1. The new era of thinking and practice in change and transformation (NHS IQ)

The aim of this paper is to:
• capture key ideas about change and transformation from leading practitioners, researchers, thought leaders and opinion formers across the globe
• apply these ideas to a health and care context to determine actions that can be taken to create transformation strategy and develop change leaders who can
accelerate change and achieve their goals
• provide leaders of change, at all levels, with an ‘action list’ to support local and system-wide change
• make available to colleagues in health and care a wealth of ideas, opinions, research and resources about the future direction of change

2. NHS England – Change Model Guide

Great change needs strong foundations. Making change happen isn’t easy, but we hope this guide will help.

The Change Model provides a valuable framework to enable effective and sustainable change that delivers real benefits for staff, patients and communities. It has been co-produced with hundreds of health and care staff and based on credible evidence and experience. The Change Model is for anyone who wants to make a difference – you could be in a clinical or a support role at any level of an organisation.

2.1 Improvement Tool Key Questions

Improvement tools:  The evidence suggests that using an evidence-based improvement tools improves the likelihood that a change programme will be successful.  There are a number of improvement tools available (Lean, model for improvement etc) and they will often include elements from other parts of the NHS Change Model e.g. measurement, engagement, leadership.  All elements of the model work best when integrated together. The other elements are outlined below under Point 2.

2.2 Leadership by All Key Questions

Leadership by all: A truly patient-centred NHS will require involvement of patients not just in their own care but in changing the way care is received by everyone. Patients and the public can guide us to the most effective service models from their perspective but need to be empowered and supported to lead. The following questions will help to understand or inform the thinking around the planned change

2.3 Measurement Key Questions

Measurement:  If you don’t focus on measurement you won’t know whether progress is being made on the processes we follow and impact being made. We should not be surprised about what we agree to measure, as it should be linked to our shared purpose.

The following questions will help to understand or inform the thinking around the planned change.

2.4 Motivate & Mobilise Key Questions

Motivate and mobilise: This is about stakeholder engagement and involvement but it’s also about asking individuals to take action – to be part of the change, to collaborate in designing and delivering the future.
The following questions will help to understand or inform the thinking around the planned change.

2.5 Our Shared Purpose Key Questions

Our Shared Purpose: Developing and agreeing a shared purpose is the fundamental place to start in using the change model in any change process.

The following questions will help to understand or inform the thinking around the planned change.

2.6 Project & Performance Management Key Questions

Project and performance management: To ensure that the changes we plan get delivered we must have ways of making sure that the change is happening and early warning systems for any problems or barriers to our agreed plans for change.

The following questions will help to understand or inform the thinking around the planned change.

2.7 Spread & Adoption Key Questions

Spread and adoption: This is as much about copying good practice from elsewhere as it is about sharing what is going well for us with others. We all need to share what works, learn from others and spread good practice as well as having new ideas.

The following questions will help to understand or inform the thinking around the planned change.

2.8 System Drivers Key Questions

System drivers: The NHS is a complex system with many different parts interacting. Part of the system is the incentives (for example payment systems for providers of care) and sanctions (for instance standards of care and penalties for failing to meet those standards). The incentives and sanctions can drive together to promote change (though sometimes they don’t) and they can operate on a personal or a system level.

The following questions will help to understand or inform the thinking around the planned change.

3. Innovation Evaluation Proposition

The challenges facing health and care services are well documented. So too is thecentrality of innovation in addressing them. We need new ways of doing things and new things to use: more of the same is not an option.

So we must encourage innovation. This means many things. Not least it means nurturing an enquiring, curious and experimental environment that supports people – and especially frontline clinicians – to put their ideas into practice. Only this way will we improve patient care, outcomes and the use of scare resources. But innovation also needs evaluation. This proposition is designed to address this need.

4. SSA Tool 10 – Understanding your Problem Solving Style

Tool 10, is an exercise to help you gain insight into your current, personal problem solving style. You can also use the same diagnostic across your team to create a balanced approach to problem solving and innovating.

The tool takes you through the 8 stages of the problem solving wheel, identifying where you may want to spend time building your skills in some of the stages.

5. SSA Tool CLA 4.03 – Problem Solving Toolkit

This problem-solving toolkit can be used to tap into the enterprising talents, ideas and energies found within your organisation, together with your partners and acrossyour local communities. It provides you with a simple structure for the incubation and problem-solving process, together with toold that you can use to facilitate each of the 8 steps.

6. SSA Tool CLA 8.01 – Collaborative Incubator- A Common Process for Community Engagement

As a collaborative leader attempting to engage your partners and community to help you, viewing the engagement process as a long-term programme and commitment is the first step you must take on this journey.

The Collaborative Incubator Model is an alternative change methodology to the NHS Change model. It has three broad phases and provides a model template for a sustainable community/ stakeholders engagement process.

7. SSA Tool CLW 5.01 – Are you leading a balanced innovation team?

Tool CLW5.01 will provide you with a rough and ready insight into both your own innovation leadership behaviours, and those of the people you draw together to work on your internal collaboration activity.

Effective innovation leadership is about getting a balanced mix of people in the room. Tool CLW5.01 will help you begin the journey to assembling the right mix of people to make innovation stick.

8. SSA Tool CLW 7.01 – Collaborative Leadership Checklist

Collaborative leadership is a skill that not everyone has. The good news is that it can be learned.

Not investing in yourself, your organisation and your partnership’s capacity to collaborate is a surefire recipe for failure. Tool CLW7.01 is designed to help you assess your readiness as a collaborative leader.

9. Enabling innovation and adoption in health and social care – Developing a shared view

This publication aims to provide a set of evidence-based principles that can
underpin innovation in health and social care providers and help them to deliver real improvements for the people who use their services. This isn’t an innovation methodology – since the evidence tells us there are many ways to succeed – but it is a set of things that all providers should think about and incorporate in their approach.

Alongside these principles, we also want to dispel some myths that get in the way of innovation. There is a tendency in our sector to think that invention is more valuable than adoption, and that it is only the biggest and most established providers that we should look to for solutions. We want to start to correct this and encourage greater enthusiasm to adopt some of the fantastic ideas already out there.

10. Innovative Models

Innovative models of general practice draws on national and international literature and interviews with primary care leaders in the UK and internationally to develop a set of principles to guide the development of new models of care that might address the challenges facing general practice.

The authors provide examples of a range of innovative models and conclude that building strong relationships – between patients and professionals, between professionals within general practice and beyond, and between general practice and wider communities – is central to the success of many of the models they studied and suggest that any new model of care for general practice will need to include five core attributes:
• person-centred holistic care
• accessible care
• co-ordination
• continuity
• community focus