Helen Bevan engagement report

Best tweets

• Mar 4, 20261.9x their median

  Peer influence is the single most powerful driver of change adoption. It’s something those of us working in change practice have long known: the trusted colleague who says "this worked for us"; the visible shift in practice from someone others respect; the informal chat that carries more weight than the top-down directive. Peer influence is change experienced through relationships, not instruction. And guess what? New research from @Microsoft (Nancy Bahm & colleagues) confirms that peer influence is also the most important enabling factor in AI rollout. AI adoption is stalling. Uncertainty makes people choose caution over experimentation, so learning goes underground. When they see trusted colleagues use AI, adapt it to real work & share learning, they’re far more likely to regularly use it themselves. Without social proof, even the best infrastructure & training can’t drive progress. The research data shows the importance of peer influence in AI rollout. A one standard deviation increase in positive peer influence raises the likelihood of being a heavy AI user by 8.9 % points, & increases the probability of using AI agents by 10.4 points. Leadership mandates have no direct effect on usage once peer influence is accounted for. The conditions for change are clearer than ever. Culture, psychological safety & trusting relationships aren't "soft" enablers - they’re the powerful mechanisms through which change spreads. In their absence, even the best technology investments fail to scale. Six actions for leaders of change: 1. Create visible learning environments: We can’t scale AI by urging adoption. We scale it by making experimentation seen, shared & socially safe. Learning channels, group forums & dedicated team spaces can make a big difference. 2. Model use publicly: Leaders who demonstrate their own AI use (including their failures) give others permission to try. Seeing a leader use AI in a meeting normalises it more powerfully than any communication cascade. 3. Build psychological safety first: Fear suppresses adoption. People who feared falling behind were less likely to experiment. Safety is not a precondition: it IS the intervention. 4. Invest in social capital: Trusted peer relationships are the channels that AI learning travels through. We must actively build connection within & across teams. 5. Encourage consistently, not in “bursts”. Heavy AI users were 4 times more likely to describe their leaders as "consistent" in encouragement. Lists of approved tools & mandated training modules do not build cultures of learning. 6. Carve out protected time for peer sharing: A standing 15 minutes in monthly team meetings to share AI prompts & real outcomes creates the informal learning loops that formal training never can. The research confirms what change practice has long taught us: people change through their relationships, not through policy. AI rollout is just the latest, most visible proof. https://t.co/C24IDaCaaJ

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• Aug 30, 2026

  What happens when the performance targets we chase take the place of the purpose we set out to serve? Goodhart's Law: "When a measure becomes a target, it ceases to be a good measure." A famous historical example is the "cobra effect". During the British Raj, the government, concerned about the number of venomous cobras, offered a bounty for every dead cobra. Initially, this worked well. Then people started breeding cobras for the bounty income. The reward programme was scrapped so the breeders set their snakes free & increased the cobra numbers. The pattern repeats across centuries & contexts. A modern example involved carbon credits. The United Nations set up a programme to pay companies for destroying HFC-23 (a potent greenhouse gas), a byproduct of refrigerant chemical manufacture. The payments were so lucrative that companies in some countries increased production of the refrigerant specifically to generate more of the HFC-23 they’d be paid to get rid of. Health & care has many “cobra effect” examples. The US Hospital Readmissions Reduction Program penalised hospitals for 30-day readmissions. Readmission rates fell. Retrospective analysis of eight million hospitalisations found that 30-day mortality rose for patients admitted with heart failure & pneumonia. The measure improved. Many patients deteriorated at home. This isn’t an argument against measurement. Every improvement initiative I’ve worked on depends on data. Goals give direction. Metrics help us learn, surface inequity & hold us to account for outcomes we say matter. The risk sits in the moment the proxy measurement quietly becomes the purpose. @Digitaltonto argues that leaders should manage for mission, not only for metrics. He points to many activists touting a “rule” from Erica Chenoweth's research that once a protest movement mobilizes 3.5% of the population, it achieves its goals within a year. Some uprisings mobilised more than 6% of a population & still failed. Others succeeded well below 3.5%. The number described what happened in movements that won. It did not manufacture the winning. Five ways to cobra-proof our metrics: 1) Map the whole system. The cobras were bred because the incentive was designed in isolation from the system it was meant to change. 2) Ask the gaming question before launch. Could a team deliver this number in full without delivering the outcome we care about? If the answer is yes, the metric is already fragile. 3) Pair every metric with a counter-metric. Readmissions with mortality; waiting times with clinical outcomes; activity with the experience of patients & colleagues. 4) Have conversations with teams that constantly bring us back to the bigger context. Stay focused on purpose so that the target doesn't become the proxy purpose. 5) Build fast feedback loops. Ask frontline teams & patients what the data is not showing. Distortion shows up in stories long before it shows up in a dashboard. The work of a change leader is to keep the purpose more vivid than the number. When everyone can see clearly what we are here to do, the measure is more likely to stay in service of it. Links: https://t.co/vIqG5uMSV1 by @Digitaltonto and https://t.co/RudKLxIqQO by Science Insights. Second graphic by @sketchplanator

  11835377.5K viewsView on X
• Apr 9, 2026

  Organisations are not "fungible". “Fungibility” is an assumption that if you redesign an organisation & replace one set of people with a different set, you will still get equivalent outputs. This mistaken belief underlies many organisational restructures: that you can redistribute roles, reporting lines & teams without meaningful loss. I've been reading "Communities Are Not Fungible", a recent essay by @JoanWesten7568. She examines 1960s urban renewal, when planners believed demolishing old neighbourhoods & rehousing residents would allow communities to reform. They didn't. The residents moved. The community did not. A community is not a set of people: it is a historically produced web of relationships between them. Destroy the web, & you have strangers in a building. The parallel to organisational life is uncomfortable. When we restructure, we may preserve many of the people but destroy the relational infrastructure that made them effective. The informal trust that lets someone ask for help. The shared knowledge of who to call when a process stalls. The accumulated understanding of each other's judgment. These live in relationships, not individuals. Redrawing an org chart doesn't transfer them. Research backs this up. Tacit knowledge - the "knowing how" driving real-world performance - depends on trust to flow. Break those relationships & you block the transfer. Studies show informal networks persist along old lines long after formal structures change, creating tension between old loyalties & new mandates. Social capital is the value created by connectedness. It can be destroyed in restructuring & take years to rebuild — a cost that almost never appears in a business case. What leaders can do to protect collective value: 1. Audit informal networks before redesigning formal structures. Use, eg., System Network Analysis or Relational Coordination. Breaking key network nodes causes capability losses no productivity model captures. 2. Treat relational capital as a real cost. Business cases for restructuring rarely account for social capital destruction. Making it visible leads to better decisions & stronger cases for change. 3. Design around high-value relationships. Identify relationships carrying the most trust & history & actively design the new structure to protect them while enabling necessary change. 4. Invest deliberately in building new relationships. Create conditions for them to form through shared work, peer learning & social connection. 5. Give explicit attention to belonging & psychological safety for everyone (not just those who lose or change roles): This creates conditions for the discretionary effort that makes new structures succeed. 6. Slow down at the point of irreversibility. Ask not only "what do we gain?" but "what do we lose - & can we recover it?" The value of an organisation is not the sum of its people's individual capabilities. It is the web of relationships between them. That web is not fungible. Link to Joan Westenberg's essay: https://t.co/GFZo1McA7V. Thanks to @charlie_psych who sent me the essay.

  114403611K viewsView on X
• Aug 2, 2026

  Are we getting "staff engagement" wrong? In a few weeks the 2026 NHS Staff Survey will commence, the largest employee survey in the world. In the 2025 survey, the worsening scores for “engagement” (a five year low) were one of the greatest areas for concern. We tend to treat engagement as a dial. Up is good. As a @NHSEngland Board report stated “a 1% increase in the engagement theme score generally equates to a 1-1.5% increase in productivity”. Down is a problem to fix, with pulse surveys and an action plan. We need some additional thinking. I’ve been reading recent papers based on frameworks from William Kahn, the originator of the concept of “employee engagement” (links in comments). They don’t describe engagement as a dial. They view it as people choosing whether to bring their full selves into a role or withdraw to protect themselves from it. Withdrawal is not an absence of energy. It is energy redirected elsewhere. When we label someone as "disengaged," we mean their energy has stopped flowing toward the organisation's priorities. We need to understand where it has gone instead. In health and care, we can see it going in three directions: - Self-protection: when people feel they have been let down by decisions above them and guardedness becomes a rational response to what they perceive as institutional betrayal - Identity outside the role: when a job stops giving back and people reinvest in family, community, or a professional network that feels more meaningful than the org chart. - Resistance: when people are highly invested in protecting patients or colleagues from decisions they believe are wrong, just not in the direction that leaders want. Disengagement is not apathy. It is agency, just pointed somewhere else. Global data supports this. Falls in workforce engagement are happening across many industries. It is driven less by people in frontline roles and more by a decline in manager engagement, which moves down through their teams. The “disengagement” problem often starts with the people we are asking to fix it, not the people we describe as having it. For those of us leading change in health and care, three moves follow. 1) Replace "how do we engage/re-engage them?" with "what are they engaged in instead, and why did that become more worthwhile than this?" Make it a diagnostic, not a motivational campaign 2) Look one level up before looking at people at the frontline. Engagement is substantially inherited from line managers. Have the conversation with the team leader. 3) Find data on the causes of withdrawal. We can use Kahn’s framework of meaningfulness (a purpose conversation), safety (a trust conversation) and availability (a capacity conversation). We need to understand all three. People are not empty containers waiting to be filled with motivation from above. They are already full. Change leadership means understanding what they are full of and building the trust and conditions for that energy to flow back toward the people and purpose we serve. References: Hart, J. R., & Turesky, E. F. (2026). Work that matters: Knowledge worker employee engagement — insights for leaders and organizations. Organization Management Journal. https://t.co/6vcYPLWRIS Gallup. (2026). State of the global workplace: 2026 report. Gallup. https://t.co/Z9IvIfImq7 Health and care specific: Al-Farsi, Y. (2026, May 26). Systemic moral injury in health systems: When institutions cause harm without intent. Health Care Analysis. https://t.co/22HqsBkMGs Jalali, R., Fatahi, S., & Amiri Kolehjoubi, A. (2026). Quiet quitting in nursing: A concept analysis. BMC Nursing, 25, 163. https://t.co/lHY5nP7iFu The classic article: Kahn, W. A. (1990). Psychological conditions of personal engagement and disengagement at work. Academy of Management Journal, 33(4), 692–724. https://t.co/zGEpUluZZ0

  992113510K viewsView on X
• May 1, 2026

  Why "communication" and "persuasion" are insufficient approaches to change across an organisation or system. Communication campaigns can build awareness, but they rarely change behaviour at scale. Persuasion works well when our audience is already open to change. But when we lead any significant change effort, we work across the full spectrum: people who proactively advocate for change, those who passively accept it, and those who actively resist it. For a large portion of that population, even the most sophisticated argument will not shift their position. We change through our relationships. I've learnt greatly from @Digitaltonto (link at the bottom of this piece). Decades of social science research shows we're profoundly shaped by the people around us: our colleagues, peers and professional community. This influence extends not just to our immediate connections but three degrees out: to their networks and the networks beyond. When researchers have studied people who made major shifts in their thinking (e.g., leaving long-held beliefs, changing deeply ingrained ways of working), they consistently find that change followed a shift in their social environment, not exposure to a better argument. People did not think their way into new behaviour. They were drawn into it by those around them. This has profound implications for how we lead change. The real levers are not in our communications strategy. They're in our social architecture. Five things we can do as leaders of change to build our social architecture: 1) Find the people who are already moving: People who already believe in what we are trying to do and are quietly making it happen. Find them and connect them to each other. We are not creating energy for change — we are locating it. 2) Create the conditions for peer-to-peer spread: People adopt new ways of working when they see colleagues they respect doing things differently. Prioritise proximity over broadcast. Small group conversations, site visits, and shared learning across teams carry more influence than organisation-wide communications. 3) Make progress visible at the local level: Transformation does not announce itself top-down and cascade neatly through an organisation. It spreads when people can see it working nearby, in their context, for people like them. Celebrate local progress loudly and often. 4) Connect people to the difference their work makes. Creating regular opportunities for people to hear from, or spend time with, those they ultimately serve is one of the most underused and most powerful tools we have as leaders of change. 5) Put our energy where it will travel furthest. Build on the readiness that exists, make it visible, and let success do the persuading that arguments could not. None of this makes effective change communication redundant. People need clarity, honesty and a coherent narrative about where we are heading. But that is the scaffolding, not the structure. Change travels through people, through trust, through the invisible threads that connect one person's conviction to anothers. See: https://t.co/k6JJkHhO7X.

  9433345.5K viewsView on X
• Feb 22, 2026

  To thrive and survive as a change or improvement leader in a big system, we need to be competent. We need to be able to redesign processes, apply improvement methods, analyse data, mobilise teams & achieve outcomes. A February 2026 HBR article by Annie Peshkam (“To lead through uncertainty, unlearn your assumptions”) says that this isn’t enough. She distinguishes between “competence” (doing things well) and “capacity” (staying present when action will not resolve the tension). As change and improvement leaders, we have invested heavily in competence: QI methods, governance, pathways, PMO disciplines. We have invested far less in capacity: the inner steadiness, emotional regulation and shared sensemaking that allow us to hold complexity with our teams. Capacity is the ability to pause instead of jumping to solutions; say out loud what is difficult about a change; keep conflict in the room and work with it rather than pushing it into the “meeting after the meeting”. The systems we work in are in sustained uncertainty: financial pressure, workforce depletion, reform agendas, unrelenting demand. Deloitte's Global Human Capital Trends survey of 14,000 leaders found that, in this context, we must look beyond efficiency and predictable results and instead elevate resilience, adaptability, and human connection. Yet our improvement/performance approaches still reward leaders who give quick answers, project confidence and absorb team anxiety. These assumptions shrink rather than expand our capacity to lead. How can change and improvement leaders build capacity? 1) Embed personal practices of pause and reflection into our leadership routines, especially in "high‑stakes" meetings. 2) Start key conversations by naming the tension in the room and giving people time to speak to it before moving to plans. 3) Design our improvement structures (huddles, steering groups, programme boards etc) as “holding environments”, where disagreement and emotion are legitimate data, not distractions. 4) Stop carrying the burden alone: share sensemaking work with our teams, service users and communities, and make that sharing visible. 5) Invest in development focused on emotional steadiness, presence and curiosity, alongside the technical disciplines of QI and "change management". We talk a lot about learning cultures. This article challenges us to cultivate unlearning cultures in addition. The shift from competence to capacity is not a “nice to do”; it is central to our ability to lead change and improvement in the face of relentless uncertainty. https://t.co/nViMIBVw6N

  9426345.4K viewsView on X
• Mar 28, 2026

  A key task for leaders of change is to plan for emergence. This sounds contradictory. Emergence, by definition, cannot be fully predicted or designed in advance. However, planning for emergence is not the same as planning the outcome. It means deliberately creating the conditions, structures & relationships from which new, better ways of doing things can arise. In big complex systems like health & care, genuinely new ways of working do not typically arrive through detailed plans cascaded from the top/centre. They arise through the depth & strength of relationships between people working toward shared intent. This has big implications for how we approach improvement & transformation. Interactions alone are not enough. It is the QUALITY of relationships that determines whether those interactions generate something genuinely new, or simply reproduce existing patterns. Strong, trusting, reciprocal relationships create the conditions for new ideas to surface, be tested & take hold. This reframes what we need to prioritise as leaders of change. We typically invest heavily in frameworks, methodologies & governance structures. We invest far less in the relational infrastructure that makes these elements work. Yet evidence from effective change practice shows that relationships are not the soft backdrop to change. They ARE the mechanism. How we can build a “relational infrastructure for change”: 1) Audit the “relational health” of our systems: not just stakeholder maps, but actual levels of trust, psychological safety & reciprocity across boundaries 2) Design for connection before content: create conditions for people to build relationships before asking them to problem solve together 3) Invest in boundary-spanning roles & practices: connect across organisational, professional & community divisions 4) Slow down to speed up: time spent deepening relational understanding generates faster & more durable change 5) Treat relational breakdown as a system signal: when collaboration stalls, diagnose the relational dynamics, not just the technical problem 6) Build leadership capability in relational practice (“soft skills”): deep listening, holding space for difference & facilitating genuine dialogue are core change competencies, not peripheral ones 7) Create forums designed to strengthen cross-system relationships: not just share information or report progress 8) Measure relational quality as a leading indicator of change capacity alongside traditional delivery metrics This approach to change is not a rejection of rigour or accountability. It’s a more sophisticated understanding of how change actually works in big, complex systems. A tool I use it often in my own change practice (& share with others) is the “voices” model by Bill Bannear. It helps us reorient the work of change from designing the right plan to cultivating the right conditions: https://t.co/CL8n05oUZY

  8129755.4K viewsView on X
• Jul 19, 2026

  Leaders of change and improvement don't typically fail because they lack technical skills. More often, they fail because they never built the relationships that make change possible, or didn't give those relationships enough attention during the change process. A new research-based report, "The Space Between People," by @CCLdotORG defines leadership as a social process: "[Leadership] lives in the trust formed through repeated interaction, the shared understanding that allows people to act without constant realignment and the informal networks through which leadership travels." The authors call this relational infrastructure: "the human foundation that makes leadership possible". For most of organisational history, relational infrastructure developed largely on its own. Proximity and stability built trust as a byproduct of working alongside one another. That condition has gone. AI-mediated communication ("the net effect is more communication but less connection"), hybrid working, global expansion and continuous urgency now actively work against connection forming. Many organisations haven't grasped the implications for leadership, change leadership or leadership development. The symptoms are playing out everywhere: staff survey "engagement scores" keep falling; leaders make decisions based on what the system reports rather than what's actually happening; agreements reached in the room unravel days later; trust that looked solid collapses under real pressure because it was built on role rather than relationship; leaders see only the polished, delayed version of events because they lack the close ties to fill in the gaps; setbacks hit harder and last longer without strong relationships to absorb the shock; and people who feel psychologically unsafe hold back, instead of contributing fully. What should we do? Connection is an interpersonal capacity. We can't build relational infrastructure by developing individual leaders in isolation, however capable they are. We have to build leadership development around the social architecture that makes leadership possible at scale. Four suggested ways to do this: 1) Examine leadership development activities through a relational lens, creating conditions for leaders to work together, not just perform better individually. 2) Design connection deliberately into leadership transitions, when relational infrastructure is most fragile. 3) Invest in the human capabilities AI can't replace: listening, trust-building and boundary-spanning become differentiators, not lower priorities. 4) As senior leaders, visibly model the connected behaviours we want from everyone else. My own reflection (amongst many): we've long assumed that building "shared purpose" or "shared aims" is enough to generate the relationships that change and improvement depend on. This research suggests otherwise. Connection has become something we must deliberately design for, not something we can rely on emerging. Access to the paper: https://t.co/44U5kXoo85.

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• May 18, 2026

  The teams that deliver the strongest performance in periods of rapid change are those that experiment & learn the fastest. That’s a central finding from @RonFriedman's latest @HarvardBiz article "How to Build a Superteam That Keeps Getting Better." He surveyed more than 6,000 knowledge workers across many sectors, including healthcare. He identified "superteams": those getting top scores on performance & effectiveness. Three things set them apart: (1) they get more done by managing time, energy & attention; (2) their members actively make each other better & (3) they keep building skills & improving over time. The research identified seven practices, all relevant to change leadership (here with my comments). Superteam leaders: 1) Run more experiments. Superteams experiment nearly 50% more often than average teams. Small, focused tests beat big rollout programmes. The key leadership role is making it safe to try (& fail). 2) Make curiosity contagious. Leaders of superteams are 56% more likely to ask thoughtful questions & 53% more likely to genuinely learn from team members. In change work, the formal leader rarely holds the most important knowledge. Curiosity is how we access it. 3) Ask "What are you stuck on?" Superteam leaders orient discussions toward problems, not updates that signal control. Issues surfaced early get addressed. The ones buried in progress reports become crises. 4) Roll up their sleeves, even when they don't have to. The difference between involvement & micromanagement comes down to intent. Leaders who work alongside their teams signal no task is beneath them & gain real-time understanding about where change is stalling. 5) Make feedback feel like support. More than 90% of superteam members say their leader delivers feedback that motivates without feeling critical. How we respond to setbacks shapes whether people keep trying — or go quiet. 6) Support team member’s growth, even when it takes them elsewhere. It is not a loss - it’s an investment. Superteam members are twice as likely to feel supported on leaving and three times more likely to remain connected. For change work, that extended network is an asset. 7) Lead with meaning, not just metrics. Leaders of superteams are 59% more effective at helping people understand why their work matters. Purpose is not a “soft extra”. It’s the difference between sustained commitment & change that fizzles out. The article's case study is the Oklahoma City Thunder: a basketball franchise that rebuilt itself twice from the bottom of the league to championship level by trading away stars, abandoning conventional tactics, & treating every setback as data. Their motto is “Labor omnia vincit”: work conquers all things. Those of us leading change in health & care can see the relevance. We build great teams through routine leadership habits: curiosity, experimentation, honest feedback & staying close enough to the work to know what is actually happening. That’s not a change programme: it’s a daily practice. Link to the HBR article: https://t.co/KBe6xet0In

  7631534.5K viewsView on X
• Sep 20, 2026

  To what extent do we use the wisdom of the whole workforce when it comes to resolving difficult issues? I'm a big fan of organisational network analysis (ONA). It maps and measures how communication, collaboration and influence really flow between people. It reveals the "hidden organisation": the informal networks that org charts never show. In leadership circles, we talk a lot about "collective” or "distributed” or “empowering” leadership. ONA often shows a different picture. @RLalleman77215 from @InnovisorInc recently shared data from an example organisation. The top two layers of leadership make up 4% of the workforce. They absorb roughly a quarter of all the requests for help. When those leaders need help themselves, they turn to each other three times more often than they turn to other colleagues. Because the senior group is so much smaller, person for person a senior colleague is around 70 times more likely to be asked than anyone else. Without ever deciding to, the most experienced people in the organisation have arranged things so almost every problem they struggle with is thought about by the same small group. A closed loop at the top: leadership talking to itself. This pattern is not unusual. Rob Cross's research across more than 300 organisations found that 20% to 35% of value-adding collaborations involve only 3% to 5% of people. 766,000 people responded to the most recent NHS Staff Survey. More than half did not agree they are involved in deciding on changes that affect their work area, and the proportion who do agree has fallen for the second year running. We measure it from the other end in the NHS, and the answer is the same. Different measure. Same conclusion. This means that: - A small group with similar jobs and experience makes the decisions, so they all miss the same things. - The people closest to the work hold knowledge that is never asked for, so better options go unseen. - Work queues behind a small number of overloaded leaders, so good decisions arrive slowly or too late. - People stop offering ideas once nothing comes of them and research shows that organisations with lower engagement tend to get worse outcomes. Some actions we can take as leaders: - Audit our own help networks. List the last ten people we went to with a hard problem. Count how many of them do the core work of the organisation. - Map the “hidden organisation”. ONA shows who people go to in practice and where to focus action. It seldom matches the org chart. - Change who is in the room. Make it a rule that decisions about a piece of work include someone who does that work. - Ask the questions only people at the front line or point of care can answer. Go and ask them directly, with nobody summarising in between. - Show what changed. Visible follow-through keeps people engaged. There is a massive, untapped well of wisdom within people inside our organisations. It stays largely untapped for as long as we keep turning to each other when we get stuck. Richard Santos Lalleman's original post (Innovisor organisational network analysis): https://t.co/S4oaSYHBA0 Cross R, Rebele R & Grant A. Collaborative Overload. Harvard Business Review, January-February 2016. https://t.co/AetHUaPtWq

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