of the Light Brigade sets out the perceived duty of soldiers in the 19th Century; to follow orders, even if that results in their death. However, in my near 20 years in the Army I never once met a soldier for whom the why was not critically important, especially if the lives of themselves or others was at risk. I cannot imagine it was ever any different, in any walk of life.

I’ve been told “Ours not to reason why” a couple of times in the NHS. I think it is code for “we both know this doesn’t make sense, but I’ll do it, just for you”.  It seems despite my best act, it’s all too easy to spot my true feelings when I don’t personally buy into something. People don’t buy from people they don’t trust, so before you try to sell a cause, be sure it’s a cause you truly believe in – if not, you’ll quickly be found out. It’s also worth reiterating that I’ve only been told this a couple of times – people will only give you the benefit of the doubt once or twice. If you are to remain credible, you simply cannot keep sending a message that ‘Y’ is what is really important, if you continue to ask people to do ‘X’.

I find it really exciting to have a cause I truly believe in and my natural tendency is to want to share that with others and find like-minded people. I guess it must be everyone’s natural tendency – you can see it play out in the local on a Friday night, on social media, in conversations at the bus stop. People just want to talk about it and the more nods they get, the more enthused they become. So what happens when we get to work? Is the raw emotion, passion, honesty and animation suddenly switched off as we light up our PCs, fire emails and nurture sterile plans, papers and reports?

If we want to find people that share the cause, we need to strip it right back to basics – tell our heartfelt story of why this is important and what the future looks like through our eyes. I am sure people can be taught how to do this, but my own belief is that if you truly believe in what you are doing then it will come naturally. How amazing and inspiring are people when they just take to the stage and tell their personal story? They always outperform the stage-managed manikin.

Once I’ve found people that connect with the cause, it only matters that together we want to achieve something – it has to be our cause, not my cause. It’s hard for us control-freaks, but as more and more people join the movement, they need space to tell their own stories, to influence others and shape our shared future together – everyone has to have their fingerprints on it.

You know, looking back this is exactly how it was when Dr Vivien Twaddle and I first ‘connected’. It felt special, it felt right and a year or two later there was a whole new vision for services that service users and carers, clinicians, partners and staff all saw as their own. It was so energising and so purposeful, but it was not without its difficult moments.

So what happens when others are less inclined to sign up for the cause? Well, the first thing is to recognise that not everyone thinks like you do – crazy I know, but really, they don’t. This does not make them monsters, ignorant, cynical or bad people. In fact what they are more than anything is people able to offer you great insight into the possible fallibilities of your desired future. So, embrace and listen and maybe one day you will come together.

That said, there always comes a time when others may try and distract or weaken the momentum we are working so hard to build. We must act to defend it, and whilst accepting how passionate the cause is to us personally, there are many strategies available to us before we need to adopt a war-footing. If you have not read the Art of War by Sun Tsu then you should give it a go.

I’m feeling really energised now, we have all these like-minded people together, all pursuing the same goal and we are growing in number every day. Only now should we start thinking about what and how.

Next time:  Urgency and pace

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 #2 – Purpose and the importance of Why?

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

  2. Pingback: 10 years an NHS change agent: Learning #1 – Success is possible | NHS Improving Quality

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