How Enabling Leadership Can Help Spread and Adoption of Innovation and Improvement - One of the Seven Interconnected Principles

The recently launched Guide, Leading the Spread and Adoption of Innovation and Improvement: A Practical Guide, offers seven interconnected principles. This blog is the second in a series of blogs, each focusing on one of the seven principles. 

These principles represent important aspects to consider for spread and adoption and are explained in the Guide. All the seven principles are important; they are interconnected, each will have a different importance and require different actions in different settings. Relational, interpersonal elements of spread and adoption – looking at how people can work together – is a common thread within each of the principles.

Leadership - what is needed?

Leadership is one of the seven interconnected principles in the Guide. An ‘enabling leadership’ style, which facilitates interactions between key people that transforms relationships leading to collective action, is needed to enable the spread and adoption of complex innovations. 

An enabling leadership style requires a mindset shift such that ‘my role is to think about how I can facilitate and enable adaptation, emergence and change’, rather than directing people what to do. This includes knowing when and where to bring people together to work collaboratively in a facilitated way and (further) build relationships, trust and agreement on a shared purpose and collective action on spread and adoption through creating a safe, adaptive space. 

More details on this complexity leadership work and creating adaptive spaces is in the information list below.

Leaders need to:

• Maximise connections within and across the system and boundaries, acknowledge the complexity of the task and deal creatively with increasing complexity, uncertainty, diversity, and polarities in our complex adaptive heath and care system. See complexity principle in the Guide for more information or the first blog in this series.
• Strive to create the environment and relationships for innovation development, spread and adoption seeking and sharing learning with others creating a learning system.
• Strategically coordinate spread of innovations across the system, with support from key stakeholders, to maximise benefit and avoid duplication or distraction of effort. 
• Co-create spread and adoption plans with service users, carers and local people. Utilise peer leadership to include the voice of people with lived experience.

Applying this principle to practice

The Guide offers a list of questions to help apply this work to practice. The questions will be of varying relevance depending on the individual context. Some of the questions are:

• How will leaders be supported to develop an enabling leadership style?
• How well do leaders understand the challenges of working with complexity and how to respond?
• How will you create a context that is receptive to innovation development, adoption and spread?
• How and when do you need to create an adaptive space? And who needs to be included?
• How will you create a shared purpose?
• How do you embed a habit of learning so that seeking, reflecting and sharing knowledge is routine?
• What is the strategic plan for spread and adoption?
• What expertise, in innovation development, spread and adoption and quality improvement, is available?

An enabling leadership activity of systems convening may be helpful. Systems convening involves working on sustainable change, across challenging silos, in complex social landscapes, amid changing circumstances. Systems convening, as a way of leading, matches well the complexity of the spread and adoption challenge in our health and care setting.

• Systems convening is needed for complex situations, programme management alone may work when the spread and adoption challenge is simple or complicated and independent. 
• Complex changes require both system convening and programme management activities working together, each bringing valuable, complementary contributions, to enable spread and adoption. This is illustrated in 'A winning partnership – System Convening combined with Programme Management improves patient experience', full video here, short video here and blog here from the Northern Care Alliance and Greater Manchester Cancer Alliance.

These seven interconnected principles can be used by individuals, or by a team, and at all levels; local, regional and national and settings where the spread and adoption of complex change is needed. These principles can be used to inform planning and to inform ongoing reviews. 

This blog Introduction to the Seven Interconnected Principles for Spread and Adoption offers an overview of all seven principles.

Details of how these principles apply to the work we do are described in How the Seven Spread and Adoption Principles Work in Practice: the Continuing Healthcare Improvement Collaborative case study. 

Want more information? 

More details on leadership, including systems convening, in the Leading and Connecting across systems in further resources section of the Guide.

More information on the seven spread and adoption principles and system convening is available on the NHS Horizons website including blogs on leadership:

• Why an ‘Enabling Leadership’ Style is Needed for Innovation, Spread and Adoption
• COVID-19 Crisis: Creating Adaptive Spaces and Enabling the Spread and Adoption of Innovation
• COVID-19 – A Complexity Leadership Response

If you're interested to read more there are previous blogs and further blogs to follow. Please do subscribe to this blog and follow @DianeKetley @HorizonsNHS, #nhsspread.

We would love to hear your feedback about the guide, and how you will use it. Send a tweet to @DianeKetley @HorizonsNHS #nhsspread. If you prefer email, get in touch at England.si-horizons@nhs.net.