Change facilitator, strategist, speaker. Prof. of Practice in Health & Care Improvement
@WarwickBSchool
. Advisor
@HorizonsNHS
. Senior Fellow
@TheIHI
. Views own.
I’m celebrating! Today I completed my last day in a full time job after 40 years of being a public servant. I’ll be back in a couple of weeks as a part time strategic adviser to
@HorizonsNHS
with the time & space to support health & care transformation in wider ways
When I think back over my 40 year career, the best, most impactful times were when I had a boss who understood me & who believed in me. Maybe as leaders, we should all aspire to be that boss that others remember. Sketchnote by
@anujmagazine
based on a tweet by
@ValaAfshar
I'm having lots of conversations with people about how tired everyone is feeling right now. This graphic from the brilliant
@EmmaNeuropsych
offers some clues. It's time for some self love and care
A powerful new visual of the famous Desmond Tutu quote, created by
@Juliet_Young1
: ‘We need to stop just pulling people out of the river. Some of us need to go upstream and find out why they are falling in’.
Many people who, like me, are in the latter part of our careers understand that our role is increasingly about planting trees. This means developing the people who'll be our successors & helping them to shine. It also involves getting more radical about change. Art:
@ImpactWales
My dad was a sailmaker & he was brilliant at sewing. He taught me & I studied art & textiles to A level. Then I stopped. I’ve just completed my first piece of textile art after a 40 year gap & it’s hanging over my fireplace. It took me 200 hours.
#NeverTooLateToResumeWhatYouLove
In health & care, we often focus on a narrow concept of improving "staff experience", when we could be building a much deeper & more profound basis of human connection at work: a sense of belonging. Belonging is when an employee, regardless of their background or role, knows that
Belonging at work really matters. Employees with a strong sense of belonging outperform others on almost every metric, from engagement & retention to performance & wellbeing. Good leadership supports belonging: People with an effective manager are 6X more likely to feel this
How to recognise emotional intelligence (EQ): seven traits. As we move into a different future, beyond
#Covid19
we need lots of EQ. Thank you for the sketchnote
@ImpactWales
Yesterday I posted "the 25 micro-habits of high impact managers" that often go unnoticed, but can make a massive difference to the health/performance of a team, by
@firstround
.
@tnvora
did a brilliant job turning it into a sketchnote
#AYearofTweets2021
I joined the NHS on 7 Sept 1991 - 30 years ago today. I joined via a scheme to recruit leaders from other sectors with the potential to be NHS CEOs within 5 years. I never got to be a CEO - I became an NHS improvement leader (the best job in the world) & I'm still happily there.
A powerful way to rethink imposter syndrome. Flip to a growth mindset: "The highest form of self-confidence is believing in your ability to learn". Thank you
@tnvora
This week I start my new role as Professor of Practice in Health and Care Improvement at
@WarwickBSchool
. I'm excited to be part of the new centre for health & care improvement that WBS is establishing. I will continue to act as Strategic Advisor to
@HorizonsNHS
. There is such
The psychological safety hierarchy of needs at work by
@heidipsychology
. I appreciate how Heidi has created three categories. At the base are basic safety needs like not being micromanaged. Next is psychological needs like belonging & sense of esteem. At the top is
Marshall Ganz, who is a massive influence on my practice as a leader of change, defines leadership as "taking on the responsibility of creating conditions that enable others to achieve a shared purpose in the face of uncertainty". This graphic by
@lizandmollie
reminded me of it
Just because someone is high up on the organisational ladder doesn't make them influential. If it did, top-down change projects would always succeed. There are other factors that create influence far more than status does By
@tnvora
#100RepeatTweets
no.35
I put together a deck of 33 slides made up of graphics I created for Twitter posts in 2021. Each one is a gem of wisdom from other people's work that can give us perspective, ideas or models for change. The original articles are easy to find:
Data is critical to improvement but without a meaningful context that people can connect with, it's hard to use data to motivate change. When we explain data with a compelling story that links to people's values & sense of shared purpose, magic happens
#QITwitter
Art:
@gapingvoid
Too often when we think about ways to "improve productivity", it's about changing the process so we can get more work done with the same or less. Yet the most powerful ways to improve productivity are relational & behavioural, linked to purpose. Great graphic by
@positivepresent
How to be trusted: 1) Walk the talk 2) Keep commitments 3) Behave consistently 4) Don't misrepresent the truth 5) Don't withhold information 6) Don't gossip 7) Don't throw others under the bus 8) Keep confidences 9) Support others
#100RepeatTweets
no. 49
A systematic review of research on workplace breaks shows that:
1) Regular micro breaks can be better than longer breaks
2) Outdoor breaks & fresh air are better than indoor breaks
3) Scrolling social media is the most common break type but it creates emotional exhaustion
4)
When leaders create 3 key conditions they get better outcomes from people. 1) Autonomy: do not micro-manage or enforce bureaucratic rules 2) Competency: give positive feedback 3) Relatedness: build teams with a sense of belonging Via
@CQ_Net
@anafabrega11
Maslow's hierarchy of needs is one of our best known/best loved models in leadership. Yet Maslow never presented it as a pyramid or hierarchy.
@dhambeukers
has redrawn it as circles. I like the addition of a 6th component: our need to be part of & protect the bigger system,
The old rules & hierarchies are being thrown out of the window. People are looking for integration of work & well-being. We need to build teams, practices & processes that are not just high-performing but have a strong fabric of trust woven in: By
@tnvora
In a fearless organisation, people feel psychologically safe to challenge current thinking & practice, without fear of being criticised, shunned or ridiculed. It's tough to build a fearless organisation but people & performance levels flourish in them. By
@AmyCEdmondson
@tnvora
Adaptive leadership means shifting from being the leader who “knows it all” to the leader who's a “learn it all.” Five critical leadership skills for creating an environment in which learning things the organisation does not know how to do is valued over implementing flawlessly
Researchers at MIT have questioned whether SMART goals (specific, measurable, achievable, realistic, time-bound) actually work. They suggest we might get better outcomes if we make our goals FAST not SMART: Via
@mitsmr
@Haypsych
#100RepeatTweets
no. 33
Psychological safety: Safety is not the same as comfort. A leader's role is not to protect their team from discomfort. It’s to protect them from harm - and to help motivate them to push through the discomfort and harness it for growth: By
@shanesnow
Humility matters in senior leaders. A new study found when there's a more humble CEO at the helm, its leadership team is more likely to collaborate, share information, jointly make decisions & have a shared vision: Via
@AmyCEdmondson
Graphic
@julianstodd
Empathy is the heartbeat of leadership. Seven ways to practice it:
1) Show genuine care & concern
2) Be present
3) Ask questions
4) Listen to understand
5) Be curious, not judgemental
6) Connect through emotion
7) Act with compassion
Thank you
@DannyLangloss
@Brilliant_Teams
It’s easy to think “it’s just a few minutes.” But as the number of people that you hold up increases, the true cost of being late scales rapidly. Being 10 mins late to a meeting with 10 others is 100 minutes. I'm doing some work on improving meeting practice currently so this
“The signs that you have a great manager are the actions you don't think about until later". Here are 25 little daily habits of managers that often go unnoticed, but that can make a massive difference to the health & performance of the team By
@firstround
As much as 80% of the knowledge in an organisation is undocumented. That's why networks, communities of learning/practice & sharing conversations are often more effective than good practice repositories/portals, metadata or search systems: TY
@nickknoco
As leaders of complex system change, we should value the creation of relationships as a key outcome in its own right:
- We need to stop trying to design the solution & instead design for the conditions that enable the emergence of many solutions
- Fostering more, quality &
My Twitter account got hacked and the hackers deleted all of the 35,000 accounts I was following. So if I’ve stopped following you, it isn’t personal. I can only follow a few people each day so it’s going to take a while to build my following list back up. Bear with me!
As leaders, every situation we face and every person we encounter will be unique. But we can increase the odds of choosing the right thing to do if we remember these ten things about people: By
@wallybock
We often use "empathy" & "compassion" interchangeably, but they're different. We should connect with empathy & lead with compassion. Compassion means having a good understanding of what the other person is experiencing & a willingness to act: V
@harvardbiz
Too often, large scale change is seen as strategy & tactics by senior leaders, but no small group can drive change alone. It's why organisations with strong, trusting relationships are more likely to deliver transformational change:
#100RepeatTweets
no.67
Anyone who facilitates meetings or finds themselves having to organise the team away day should look at this fantastic free resource. It's the library of 1,000 facilitation techniques from
@SessionLab
. I use it often for ideas for sessions I'm leading:
A key role for leaders of change is to create a sense of belonging so everyone's seen & valued for their own unique selves. Diversity & inclusion are important, but belonging takes us a step further. When we feel we belong, we thrive, and so do the people around us. How to build
Any team meeting, virtual or face to face, should always start with a team check-in, that is a core part of the agenda. Check-ins provide a massive psychological boost to our teams: Thank you
@aimyourteam
@dbarrath
Leaders who create the time & space for team dialogue based on learning, trust & appreciation build engagement. And engaged teams experience more joy in work & get better outcomes. Graphic by
@ImpactWales
Nearly 50% of NHS people are managed by a band seven leader. These leaders are key to performance gains & one of our greatest untapped leadership assets. See this from
@BCG
on the hidden potential of public sector frontline leaders:
#100RepeatTweets
no.28
We already knew empathy is an important leadership competency, but new research takes this further. Empathy promotes innovation, inclusion, collaboration, engagement & reduces work/home tension: Via
@Tracybrower108
@inspiredleader
. Graphic:
@ImpactWales
Now, more than ever, people need to feel a sense of connection at work. To be effective leaders, we have to care for & be connected to the people we lead. We must invest in understanding them & their lives. Empathy is what fuels connection: Via
@DougConant
I've just been writing about the critical role of tacit knowledge in change & improvement. As much as 80% of the knowledge in an organisation is tacit & undocumented. Yet this tacit knowledge is most likely to lead to big breakthroughs for innovation and improvement. That's why
8 ways to influence without authority: 1) Character - lead by example & always follow through 2) Expertise 3) Information 4) Connectedness (relationships) 5) Social intelligence 6) Networking 7) Collaboration 8) Access to funding: By
@JesseLynStoner
@tnvor
Micromanagement has a terrible impact on psychological safety. Micromanaged teams always have low scores in assessments of psychological safety. To deal with it:
1) make efforts to find out if it's happening amongst the teams you lead (people usually don't tell spontaneously)
2)
We should invest in developing the character of our leaders. Character is a strategic asset: “Character is more than ethics... fostering a culture where it is valued equally alongside competence can result in better decisions & better outcomes”: V
@mitsmr
Many commentators talk about the importance of so-called "soft skills" for leadership into the future.
@IDEOU
has (so appropriately) rebranded them as "power skills". Here's their brilliant list of 12 key power skills:
1) Cultivating joy
2) Meaningful collaboration
3) Small-scale
If we want improvement across a system, we need to hold each other to account for behaviours, not just outcomes. When leaders & teams behave respectfully to each other at work, they create the conditions for improvement far more than any outcome-oriented performance drive:
Such sad times. Just heard about the death of Alan Nobbs
@Alannobbs
. Alan was one of the best people I ever worked with. He was a developer of leaders, champion for well-being & passionate advocate & activist for improvement in the NHS. Alan was just an outstanding human being.
We can learn a lot from North East & North Cumbria integrated care system
@NENC_NHS
& their approach to improvement. Their goal isn't to "be the best" but to "be the best at getting better". This helps create a shared mission to build capability for change & to always keep
Workplace teams today don’t necessarily follow "traditional" development stages - forming, storming, norming & performing. Teams are increasingly dispersed, virtual, temporary & remote. Five characteristics of effective teams in a modern age: By
@rgmcgrath
Taking breaks at work is critical if we want to avoid decision fatigue. Behaviours that might seem like “slacking” may actually be useful devices for staying productive.This applies whether we are working remotely or face to face: Thanks
@AbhijitBhaduri
8 ways to influence without formal authority: 1. Character (eg, being respectful & trustworthy) 2. Expertise 3. Information 4. Connectedness 5. Social intelligence 6. Networking 7. Collaboration & bridge building 8. Access to resources: By
@JesseLynStoner
I'm preparing for a talk on "leading change across boundaries" next week. I'm stressing the point that when we're leading change across silos & systems, we can't just be programme managers, we have to be systems convenors: bringing people together with shared purpose. For an
When we're setting goals for a change/improvement project, the standard advice is to think "SMART" (specific, measurable, achievable, relevant, time-based).
@artpetty
says it's time to move on from SMART goals: we need goals that are 1) learning-orientated (we can only achieve
"Everyone shines, given the right lighting". What are we doing as leaders to give the right lighting to our team members and colleagues? What a powerful thought
@sherrillknezel
Conversations about trust at work often focus on the relationship between leaders & their teams. As (or more) important is trust between team members. Research with 1,000 workers identified five trust-based behaviours that set the highest performing teams apart. These teams:
1)
In praise of "connectors" in organisations & systems. Connectors are people with links to many others in different groups. They are often unnoticed & underappreciated, yet they play a vital role in change across systems: crossing silos, disseminating information & mobilising
We can implement all the performance improvement initiatives or new quality systems in the world. But if leaders don't light the way to change through their own everyday behaviours & practices, it isn't going to stick. This new blog sets out powerful
New research shows 5 things high-performing teams do differently: 1) Talk on the phone to each other 2) Have more productive meetings 3) Invest time in bonding over non-work topics 4) Show appreciation to each other 5) Behave authentically: By
@RonFriedman
A Dutch proverb: "Trust arrives on a tortoise & leaves on a horse".
How to build trust like a tortoise:
1) Consistency
2) Transparency
3) Active listening
4) Fulfil promises
5) Respect boundaries
How to stop trust from eroding in a horse situation:
1) Acknowledge mistakes
2)
Psychological safety hierarchy of needs. There's a powerful premise. As leaders, we want our teams to do their best, most productive work. Yet our leadership behaviours - micro-managing, work dumping etc, can block this at a fundamental level. V
@heidipsychology
@Juliet_Young1
Prevention is generally a better, cheaper option than treatment/cure. Yet often our systems are set up to encourage and reward treatment/cure. it's time to move upstream. Thank you
@_workchronicles
Research into organisations/teams that have implemented "meeting free" days at work. It showed that "no-meeting" days improve autonomy, communication & engagement, resulting in decreased micromanagement & stress, which caused productivity to rise V
@mitsmr
The organisations with the best experiences/outcomes of change are typically those with a culture of learning: where everyone can try new things, maybe fail & feel supported & respected. It needs psychological safety: By
@AdamMGrant
#100RepeatTweets
no.46
Mid-level leaders ("middle managers") are likely to be the people playing a critical role in keeping our organisations going right now. Let's celebrate the outstanding contribution they are making: Via
@FT
Graphic
@AbhijitBhaduri
Research into the behaviours of leaders who deliver transformational change. The factor that makes the biggest difference between those who deliver & those who don't is whether leaders embrace the emotional journey of their people. 6 behaviours that improve the odds of
Leading across a system requires a massive & ongoing commitment to the practice of collaboration. A new report from
@TheKingsFund
sets out six areas of practice for effective collaborative leadership:
1) create a safe, inclusive & trusting environment
2) build & maintain healthy
A new version of the iceberg graphic from my team
@HorizonsNHS
. Leaders (especially those at the top/centre of the organisation/system) tend to focus their actions on factors above the waterline. For deep, sustainable change, we also need to tackle issues below the waterline.
If, as leaders, we just remembered these ten things about people every time we encountered "bad" behaviour or a tricky situation, we might make a lot more progress: By
@wallybock
You can't change the culture of an organisation by making a rational plan for it, or by declaring it or by restructuring. The only way to change culture is to change the way people work with each other over time. Think many small changes: Via
@stratandbiz
A beautiful free resource on storytelling for systems change. Written for an Australian context but widely relevant. Stories can help us to build empathy, shift mindsets, create connections, see new possibilities, heal, teach & learn: Thanks
@theasnow
We often see the "J curve" in change. We expect the change to lead to quick benefits, but things may get worse before they get better. This can lead to "leadership tinkering" where leaders don't allow time for benefits to kick in but start changing more things. Pic:
@tom_geraghty
For anyone who leads/facilitates workshops or planning sessions - virtual or face to face.
@SessionLab
has over 900 methods in its free library of facilitation techniques: I particularly like the section labelled "action" - tools to create better decisions
An excellent guide for managers covering how to help your team (and yourself): 1) By calibrating emotion 2) Work through uncertainty 3) Push back against perfectionism 4) Beat burnout. All four are factors that hold teams back: By
@firstround
@lizandmollie
The characteristics of changemakers. The
@designcouncil
has studied change excellence in practice & identified the attributes of the most effective leaders of change across systems:
1) System thinker: has the ability to see how everything is interconnected in a bigger picture.
Download "A practical guide to kindness in the workplace" for free. Chapters include:
- The science behind kindness at work
- Kindness in leadership
- Operationalising kindness
- Promoting inclusion & diversity through kindness
- Kindness in performance management
- Measuring the
We should embrace and support the mavericks, rebels, heretics & renegades in our organisations. Rather than being difficult troublemakers, they may just be the brilliant people who can shift us into a different future Via
@mitsloan
#100RepeatTweets
no. 70
Your leadership behaviour: Are you a multiplier or a diminisher? Multipliers bring out the best in those around them & help them to grow. Diminishers are smart people who don't help others around them to become as smart: By
@tnvora
#100RepeatTweets
no.82
After a year of home working, so many people are experiencing MS Teams fatigue or Zoom fatigue or whichever-virtual-platform-they predominately-use fatigue. Research on its impact & ways to alleviate it is now getting published. Great sketchnote
@Haypsych
"Hard skills" are specific technical knowledge & training. "Soft skills", eg authenticity & empathy, are a mix of what we’ve learned & where we’ve come from. We need both. The last 21 months have shown how key "soft skills" are. We need to call them something else
@SusanDavid_PhD
Here's a great sketchnote from
@BurnhamLandD
on how leaders can enable a powerful culture of psychological safety in the workplace. The ways we behave, the relationships we build & the things we give priority to, create the conditions that enable our teams to do their best work.
It's time to dump the "leader" vs. "manager" distinction. It puts the practice of leadership on a pedestal and relegates the work of managers to some lower rung on the professional evolutionary ladder. Rather, we need more people at all levels who can inspire, motivate, teach,
What's the difference between psychological safety & trust? Psychological safety consists of beliefs concerning the norms of the team– what it means to be a member of that team. Trust focusses on the beliefs one person has about another: By
@tom_geraghty
Starting team meetings with a check-in &/or having regular team check-ins is such an important part of leadership practice. Check-ins prime the behaviours that make collaboration possible. Here's a website with some great check-in resources: & a framework
When I think back over my own career, the times when I felt I could do my best work & was most supported, was when I had an affirming leader. Sincere words of affirmation don't take much effort & have a disproportionate impact on people’s self-esteem. As leaders, we should never
The NHS is moving to a "systems" mindset (rather than single organisations/silos) so we can better support people in their health & care. We must role model "systems" in how we think & behave as leaders:
@anosikec
@SocialChangeAg
#100RepeatTweets
no. 73
Recognition at work matters. People who feel "recognised" by leaders are 40% more engaged. There's a growing movement towards "reflective recognition" where leaders get their team members to reflect on & share what they're proud of & why: By
@BeyondThankU
Today I was putting together some materials on what makes a great team & I included this "classic" sketchnote which was a collaboration between
@HorizonsNHS
&
@FabNHSStuff
. It has been downloaded hundreds of thousands of times & is as relevant as ever. Fab artist:
@LeighAKendall
The pandemic experience has shown the importance of compassionate leadership. We need to move to "wise compassion", based on leadership competence, deep understanding of what motivates people & leading others to achieve priorities:
#100RepeatTweets
no. 86
Those of us who have been mostly working virtually from home for the past sixteen months have been visited many times by the four horsepeople of procrastination