This document discusses strategies for leading large scale change. It notes that the greatest danger is not micro-managing but "macro-leading". It also discusses that the 3% rule appears true for social media, where 3.3% of tweeters accounted for 85% of retweets in health and healthcare. The document lists who may typically make change happen through formal leadership roles but notes most influencers are actually "mavericks and rebels" like deviants who do things differently and the hyper-connected who spread behaviors at scale. It emphasizes engaging investors in change rather than just seeking buy-in.

1. @helenbevan
Leading for spread, adoption and
large scale change
Source of image: @voinonen

2. @helenbevan
2
The greatest
danger today is NOT
micro-managing:
it is MACRO-LEADING
Henry Mintzberg

3. @helenbevan
Beware the chasm!
Source of image: @voinonen

4. @helenbevan
Beware the chasm!
Source of image: @voinonen

5. @helenbevan
Over the past 20 years there have been more than 100
NHS-wide pioneer/pathfinder/pilot/demonstration sites

6. @helenbevan
It’s an issue of power
Power is one’s
ability to achieve
goals
Bertrand Russell
6

7. @helenbevan
Jeremy Heimens, Henry Timms
This is New Power
old power new power
Currency
Held by a few
Pushed down
Commanded
Closed
Transaction
Current
Made by many
Pulled in
Shared
Open
Relationship

8. @helenbevan
Connect with the 3%
Just 3% of people in the organisation or
system influence 85% of the other people
Source:
research by
Innovisor

9. @helenbevan
The 3% rule also appears true for
social media
Source: research by Graham MacKenzie using NodeXL
In health and
healthcare globally,
tweets by 3.3% of
tweeters accounted
for 85% of retweets

10. @helenbevan
WHO will make the change happen?
List A
• The Delivery Board
• The programme sponsors
• The Programme
Management Office
• The Delivery Board work
streams
• The Clinical Leads
• The Directors of
participating organisations
• The Change Facilitators
Source: adapted by Helen Bevan
from Leandro Herrera

11. @helenbevan
WHO will make the change happen?
List A
• The Delivery Board
• The programme sponsors
• The Programme
Management Office
• The Delivery Board work
streams
• The Clinical Leads
• The Directors of
participating organisations
• The Change Facilitators
List B
• The mavericks and rebels
• The deviants (positive). Who do
things differently and succeed
• The nonconformists who see
things through glasses no one else
has
• The hyper-connected who spread
behaviours, role model at a scale,
set mountains on fire and multiply
anything they get their hands on
• The hyper-trusted. Multiple
reasons, doesn’t matter which
onesSource: adapted by Helen Bevan
from Leandro Herrera

12. @helenbevan
WHO will make the change happen?
List A
• The Delivery Board
• The programme sponsors
• The Programme
Management Office
• The Delivery Board work
streams
• The Clinical Leads
• The Directors of
participating organisations
• The Change Facilitators
List B
• The mavericks and rebels
• The deviants (positive). Who do
things differently and succeed
• The nonconformists who see
things through glasses no one else
has
• The hyper-connected who spread
behaviours, role model at a scale,
set mountains on fire and multiply
anything they get their hands on
• The hyper-trusted. Multiple
reasons, doesn’t matter which
ones
Source: adapted by Helen Bevan
from Leandro Herrera

13. @helenbevan
Do you remember that 3% of people in an
organisation influence 85% of other
people?
Most of them are NOT people on list A
Formal leaders typically make up 12% of an
organisation and drive conversations with
55% of other people
Source: Innovisor

14. @helenbevan
Mark Jaben on the science behind resistance
What NOT to do
But what we do do
Engage
people here

15. @helenbevan
Mark Jaben on the science behind resistance to change
What NOT to do
(but what we usually do)
We don’t need buyers (who “buy-in” to change)
We need investors
What TO do
Engage
people here
Engage
people here

16. @helenbevan
Emerging themes in spread
• Increasing attention to the demand side, to
better understand the adopter’s point of view
• Coalition building (social movements and social
media)
• Increasing attention to system conditions
• Acknowledgement of context sensitivity
• The importance of co-design for subsequent
scaling (investors not buyers)
Source: David Albury