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| 6 minutes read

Tweets of the Week, 18th June 2021

The Horizons team features many influential Twitter users. This curates a wealth of insights, knowledge, and information about transformation in health and care from other thought leaders across the world. (Tip: to read an article or watch a video mentioned in a tweet, click on the blue text. To view the original tweet, click on the image).

Psychological Safety 

Over the past few months, the NHS Horizons team worked with integrated care system leaders & Amy Edmondson on how to build psychological safety at system level. It's critical if we want systems to deliver large scale change. The report was published last week, view it here.              

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. 

School for Change Agents 

This week, our amazing colleague Leigh Kendall presented on the power of storytelling and using your power to make things happen, all which is part of School for Change Agents! If you'd like to sign up to hear about when the next run of School is please sign up and in the meantime you can watch recordings of the live sessions, listen to the podcasts!

If you have recently completed the School & would like unlimited access to sessions & materials? You can upgrade for a small fee. In partnership with FutureLearn we're able to offer upgrades FREE to NHS Employees in England. More info and eligibility criteria.

It was the last of our series 1 for the Agents Assemble podcast! Our final episode featured the crew who bring you school (Kerry, Olly, Zarah and Leigh) and also an amazing star guest Dr Esther Murray, Available wherever you get your podcasts, listen/subscribe here.

This week Kerry met with the awesome #S4CA study group who shared their amazing experience of doing the school for change agents together and being change agents themselves! Thank you Hayley, Andrew, Amy  and Leighann.


A really useful thread about making your presentations in virtual meetings accessible for everyone. Thank you Emma Mendes da Costa.

Large-scale Change 

Making the transition from pilot projects to large scale change. The problem? "Pilots never fail, pilots never scale": Written about the agriculture sector but equally relevant to health & care & other sectors. 


Are you aware of the "hot tub effect" in change projects? Helen has shared that she has experienced it so many times. The project team has lived & breathed the change for ages. They wonder why the people impacted by the change don't easily embrace it & rush into action 


It is common for improvement or transformation plans to use the language of "driving" change through the organisation or system. If we want large-scale, sustainable change, we need to grow it, not drive it. Graphic via @MilFamLN 


You can show people data but if it doesn't fit their worldview, they may ignore/deny it. This fate befalls change projects too: situations perceived as a threat to the status quo can trigger inflexible thinking & a desire for closure



Helen gave a keynote talk with Goran Henriks at #Quality2021 on "How to create simple rules for your health & care system". Simple rules can be such a powerful way to move a whole group of people in a direction without coercion or compliance. 

At the International Forum for Quality and Safety the work of @RoyalFreeNHS showed us that the what matters to you movement isn’t just a “nice to have” it leads to higher staff retention which in turn leads to greater patient safety, improved quality of care and tangible efficiency benefits for public money. 

Our colleagues Leigh Kendall and Helen Bevan presented along side National Improvement Director, Hugh McCaughey on the power of tweet chats, they even hosted one live! View the slidedeck here.

Pride Month

We loved seeing the amazing Nick Prentice at the NHS England and Improvement all staff briefing to promote the celebration of Pride Month #Pride2021 Especially on What Matters To You day! @WmtyWorld #WMTY #WMTY2021.


MUST READ if you work in QI! The June 21 QI Evidence Update! 2 slides packed with updates from the last month compiled by Jess Pawley& you're welcome to #pinchwithpride for your own teams 

Sir Liam Donaldson, pioneer of patient safety & colleagues have made the Textbook of Patient Safety & Clinical Risk Management fully downloadable & free. The content is outstanding, written by leading practitioners globally @PIPSQC #100RepeatTweets no.55 

John Kotter's book "Leading Change" introduced us to the 8 steps model (the best known/used model for planning & leading change globally) 23 years ago. @KotterInc has updated it for a covid world. You can download the eBook for free

Leadership & Teams

Newly published research shows an association between Positive Leadership WalkRounds (PosWR) - an organisational practice where leaders conduct walk arounds & ask people what's going well - & the level of workforce well-being & safety culture: Via @PIPSQC

We aspire to be "authentic" leaders but what we think authenticity means may block our ability to grow & learn. Does "authentic" mean our insecure, risk-averse, historical selves? Or can we learn & act our way to becoming truly authentic?

What are the qualities of a great leader? A simple but powerful sketchnote by Hayley Lewis . Hayley first posted this more than three years ago. When we reflect on the leadership response to the pandemic, we can see these qualities are more important than ever. #100RepeatTweets no.54 

Stanley McChrystal says that if, as leaders, we want a team or organisation that's agile & effective, we must "delegate until it hurts". Here's the Radical Delegation Framework from Shreyas Doshi . He describes this approach as "game-changing for leaders & teams who are ready for it".

Self determination theory is a key principle behind the compassionate leadership movement in the NHS & wider health & care system. Here's a sketchnote by Hayley Lewis . One of the best descriptions of its ABC elements is aimed at teachers but widely relevant.

Creating the conditions for happiness around us, amidst the uncertainties & ambiguities of daily life, is a significant act of leadership for ourselves & others. Especially relevant at this point in the pandemic: Great work Tanmay Vora here are 8 factors of happiness #100RepeatTweets no. 53 

We need to stop thinking that "leaders" & "managers" are different people. It's time to 1) reunite leadership and management; 2) recognise the critical role middle managers play as connecting leaders holding the whole organisation together: The real value of Middle Managers 

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
How to be a trustworthy leader, based on longitudinal research with 3,200 leaders: 1) Be who you say you are 2) Treat others & their work with dignity 3) Balance transparency & discretion 4) Build bridges that unify
So many people are stuck in hierarchical "parent-child" relationships at work. Even organisations big on staff engagement are often highly parental; just caring, not coercive parents. We need more "adult-adult"

Virtual working 

A US online talk on "students as helpers delivering virtual patient care" - a great example of using visuals to get important messages across. It's aimed at practising clinicians to help them incorporate students into virtual care visits.

As we move to "hybrid" work (some virtual, some face-to-face) beyond Covid, we should rethink what performance means, shifting from effort/hours at desks, to outputs based on set objectives.


A fixed mindset means you think that you're stuck with the intelligence level & talent you're born with. A growth mindset means you think everyone can develop their abilities, through effort & learning. Here's an ABC of growth mindset self talk by Kristin Wiens #100RepeatTweets no.51

And Finally... 

We can all relate to this amazing graphic from Liz and Mollie, it applied to many life contexts. For Helen it's about being at a later career stage. She is over-focussed on the many things she wants to do that she hasn't done yet and under-focussed on all the incredible work that she has been able to be part of through her NHS career.