Recently, I've been spending an increasing amount of time working with people actively engaged in seeking to create change: from NHS management trainees trying to use their newly learnt service improvement skills, through clinical leadership fellows striving to make the projects they have begun a reality, to clinical and non-clinical leaders across NHS Midlands and East looking at system-wide change as part of the Change Leaders programme.
I’ve noticed the dichotomies at play. On the one hand, change is something we are desperate to create, and I watch leaders do everything they can to get off the starting blocks, to cut through inertia, fatigue and reluctance, to inspire, create a vision and, as Peter Fuda terms it, use their 'burning ambition' to stay the course. On the other hand, I hear conversations about the overwhelming pressure of change sweeping tsunami-like through the NHS, giving leaders little time to breathe, let alone reflect, take stock and plan.
It is another tension that has got me thinking: if we’re looking to create change do we need to shift beliefs for people to change what they do or does it work the other way round? The old classic that is oft quoted is smoking cessation − a smoker needs to want to stop and believe they can to genuinely quit; confiscating cigarettes may work in the short term but does little in the long term. I understand that. But I wonder whether it can work in reverse − taking action might just shift beliefs. Let me illustrate with a personal story. I have long been of the view that I don't like pilates. Up until Christmas I had never done pilates, but I knew it was not for me. And then someone took me to a class. Turns out my beliefs were wrong.
So is it possible to extend our beliefs about what's possible by doing something unlikely, not just thinking something unlikely? I'm not advocating action without thought, but stepping out and doing something different, being someone different might give others the lead they need more than any 'visioning exercise' can.
The proof of NHS Change Day will be, in part, whether it feels different receiving care or working in the NHS tomorrow and whether over time this concept can build momentum and really inspire change over years to come. But whatever your view on this, that pledge wall is something special, isn’t it? Looking at that it’s much easier to believe that lasting change that improves patient care is not only possible but likely and that all these motivated leaders I am privileged to spend my days with could be pushing at an open door.