Reform Physio Reform Physio

Thoughtful Influences @ #TheBigRs 2.0 – Phil Barber


Phil Barber got stuck in at #TheBigRs 2.0 AND he’s hopeful for the future IF we can organise!

I write this blog, inspired by the recent #TheBigRs 2.0 event and the excellent TPMP episode 54. Having recently completed an MSc module on service redesign (at the University of Hertfordshire, which I would highly recommend), I wanted to offer my thoughts and possibly some direction, and add to the wisdom of Lesley Holdsworth in the recent podcast (I can only hope to get somewhere near!) on influencing change.

I start by going back to #TheBigRs event back in April this year. I was grateful to be invited, but somewhat daunted to be put on a table next to the likes of Chris Mercer, Lesley Holdsworth, Steve Tolan and Naomi McVey. I thought there must have been a mistake or they couldn’t find any space anywhere else to put me! Our job was to discuss and come up with a plan on how to reform influence and in essence, the process of implementing change. The word change can seem scary to some and therefore difficult to drive through, but in an NHS struggling under financial pressures, transformational change is needed and it’s needed now!

Listening to TPMP was like music to my ears when I heard Lesley and Jack both talk about the need for trail blazers, and pushing the boundaries when it comes to change. I particularly liked Lesley’s comments when she said: every professional has a responsibility to push the boundries and make things better. So true! So, how do we go about implementing change? I particularly like the Kotters – 8 steps of change model introduced to me on my MSc module ( The model is a step by step process which I have outlined:

Step 1: Create a sense of urgency. Something theBigR’s has done, driving forwards the case for reforming practice, and an end to the low value care that most on twitter like to call out. The Kings Fund highlights here the urgent need for quality improvement:

Step 2: Form a powerful coalition. My table at theBigR’s had an abundance of influential people with some invaluable experience and knowledge, and that was just a small selection of the who’s who of the physio world there on that day. We can safely say this is another box ticked.

Step 3: Create a vision for change. It’s vital to know what it is that we are working towards. As Lesley and Jack discussed in the TPMP, there isn’t much point in planning if you don’t know what you are trying to achieve. This is where I feel we are at now and the October BigR’s conference will hopefully set out an agreed vision and pathway.

Step 4: Communicate the vision. Know your stakeholders and work out how to get a seat at the table. My table at #TheBigRs discussed that although we have more physiotherapists on the boards of Directors and NICE, it’s going to take some knocking on doors and telephone calls as we need more voices. Naomi mentioned that we have far greater power as a team of AHP’s, rather than just physiotherapists, something we need to consider.

Step 5: Remove obstacles. We need to recognise those that are delivering change and reward them for their efforts. Going back to Lesley’s comments, we should all be at the heart of this and transform the laggards into the early adopters. Sometimes the fear of change can become an obstacle we need to remove. Some may be worried about making mistakes but if we don’t make mistakes, we’ll never learn. If mistakes aren’t accepted as part of the process, then we’ll stifle creativity. Ken Robinson touches upon this in his hilarious Ted Talk (well worth 20 minutes of your time).

Step 6: Create short term wins. Make the changes that can be done easily, quickly and with lower cost. It’s highly motivating and essential we all do this if we are to pull the laggards up with us.

Step 7 and 8: Build the change and anchor it in. Analyse what went right and shout it from the rooftops to those that need to hear it. Satisfy the stakeholders and push forward for continual improvement.

The greater in numbers we are, and the bigger the voice we have, will make these steps far easier to take. I will be in attendance in October at the next theBigR’s event and I hope you will too, so we can continue the journey.

Share Project :