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5 Steps for Effective Change

29 May 2017

I wrote recently about coproduction as being essential for successful change and shared a simple model for how to go about it. Today I thought I’d share some reflections on that model, going a little deeper into the steps and why they are in the order that I have placed them.

Here’s the model again…


Many problems can be solved ‘on the hoof’; there is a place for that. But when it comes to solving the sort of long-standing, entrenched issues that are holding many of our services and organisations back, it is essential to first step off.

Caught up in the torrent of day-to-day pressures, our judgement and our ability to listen closely to what matters to others are compromised. We find ourselves swept along by the assumptions that have brought us to where we are, leaving us blind to the things that will need to change to get to somewhere different and better.

Failing to stop, leaves our efforts carried by the momentum of the status quo and so the status quo persists.


A common critique of many change efforts is that they start with a plan. There is some truth in this. We’ve probably all seen examples of solutions being implemented in search of a problem or top-down changes being required of local services, where everyone on the ground knows that what’s wanted and what’s needed are, at best, an imperfect match.

So if too much change starts with a prescription then it’s tempting to think that the better place to start is with a diagnosis. For example, we can map processes, gather data and synthesise a detailed picture of the ‘as is’. Change based on knowledge; who can argue with that?

But truth (and therefore knowledge) is in the eye of the beholder and when we look, we always look from somewhere; perspective shapes our analysis.

Perspective also shapes how others interpret our analysis and so by starting with diagnosis it’s easy to create islands of perspective, each seeing the same data as proving something different and each giving different weight to different observations.

The curious thing about this is that often, no-one is wrong; each perspective is true from that perspective.

Addressing this issue is fundamental to building a platform for successful change.

Key is understanding that developing a shared commitment to action relies on building trust and understanding. Stakeholders in change need to believe that their needs and perspectives are being understood from their point of view, that these are sincerely valued by others - not just given air time - and that the work of diagnosing issues and opportunities, then later of taking action, will be respectful of them. 

In order to build trust it is essential to spend time together (another good reason why the first step for coproduction is STOP). Taking this time to LISTEN to each other before diagnosing the ‘as is’ is essential. It provides the opportunity to start to develop an understanding of each other’s needs and perspectives; an opportunity too, to demonstrate that we are sincerely committed to improving that understanding and to taking seriously what we learn.

Very often the act of listening and discussing these things is enough to transform the quantum of trust in a relationship but even when uncertainties persist, it is enough to give stakeholders specific and shared lines of enquiry to explore together during their diagnostic work. For example, where needs or perspectives appear to be at odds, these can become focal points for stakeholders to go and look together. 


Looking is the next vital step. The activity is to look together, not to commission others to do so and brief back. Looking in this way takes diagnosis out of the realms of abstract analysis and converts it into a continuation of the effort to LISTEN to each other.

During LOOK, stakeholders explore how their system is working in practice and why. To do this they need to go to where work is happening and to establish what’s normal. While they do that, their focus is on continuing to listen to each other in order to understand similarities and differences in how they are each interpreting and reacting to what they discover as they LOOK.

LOOK is therefore a process of learning to LOOK and LISTEN together so that shared action can be agreed. Often differences in perspectives dissolve as a result of the new understandings that this process creates but the objective is not to homogenise perspectives. Rather it is to establish a platform of trust and understanding from which commitment to shared action can flow.


The world is deeply complex and no amount of looking and listening can create certainty about what will happen when action is taken to improve. Rushing to implement ideas at scale can therefore be risky for stakeholders in a change. Specifically though, taking action almost always implies different risks and benefits for different stakeholders. Deciding to act at too large a scale too soon, can therefore rapidly undermine the trust that has been built. It can play on uncertainties and lead to fear of what this change might mean for us as opposed to them.

In effect, the decision to change at scale too early, can push stakeholders apart by implying that they didn’t really care about our needs after all and that all the listening and looking together was just gamesmanship to get us to do what they wanted all along. In the rush to leverage what seem like good ideas, rapidly and at scale, it’s easy therefore to undermine the whole change process and to create stalemates that are hard to recover.

For these reasons, it’s essential to learn how to develop and TEST ideas on a small scale and in such a way as to connect what has been done to how this has impacted the needs of different stakeholders.

By working in this way, it is possible to treat the work of testing changes as a further continuation of the effort to LISTEN and LOOK together. Stakeholders can ask what their actions are achieving and how they are each experiencing and interpreting this and they can ask, "How are these changes we've tested impacting our needs, separately and together?".

By continuing to be mindful of each other’s needs and perspectives, trust and therefore commitment to change continues to grow between stakeholders, creating the environment in which changes with ever greater ambition can flourish.


The last step for successful coproduction is about demonstrating commitment to each other’s needs through action.

In perfectly designed systems of work, stakeholders win together when the system as one whole wins; however, many organisations and partnerships are not designed this way. Instead, they are designed forward from the belief that all reward should be contingent (unless you do this you won’t get that).

As a consequence, it’s common to find that the best way for each stakeholder to meet their own needs is, at face value, to optimise their part. But since the parts are not the whole, doing each thing better commonly serves to make everything worse; the more efficient each part is the less effective the whole.

Hospitals are a prime example. While a short average length of stay can reflect an efficient and effective healthcare system it can also reflect:

  • a tendency to admit people who should not be admitted; it being easier to keep average length of stay low for a population of patients where a zero length of stay would be more appropriate.
  • a tendency to discharge too quickly or before community services are fully ready; for example, a focus on patients being ‘medically fit’ as the criteria for them being ready for discharge.

In other words, what can be heralded as a sign of departmental success - an efficient hospital ward - can actually be a sign of systemic failure, locking in place norms for sub-optimal ways of working.

Problems like this are not because measures such as length of stay are bad measures per se. Rather it is because any measure of performance only reflects a glimpse of the whole, requiring an act of synthesis to understand what it means to see and to manage performance ‘in the round’.

In making the ways we manage and reward performance contingent on results within individual departments, roles, functions or domains we create the conditions in which stakeholders can only win at each other's expense and so can only lose together. It is to leave stakeholders at odds with each other but only because they are at odds with how their shared system has been designed and is being managed.

The last step for effective coproduction is therefore for stakeholders to RESPOND when these points of tension surface. This means committing to action that either designs out or mitigates the existence of win-lose scenarios; acting together to redesign their shared system so that their approach to rewards, incentives and performance management enable them to win together into the future.

If what you’ve read resonates with you then you can find out more by contacting us at We will take the time to understand your situation and we won’t give you the hard sell.


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