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s t x e t n o C x e l p m o Working in C allenge h Stepping up to the c Birmingham 22. 11. 16 @NHSE_Do. OD www. nhsemployers. org/od

Hello my name is Paul Taylor Assistant Director OD NHS Employers @NHSE_Paul. T Karen Dumain National Programme Lead OD NHS Leadership Academy @karendumain 1 @NHSE_Do. OD www. nhsemployers. org/od

We are Do OD Our goal is to help the NHS deliver the safest, highest quality care to patients by enabling people to transform systems. Our work is underpinned by principles of Co-production, Curiosity, Creativity & Courage @NHSE_Do. OD www. nhsemployers. org/od

The values of OD Participation Social justice Equality Helper not Guru Respect Inquiry Self efficacy @NHSE_Do. OD Democracy Fairness www. nhsemployers. org/od

y a d o t r e h t e g o t g in k Wor Curiosity Courage Creativity Confidentiality Co-creation Challenge @NHSE_Do. OD www. nhsemployers. org/od

Lines of inquiry 1. Working in complex contexts • What does ‘place based’ OD look like? • How can the practice of OD contribute to efficiency and productivity challenges? • How do we shape healthy and safe cultures? 2. People transforming systems • Can we design and deliver OD strategies with impact? • What’s the role of OD in the current and future NHS? 3. Building capacity and capability • What help do we need so we can be more reflexive practitioners? • How can we diffuse OD capability across clinicians and managers? • What are the OD essentials we need to demonstrate our value? @NHSE_Do. OD www. nhsemployers. org/od

xts e t n o C x le p m o C in Working • Bring out a deeper understanding of the complex system architecture and how the OD community is responding to this shift. • Identify our preferred futures and take action to achieve this. • Put OD theory into practice as a means to build our confidence, competence and capability. @NHSE_Do. OD www. nhsemployers. org/od

xts e t n o C x le p m o C in Working @NHSE_Do. OD www. nhsemployers. org/od

e s o p r u p d e r a h s r Ou @NHSE_Do. OD www. nhsemployers. org/od

NHS Constitution The NHS belongs to the people. It is there to improve our health and wellbeing, supporting us to keep mentally and physically well, to get better when we are ill and, when we cannot fully recover, to stay as well as we can to the end of our lives. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches our lives at times of basic human need, when care and compassion are what matter most. @NHSE_Do. OD www. nhsemployers. org/od

NHS Constitution The NHS belongs to you. It is there to improve your health and wellbeing, supporting you to keep mentally and physically well, to get better when you are ill and, when you cannot fully recover, to stay as well as you can to the end of your life. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches your life at times of basic human need, when care and compassion are what matter most. @NHSE_Do. OD www. nhsemployers. org/od

NHS Constitution The NHS belongs to me. It is there to improve my health and wellbeing, supporting me to keep mentally and physically well, to get better when I am ill and, when I cannot fully recover, to stay as well as I can to the end of my life. It works at the limits of science – bringing the highest levels of human knowledge and skill to save lives and improve health. It touches my life at times of basic human need, when care and compassion are what matter most. @NHSE_Do. OD www. nhsemployers. org/od

@NHSE_Do. OD www. nhsemployers. org/od

Source: Ralph Stacey @NHSE_Do. OD www. nhsemployers. org/od

t Why OD is importan • The need for a different lens • OD = Complex adaptive systems • The changing nature of change @NHSE_Do. OD www. nhsemployers. org/od

Past & Present @NHSE_Do. OD www. nhsemployers. org/od

Check out… Salama, A. (2010) @NHSE_Do. OD www. nhsemployers. org/od

@NHSE_Do. OD www. nhsemployers. org/od

(1974) @NHSE_Do. OD www. nhsemployers. org/od

Human Systems Dynamics Nothing is intractable Griffiths MSc Consulting Associate hsdinstitute. org © 2016 Human Systems Dynamic Institute | Use with permission. 20

Finite & Infinite Games FINITE INFINITE Fixing a broken leg Lifetime health and wellbeing Getting a promotion Developing a career Short-term performance goals Organisation’s long term fitness for purpose © 2016 Human Systems Dynamic Institute | Use with permission. 21

Finite & Infinite Games FINITE INFINITE defined field of play fuzzy boundaries opponents are known competitors can be partners rules are constant changing rules expertise is clear looking for fit been there before new territory easy to keep score everything may matter play to win play to keep playing © 2016 Human Systems Dynamic Institute | Use with permission. 22

Finite & Infinite Games FINITE INFINITE Strength Trust Skill Courage Control Adaptability Both games are essential but don’t play in one game and expect the results of the other! © 2016 Human Systems Dynamic Institute | Use with permission. 23

Exercise How are you seeing finite and infinite games show up in your work? © 2016 Human Systems Dynamic Institute | Use with permission. 24

Break @NHSE_Do. OD www. nhsemployers. org/od

m e t s y s r u o g in p p Ma @NHSE_Do. OD www. nhsemployers. org/od

Where are you in your own OD practice? @NHSE_Do. OD www. nhsemployers. org/od

Where are we as a system? @NHSE_Do. OD www. nhsemployers. org/od

Ask yourself • Who’s missing from this conversation? • What am I noticing? • How am I feeling now? @NHSE_Do. OD www. nhsemployers. org/od

Human Systems Dynamics Nothing is intractable when you: ► See patterns in chaos ► Understand those patterns in useful ways ► Take action to shift toward greater health and productivity © 2016 Human Systems Dynamic Institute | Use with permission. 30

Pattern spotting questions 1. Generalizations: In general I noticed _____. 2. Exceptions: In general I noticed _____, but sometimes, I saw _____. 3. Contradictions: On the one hand, I saw _____; but on the other hand I saw _____. 4. Surprises: I was surprised by _____. 5. Curiosities: I wonder _____. © 2016 Human Systems Dynamic Institute | Use with permission. 31

Thinking pairs “What would you like to think or talk about? ” @NHSE_Do. OD www. nhsemployers. org/od

g in n r o m e h t g in d n E - Slido Question Slido 1: What have you learned about the patterns in our system? @NHSE_Do. OD www. nhsemployers. org/od

g in n r o m e h t g in d n E - Slido Question Slido 2: What questions am I holding? @NHSE_Do. OD www. nhsemployers. org/od

Lunch @NHSE_Do. OD www. nhsemployers. org/od

“Answers have a short shelf-life. Stick with the questions. ” Glenda Eoyang, HSD Institute The ability to continuously stand in inquiry is a core skill for working effectively in complex contexts © 2016 Human Systems Dynamic Institute | Use with permission. 36

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What … are current patterns? … do you observe? … surprises you? … happened before? … are people saying? . . . is the research? … © 2016 Human Systems Dynamic Institute | Use with permission. 38

So what … are the tensions? … is important? … does success look like now? … © 2016 Human Systems Dynamic Institute | Use with permission. 39

Now what … will we do? … will we communicate? … will we measure? … will we look for next? What do we expect to be different? How will we know? When? © 2016 Human Systems Dynamic Institute | Use with permission. 40

Exercise What would working adaptively like this mean to me as an OD practitioner? Who am I working in service of? How much am I playing to their need for control and certainty? How much am I playing to my own? How could I work more adaptively when people want finite outcomes in an infinite game? © 2016 Human Systems Dynamic Institute | Use with permission. 41

Simple Rules ► Behaviours ► … guided by rules (written or unwritten) ►. . . drive patterns of performance ► Unwritten rules might be: ► … beliefs, assumptions, habits, norms. . . © 2016 Human Systems Dynamic Institute | Use with permission. 42

Simple rules for sleeping well ► ► Get up at the same time every morning Avoid going to bed until you feel sleepy Do not stay in bed if you are not sleeping Reduce the time spent in bed Source: Sleep Medicine Institute at the University of Pittsburgh (via Stanford Insights) © 2016 Human Systems Dynamic Institute | Use with permission. 46

HSD Institute Simple Rules ► ► ► Teach and learn in every interaction. Give and get value for value Search for the true and the useful Attend to the whole, part, and greater whole Engage in joyful practice Share your HSD story © 2016 Human Systems Dynamic Institute | Use with permission. 47

© 2016 Human Systems Dynamic Institute | Use with permission. 48

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Exercise 1. 2. 3. 4. 5. Choose a pattern that was important to you from this morning. What scale is this pattern? Team? Department? Hospital? Region? What existing rules might be creating or sustaining this pattern? What rules would you change? How might you do that? © 2016 Human Systems Dynamic Institute | Use with permission. 50

Q&A What questions do you have? HSD Professional certifications: Autumn 2017, UK Adaptive Action Labs: on request Web resources: www. hsdinstitute. org Consulting Associates: Griffiths (UK) griff@cocomotion. org © 2016 Human Systems Dynamic Institute | Use with permission. 51

Break @NHSE_Do. OD www. nhsemployers. org/od

“The success of any intervention depends entirely on the interior condition of the intervener” – Otto Scharmer @NHSE_Do. OD www. nhsemployers. org/od

@NHSE_Do. OD www. nhsemployers. org/od

Individual thinking What do I need to do differently in the present to create my preferred future? What will I stop doing? What help will I need? @NHSE_Do. OD www. nhsemployers. org/od

g in k in h t e iv t c e ll o C - Slido Question As an OD Community what’s our next wise action? @NHSE_Do. OD www. nhsemployers. org/od

Ending the day - Slido Question How would you summarise today in a word or image? @NHSE_Do. OD www. nhsemployers. org/od

Step up @NHSE_Do. OD www. nhsemployers. org/od

www. nhsemployers. org/OD Linked. In: NHS Organisational Development Do. OD@nhsemployers. org @NHSE_Do. OD www. nhsemployers. org/od