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What a Difference an NHS Change Day Can Make


Change Day invites anyone working for the NHS, third parties working with the NHS and patients to make a pledge (however pledging is not just on change day – you can pledge now). That pledge is a change they can make to improve or benefit patient care. The idea was seized with excitement and a seemingly ambitious target of 65,000 pledges was set to mark the 65th anniversary of the NHS last year. The official count reached 189,000 pledges, from sources including medical students at the University of York who pledged to create a mock ward, to a doctor who tried his child patient’s medicine to understand what it tasted like.

These pledges have the potential to make a huge and ultimately life-saving difference to the millions of people who use the NHS. However the pledges themselves don’t have to be huge in scale – Change Day’s success is built on small changes that together make a significant impact.

The second NHS Change Day will take place on 3rd March 2014 and a target of 500,000 pledges has been set. Such a movement comes from simple creativity and thrives on simple creativity. Kirstie Stott, Yorkshire and Humber lead for NHS Change Day, borrows a quote to underline the event ethos:

“Never doubt that a small group of thoughtful, committed, citizens can change the world. Indeed, it is the only thing that ever has.”
― Margaret Mead

“I think that quote summarises NHS Change Day,” says Stott. “It’s about people coming together to embrace change and challenge the status quo. You don’t have to be uber creative in your pledge for NHS Change Day, its sometimes just about the simple things, but where the creativity does lie is in thinking about the possibilities of doing small things together that will make a difference. Allowing your mind to think about what is possible and then doing it.”

“It harnesses the passion and dedication of staff who work in the NHS for the same reason, who share the same values, the NHS constitution, the belief that the NHS is there for us all and the reality of it being free at the point of need, it gives us all the opportunity to stand in unity and say the NHS belongs to us all and we are going to be the change we want to see.”


Examples of pledges that have made an impression on the way things are done within the NHS:

• A group of second year student nurses at the University of York pledged to create a mock ward, with students playing the role of patients. Viewing the ward through a patient’s eyes, the students quickly realised how disorientating and frightening a ward can become for patients when they don’t understand what is happening around them. For nurses used to the jargon and processes of a hospital setting, such lessons are easy to forget. The University found it so useful they plan to make the exercise a core part of the curriculum.

• Derbyshire Community Health Services NHS Trust organised over 130 pledges involving over 400 staff. One of the biggest was the mobilisation of over 220 local Innovation Scouts. They also included plans to undertake a ‘mystery shopper’ approach in service areas and make suggestions on how to improve the patient experience; to obtain patient questions via video and play them back at team meetings to discuss feedback and communication with patients and service users; spending more time each week talking to patients, service users and front line colleagues to understand their experiences and concerns and ‘keeping people motivated during these times of change’. Delegates from the Department of Health, NHS and the voluntary

• Delegates from the Department of Health, NHS and the voluntary Sector explained why Equality and Diversity must be at the core of Change Day, directly involved with communities and patients at the local level. One member went onto the street around the Department’s Richmond House HQ in Whitehall, handing out 65 copies of the NHS Constitution whilst engaging with members of the public about how we can improve the NHS.

And here is Kirstie Stott’s own pledge:

NHS Change Day came at a difficult time: 65 years in and morale was low. Kirstie says: “As the song goes, what a difference a day makes… last year we aimed for 65,000 pledges, which was symbolic for the 65th birthday of the NHS. I think some people may have been anxious that this figure was ambitious especially given the position of the NHS at that point in time, with financial pressures, low morale and poor media coverage. However I have worked in the NHS since 1998 and what I do know and can say for certain is that the people who work in the NHS make it the best place to work. It’s not a job, it’s something inside you that pulls you in and drives you: values and passion.”

The making of pledges centres on one day but the impact can be permanent. “I think the main changes are twofold,” says Kirstie. “Firstly it has engaged and empowered a huge amount of staff, they are leading from the frontline and are passionate about doing so, they are standing up for what they believe in and breaking through traditional boundaries. It has also facilitated cross-boundary and multi-professional working, challenging and breaking down barriers that historically can prevent the best care.”

“The second part is the actual pledges themselves. Imagine 189,000 members of your staff each changing something that makes your organisation have better outcomes and be more efficient, in this case ‘patients’ – that’s one hell of a success story.”

As well as proving grassroots creativity is possible in one of the largest public sector organisations, it’s also a powerful lesson in human resources, as Kirstie says: “It is proof that staff are the biggest asset to the NHS, as it demonstrates what is possible. I often see media and publicity about the NHS lacking care and compassion, and not being creative in its thinking and approach, but I would challenge anyone to say that 189,000 people pledging, for no other reason than a sense of personal satisfaction and wellbeing and for the benefit of the public we serve, isn’t doing this. The NHS is a wonderful thing, and of course it’s not perfect, but it’s full of diversity, passion, motivation, determination and values and I believe those are all essential ingredients for creativity to flourish.”

Kirstie gives this advice: “Think about what you would like to see change, remove all those ‘but I can’t, I’m not in a position to change that’ reasons, as NHS change day is about ‘seeking forgiveness not permission’. Pledge as many times as you like – you are not restricted to one chance or pledge. Draw inspiration from others, read current pledges and maybe join one of those. No-one will judge you, it doesn’t have to be grand or large scale, it’s about you and what matters to you, dig deep and be the change you want to see. Share what you are doing with others, give them chance to join you, work together, anything is possible.”

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