Change in action: The National Health Service (NHS)

- I get to attend a lot of management conferences, I hear a lot of speakers, and typically they fall, really, into two categories. You have extraordinary CEOs who talk about how they founded a company or changed a company and their stories are powerful and inspiring, but I see people sitting there thinking, "I'm not the CO. "I just don't have the levers, the power, to do that." Or you have other speakers who tell you how to be more effective in your job. How to be a better marketer, how to build a better website, or be a better team leader. But what you almost never hear is somebody telling you how to change the system when you don't own it because our assumption is that is impossible. You can only change the system if you're an executive Vice President, or the Head of HR or IT or Finance. That's wrong. Let me tell you a story about two individuals, Helen Bevan and Jackie Lynton, who were in the middle of one of the most bureaucratic, biggest organizations in the world and had a profound impact on that organization. The story starts in early 2013 and the organization is Britain's National Health Service with more a million employees. As you might imagine, it's bureaucratic. Healthcare is a very complex industry and if you are in Britain or you follow the British newspapers, just about every week you'll find a story of something that's gone wrong in the NHS. Well, Helen and Jackie had many years of experience at the NHS, but they weren't senior line executives. They were mid-level change people who'd run different sorts of traditional change projects at the NHS. They found themselves talking one afternoon to a group of young trainee doctors who had just joined the National Health Service and who were already frustrated about how difficult it was to get things done and how often doing the right thing for patients came second, third, or fourth to doing the right thing for bureaucracy. So they thought maybe there's another way to drive change here at the NHS. Now the unit in which they worked, which was an internal consulting unit, they thought that that unit was going to be disbanded within a matter of months. So, starting in January 2013 they launched their little project. They gave it a very ambitious name, The Change Day, but they said we only have 90 days to do something significant and the project worked like this. Using a little social media platform and then everything they could do with viral marketing, they invited colleagues in to fill out a simple pledge form where you could pledge something you were going to do within your job, within your scope of permissions, to improve patient care. 2013 was the 65th anniversary of the National Health Service, and they were hoping that by March when they thought the project would have to end, they were hoping to get 65,000 pledges. By the end of January they had a few hundred, by mid-February about 5,000, and by the time they ended The Day of Change in mid-March, they had 189,000 pledges. A typical pledge might come from a group of pediatricians who said, "We promise to taste every medicine "before prescribing it to kids "and a helpless parent who's going to have to try "to get it down their throats." Or it might be a group of nurses on a ward who said, "Every week, with their permission, "we'll video our patients with our camera phones "and then we'll come back and talk about "what we could to make their experience in the hospital "more pleasant for them." So imagine that times 189,000 pledges. That became the single biggest change program in the history of the NHS and Helen and Jackie launched it without any permissions, without going up, without putting together any big plans, they just started something. That's how you think if you're an activist, not an anarchist, not a terrorist, but if you're an activist. When you say, "I'm not helpless. "I'm not going to ask somebody else to do this. "This organization is my organization, "I care too much about it to be helpless "and I believe we can do something "starting where I am right now." That's the secret to making a difference. That's the secret to hacking management.