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To followership and beyond


Blog headlines

  • Sustainability and transformation parties: mandatory guidance
    5 December 2019

    As Christmas fast approaches, system leaders are getting ready for so-called sustainability and transformation parties, the highlight of the year for those who enjoy kinky integration with strangers.

  • All the latest health policy news from the general **** campaign
    29 November 2019

    Because purdah is still in force, this week’s **** has been heavily redacted. Here are the main parties’ plans for government as set out in their manifestos. A full unexpurgated version can be obtained from **** Party HQ.

  • New outfit more splendidly integrated than ever
    21 November 2019

    The emperor has announced plans for yet another new outfit, amid claims that this one will be even more splendid than the last.

  • Purdah – guidance for professionals
    15 November 2019

    After Christmas and the HSJ Awards, purdah is Martin Plackard’s favourite time of year.

  • Tools honoured in Blithering awards
    8 November 2019

    The Blithering Celebrating Success Awards are always eagerly anticipated. Every November, they recognise the commitment and dedication of people who put other people at the heart of everything they do before going the extra mile in their shoes. They also reflect the passionate belief of the organisers, Spume Media, in an awards-led approach to healthcare improvement science.

  • Provisional findings of the interim report
    31 October 2019

    The programme delivery group at One Blithering, the emergent NHS Blithering integrated care system, has published an interim report containing the provisional findings of a year-long strategic review.

  • Toast
    25 October 2019

    "The biggest complaint about the NHS which is beloved by everyone is about the food, and the biggest complaint about the food is about the lack of toast.”

  • Plackard’s misdirection and a victory for old power
    17 October 2019

    In which no one can find Plackard's signposting event, an old foe returns from his past and Sir Trevor Longstay loses interest in compassion

  • Sir Trevor defends revolving door
    4 October 2019

    Sir Trevor Longstay has hit out at proposals designed to make it harder for failed NHS directors to get new jobs with no questions asked.

  • The Blithering ICS newsletter
    26 September 2019

    Every month, the Project Management Office (PMO) of the Blithering ICS, All of Us Blithering Together, publishes a strategic briefing for stakeholders.

  • Is obeying the law bad for your health?
    13 September 2019

    (With apologies to Private Eye’s A Doctor)

  • The innovation greenhouse
    5 September 2019

    Faced with ordinary problems that they cannot solve – lack of funds, staff shortages, rising demand, falling morale (you know the ones) – our leaders propose extraordinary solutions.

  • The inclusivity summit
    15 August 2019

    As ever, Sir Trevor Longstay knew exactly what he wanted. “This has to be an exclusive event. I want all the right people there – and a decent lunch. See to it Plackard,” he said.

  • Old Matt, new Matt: Mr Hancock’s diary
    8 August 2019

    Proud to be in Boris’s cabinet but a bit peeved to be back at Health and the Other Thing. BJ hinted at the Home Office or the Foreign Office but I gather he said that to everyone.

  • The people's druggist
    1 August 2019

    The NHS is to recruit more than 1000 social apothecaries to work in primary care networks.

  • NHS Frameworx promises 'relentless focus on tools'
    25 July 2019

    NHS England and Improvement has created NHS Frameworx, a semi-autonomous delivery unit for toolkit innovation and best practice.

  • Plackard’s guide to impactful messaging as part of the NHS Long Term Plan
    19 July 2019

    What are you doing to implement the NHS Long Term Plan in your area? You should by now be talking about it in everything you do. Impactful communications is the key to delivery – and volume is the key to achieving impact. This toolkit and comprehensive suite of accompanying resources, by the NHS’s leading strategic communicator, Martin Plackard, aims to help others to deliver the NHS Long Term Plan’s central message that the plan is working.

  • Blithering Stakeholder News
    12 July 2019

    All the latest BS news from the country’s most challenged health economy. In this edition we cover the progress of an IT project under the personal direction of Sir Trevor Longstay, plus an update on the hospital's financial improvement plan and exciting news from the patient experience programme

  • Martin Plackard’s implementation framework
    5 July 2019

    This week, NHS Blithering's communications supremo Martin Plackard, looks forward to delivering the commitments of the NHS Long Term Plan. But first he has to reassure Sir Trevor Longstay, head of the Blithering STP, that the newly published NHS England Implementation Framework leaves plenty of scope for local determination

  • Make time for values
    21 June 2019

    Most of us would like to be more values-based, but finding the time can be tricky.

Friday, 29 March 2019

To followership and beyond

After the success of her last blog on thinkfulness, we asked Bev Heaver to share her thoughts on other aspects of the exciting world of change. Bev is head of disruptive horizon scanning and new futures curation at the Mod Institute. Here she unpacks some of the key resources that we all need to carry with us on our change journeys.


At Mod we don’t have a management hierarchy but a fluid leadership matrix which values not just leaders but also the many followers every organisation depends on to do "work".

The NHS needs to develop more follower-leaders (not to be confused with lead followers) who set the strategic direction for followership at locality, place and system level. We need a director of following on every board. They are every bit as vital as the director or strategy or the head of feedback and experience.

Don’t wait for permission to be passive and compliant. It’s everyone’s business to drift unquestioningly in the direction of everyone else. Make it part of everything you do.

Tip: Why not start your own Followership Academy (FA)? Better still, wait for someone else to start one.


I was at an amazing unconference the other day listening to an inspirational untalk about pulling power to the foreground. It made me realise how many times I’ve been guilty of backgrounding my own power recently.

Change agency is power. We have it individually or we share it collectively through superconnectors like me. When one of us gets more powerful, we all do.

Power makes a positive difference. It mobilises ideas and people. The word power looks great on slides and infographics. It literally empowers people. Just say it slowly in a low voice in front of the mirror a few times and you’ll see what I mean.

I’m still disappointed when someone asks “What can you do with it?” or “Will it help me get a pay rise?” These are old power questions in a new power world. They go straight on the park board.


We all know how to listen but how many of us actually do it? I know I don’t!

It’s not enough to “hear” or “understand”, sometimes you literally need to put yourself in someone else’s ears.

At our Through Their Ears active listening workshops we model better hearing behaviours by asking delegates to make cardboard replicas of their neighbours’ ears which they have to wear for the rest of the day. It’s a great way to discover your wells of empathy and compassion. There’s a prize for the most lifelike ears.


To make large scale change happen we need less of some things and more of others. We need to challenge old thinking and embrace new sprint-thinking, break old rules and make new paradigms, tear down structures and build self-sustaining ecosystems in their place.

The w-word must never get in our way. You should never have to ask “why” change is so important in an age of disruption. As I wrote recently in my blog, the Five Quadrants of Paradox, disruption is the new normal – and vice versa.  Disnormality is your ally. Embrace it.

Pointful travel

Change is constantly evolving, which is why we are on an endless journey of change with no beginning, middle or discernible point. Only you have the power to make it pointful.

Without the continual drive for change, the transformation we envision would disappear from our imaginations, and change agents would have no option but to stop telling their stories and describing their feelings and go back to their meaningless, transactional, activity based “jobs”.

It doesn’t bear thinking about.

New futures editor: Julian Patterson


Anonymous says:
Mar 29, 2019 08:54 AM

Brilliant, sounds like the ideal vehicle to take forward the bullies charter so close to much of NHS 'leadership'

Anonymous says:
Apr 05, 2019 12:18 PM

As Judge Judy says, put on your listening ears! Very few do ....