The new challenges facing leadership in the NHS are being accompanied by increased confusion and criticism. Steve Onyett examines two key themes in social movement that could liberate leaders from the fear of failure.

As the NHS Institute approaches its swansong in its present form, it invites us to explore what major mobilisation of the will of the people can show us. In looking at such social movements, two key themes emerge. The first is the need to engage heads, hearts and hands in the task of improvement through leaders engaging their intellectual, emotional, spiritual and physical energy.

Helen Bevan, director of service transformation at the NHS Institute for innovation and improvement states that: “social movement thinking is about connecting with people’s core values and motivations and mobilising their own internal energies and drivers for change…[evidence from change management studies show] people change what they do less because they are given analysis that shifts their thinking than because they are shown a truth that influences their feelings”.

The second key theme is mobilisation through effective communication using relationship networks.

Dr C. Otto Scharmer has developed a conceptual framework for connecting head, heart and hand in the form of a “U”. He states: “shifting from reactive responses and quick fixes on a symptom level to generative responses that address the systemic root issues is the single most important leadership challenge of our time.”

At the top of the “U” is simply reacting to events while at the bottom is a place of “presence”, where people connect to their deepest intentions and creativity. Achieving presence through a journey down the left hand side of the “U” involves achieving through an open mind - seeing with fresh eyes, and being able to inquire and reflect. The barrier to an open mind is the voice of judgement - dismissing the possible and staying in old and limiting patterns of thought.

The second step to the bottom of the “U” is achieving an open heart - fully using our ability to access our emotional intelligence, to tune in, to walk in other people’s shoes, to listen empathically. Engaging people’s hearts is particularly stressed by the social movement thinking promoted by the NHS Institute, often through telling stories about the experience of patients and other end users of the service, and bringing home the human consequences of both our failure to do the right things in the right way and the enormous social significance and benefits of what we do when we get it right.

In the U theory, the obstacle to an open heart is the voice of cynicism. Cynicism serves to distance us from experience as lived by those that we seek to serve. Brene Brown’s TED talk on the power of vulnerability describes vividly how our need to control and perfect leads to becoming numb and tuning out from what is really important in what we do.

The final step, the bottom of the “U”, involves achieving an open will, where we let go of old identities and intentions and tune into our authentic purpose and self. The barrier to this openness is fear of the unknown and of being ostracised or ridiculed as we demonstrate new ways of being.

Leadership needs to create a containing space where such fears can be let go of. This soft stuff really is the hard stuff for leaders to get right, now perhaps more than ever when the voices of judgement, cynicism and fear might be at their most strident.