ABSTRACT

Dedicated and hard-working staff at all levels of large healthcare organisations can be frustrated by a perceived inability to influence healthcare priorities. One way of enabling such practitioners to shape and improve services is to bring them together in 'communities of influence'. These are informal groups or networks of committed people who meet regularly to share experiences, develop a collective voice and influence policy and practice at local and national levels. Such 'bottom-up' approaches to change can complement the more conventional management mechanisms widely employed today. Communities of Influence tells the story of how a prominent UK non-profit organisation (Macmillan Cancer Support) has engaged both professionals and patients over the past two decades to improve cancer care. It will stimulate managers and practitioners alike to develop their capacity to work through networks, relationships and conversations in pursuing their objectives. This book will appeal to clinicians and managers responsible for service improvement, as well as public servants, researchers and educators interested in management and organisational change. At a time when the 'big society' is the policy idea of the day, this book illustrates what can be achieved when communities of practice become communities of influence. In so doing, the authors offer a timely counterpoint to believers in command and control and rampant competition by stressing the critical role of networks and relationships. The ideas they discuss are at once simple and complex and have the potential to be revolutionary when taken forward in the right hands. Professor Chris Ham, Chief Executive of The King's Fund This wonderful book describes how a creative, problem-solving organisation can be encouraged to start, grow and flourish. The result is a text that could act as a guide for 21st century healthcare, one of the key books for an era in which it will be recognised that new solutions are needed for the problems we face. From the foreword by Sir Muir Gray This book is a welcome antidote to the usual approaches to improving healthcare which take the form of endlessly changing organisational structures and relentless monitoring, often with dubious consequences. It presents an alternative, holding out the prospect of gradually accumulating changes in the actual work of those delivering healthcare in a complex environment. Professor Ralph Stacey, Complexity Research Group, University of Hertfordshire

chapter |9 pages

Introduction: A fresh approach to improving services

Encouraging change from the ground up

chapter Chapter 1|13 pages

The power of the collective voice

How a charity known for its nurses came to work with general practitioners

chapter Chapter 2|25 pages

Making the invisible visible

The importance of tracking life and achievements of communities over time

chapter Chapter 3|24 pages

Working with and through doctors

How a community of GPs made a difference to patient care

chapter Chapter 4|18 pages

The social life of documents

Making sure written products of communities get noticed and used

chapter Chapter 5|29 pages

Hybrid creatures

A novel way of bridging the gap between research and service improvement

chapter Chapter 6|31 pages

Cultivating a lively community

The role of the supporting team in helping a group become more influential

chapter Chapter 7|15 pages

Involving lay people as partners

How patients joined a professional community and helped shape new services

chapter Chapter 8|10 pages

Playing a long game

Benefits and risks of working with communities of influence over time

chapter |2 pages

Postscript

A writer’s personal reflections