Change - believing in the impossible

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I’ve just taken a look at the NHS Change day pledge wall. If ever you're losing faith that there is the energy to make a difference in the NHS then I recommend you do too. There are more than 130,000 pledges on there, people actively choosing to make a difference to the services they provide and to patient care. It's uplifting.

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.


Belinda Weir

Senior Consultant,
The King's Fund
Comment date
13 March 2013
Some inspiring stuff here, Liz and, as you say, on the pledge wall. I'm hearing lots of stories from programme participants in the north-west about the power of "doing something differently" and the impact on mindsets, for instance "NHS Change Day would normally have passed me by - I'm too busy. But this week I reflected and thought what I do can actually make a difference, and so I pledged..and I've encouraged my team to do that too". Hoping small changes combine to make big differences.

Fiona Rodden

Business Manager & general boat rocker,
Thames Valley and Wessex Leadership Academy
Comment date
13 March 2013
Well said Liz. It’s also very interesting to see how many of the pledges on the wall and on Twitter are based in behaviours, attitudes and values. Just like your examples of changes in lifestyle they’re challenging and quite rightly many people are asking whether these changes are sustainable.

NHS Change Day is an amazing example of a few inspiring people coming together not long ago, with a great idea that has mushroomed beyond what they ever thought possible. The next step is to take these pledges and make them happen. This is not a one day wonder. They say any change in behaviour takes months of practicing before it becomes habit. Pledgers need to recognise that these promises to change behaviours are not small at all. They are all big, challenging and the most worthwhile thing they can do to improve patient care. Most importantly though, they are possible.

Harry Longman

Chief Executive,
Patient Access
Comment date
15 March 2013
Agree with you that doing the impossible is the right way to start - believing often comes later, when we find that it works. Working with general practices on fundamental change, those most successful have just got on with it. They have prepared, they have planned and adjusted, but they have suspended their unbelief as they have made the change.

Joe McCrea

Social Media Lead,
NHS Change Day
Comment date
19 March 2013
Thanks for your very kind comments about Change Day, Liz.

The number of pledges actually hit 182,000 by the end of Expo and we are bowled over by this initial stunning success.

But this is just the start. We now are building to become a social movement for change. Anyone can join in, by hooking up with our variety of social media channels


Twitter: Follow on: #nhschangeday

Facebook : Follow on:

YouTube - 20 videos, 4,000 views and growing!


Podcast via iTunes or at OR use our NEW iPhone/iPod Touch/iPad app at

If anyone has any questions about Change Day Social Media...feel free to contact me at

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