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Writer's pictureJames Mannion

How to change the world

This post includes:

  • A TEDx talk

  • The backstory

  • An illustrated transcript (including the really good bit I forgot to say due to nerves)

  • And a call to action...


The talk

Having watched the talk, do you think Vertical Slice Politics is impossible, inevitable - or are you somewhere in-between? Join the conversation here - let's make this thing happen!


The backstory


Last Christmas, I received a WhatsApp from a friend saying there was soon to be a TEDx event in my hometown of Brighton, and that perhaps I should apply to do a talk on Learning to Learn.


At first, I dismissed the idea. As obsessed as I am with teaching self-regulated learning, it didn't really feel like TEDx material. But then, slowly, an idea for an alternative topic started to form in my mind.


I have recently developed a second obsession - implementation science, a new field of study that has emerged in the last 15 years or so in an attempt to bridge the research-practice gap in healthcare. For about five years now I have been reading everything I could on implementation science and change management. Often, it felt as though I was hacking my way through a jungle of jargon: the literature on change management is riddled with the stuff. But occasionally I would find myself so dazzled by the elegant simplicity or the deep explanatory power of an idea, that I would feel compelled to venture ever-further down the rabbit-hole.


Eventually, I felt I had gathered enough ideas together to do something useful with them. I created an 'Implementation Science for Schools' (ISS) programme for schools - and, to cut a long story short, it's been going down like hot cakes. More recently, I've created an online version of the ISS programme to make it easier to implement these powerful ideas at scale. I'm also currently writing a book - Making Change Stick: The Art and Science of Implementing School Improvement - which should be out in early 2023.


There are many powerful ideas in the ISS programme but the main idea - the big idea that drives the whole approach, really - is the Vertical Slice Team (VST). I won't go into this in detail because I explain it in the video above and also in the transcript below. But essentially, instead of leading change in a top-down way (which is what almost always happens), you assemble a VST comprising a representative sample of people from throughout the organisation to plan and execute the change process. So, in a school, a VST might include:

  • A senior leader

  • A middle leader

  • An early career teacher

  • An experienced teacher

  • The Special/Additional Educational Needs and Disabilities Co-ordinator

  • Teaching Assistants / Learning Support Assistants

And sometimes - depending on the change initiative:

  • Governors

  • Parents/carers

  • Pupils

  • Other members of the support staff

Working with a VST is insanely effective because a) you combat groupthink and create much better policy, and b) you bring the community with you, harnessing untold reserves of intelligence, problem-solving capacity and goodwill.


The more I have seen this approach working like a dream in schools - at the same time as our global and domestic politics has been unraveling at the seams - the more I have started to wonder... what if we had vertical slice politics? I recently read the excellent Why we get the wrong politicians by Isabelle Hardman, and this thought occurred to me at least a hundred times.


And so it was that, slumped on my mum and dad's sofa in the wee small hours of the morning - no doubt on the business end of an excess of port and walnuts - I rattled off a two-paragraph application to TEDx about how to fix politics and took myself to bed.


Several weeks later, I discovered - to my delight and surprise - that my application had been successful. (In fact, several months later I learned that mine was the only 'cold' application the organisers had accepted - all the other speakers were head-hunted. I think this says more about the power of the idea than my 2am prose). *


And so it came to pass. Originally my talk was called 'Implementation Science for the People' - you can still glimpse this briefly in the recording. But later I realised that was a terrible name, and so I changed it to 'How to change the world'.


All the other talks from that day were released in August, but mine wasn't. Eventually I learned that 'Big TED' had highlighted my talk as "one we'd like to notify to our subscribers, as it represents a valuable and timely idea for our global audience". Which meant a further agonising wait of 4 months, since it seems 'Big TED' has no shortage of valuable and timely ideas. But it also meant that when my talk was finally released yesterday, it landed with a splash rather than a dull thud. At the time of writing, it has had over 20,000 views in less than 24 hours since it was released.


I've received lots of incredibly positive feedback from people so far, and it seems that this 'people-powered politics' idea may just have legs. But also, transitioning to a system of vertical slice politics is obviously an insanely complicated and ambitious thing to even contemplate, and I am under no illusion about the scale of the challenge this poses.


In the spirit of the Vertical Slice, this morning I created a 'Mighty Network' - a kind of community forum thing - with a view to bringing people in to the conversation to think through what this might look like in practice.


All comers are welcome. If you would like to share your thoughts on this idea - whether you think it's impossible, inevitable, or you're somewhere in-between - please let me know your thoughts. You can do so here.



The illustrated transcript


Due to nerves, I forgot to say part of my talk, which is really annoying because it was a good bit. But thankfully I think the general gist comes across anyway. The bit I forgot to say is highlighted in bold, below.



In about ten minutes from now, I'm going to explain how we can transform life on earth into the happiest, most harmonious, least bad thing imaginable.


But first, we need to talk about the apocalypse.



75 years ago, a group of atomic scientists invented the Doomsday clock. You may have heard of it, but in case you haven’t, it's kind of a fun, accessible way of visualising how close we all are to not existing any more.


The idea being that we face a number of existential threats - climate change, nuclear war, various forms of terrifying technology - and if we don't learn how to manage these risks, then the clock will tick forward to midnight, at which point, presumably, some form of doom will ensue.

In 1947, freaked out by the fact that they had just invented the weapon that could end civilisation as we know it, the atomic scientists set the clock at 7 minutes to midnight. And there have been various ups and downs ever since, as you can see here.


In 1991, following the end of the cold war, the clock was briefly dialled all the way back to 17 minutes to midnight. And this is the least doomed we’ve been in the last several decades.


Since then, as you can see, for the last 30 years or so, we have been drifting in a decidedly doomward direction. In 2020, the Doomsday clock was set at 100 seconds to midnight - and there it remains to this day. So we're counting in seconds now. Which doesn't seem good.



According to the Bulletin of Atomic Scientists - a group that includes no fewer than 11 Nobel laureates, so these people are no slouches when it comes to crunching the data - we are - and I quote [read card] - "the closest we have ever been to civilisation-ending apocalypse”.


Now. Today's conference is called "this could be our future." So let’s be real for a moment. Civilisation-ending apocalypse could be our future. It could be our near-future.


But the Doomsday Clock also tells a more optimistic story. In the last 60 years or so, there have been eight occasions when the hands of the clock have been dialled backwards. And on three occasions, we’ve made successive steps in the right direction.

This pattern - two steps forward, three steps back - is something that repeats across many areas of human endeavour.


For example, in the world I know best - education - there's an incredibly stubborn, hopelessly unfair disadvantage gap, whereby the biggest predictor of educational success is your parents’ bank balance.

In recent years, we've made some headway in closing this gap slightly. But the gap is now widening again, year on year - and this was happening pre-pandemic. It's even worse now.


We might also look at life expectancy. In 1900, life expectancy in this country was 48. It's now 82. Which is astonishing really, isn't it?

But progress is faltering in this area, too. In many areas of this country, life expectancy is going down for the first time in decades. Again, this was happening pre-pandemic. It's even worse now.


In each of these examples, a clear pattern emerges.


We know how to make the world a better place. We just don't have the hang of doing so consistently.


Yet.


But.


We're in luck.


In recent years, a new field of study has emerged - implementation science - which is the study of how to bring about lasting, positive change in real-world contexts.



I first came across implementation science eight years ago, and I've become increasingly obsessed with it ever since.


Three years ago, I created an implementation science toolkit for schools. I've now shared this toolkit with hundreds of schools all over the world, and honestly, the feedback has been unbelievable.


And the comment I receive most often?


"I wish I'd known this years ago."


I'd like to share with you one idea from the implementation science toolkit - the big idea that drives the whole approach really.


And then I want to ask you the question that keeps me awake at night.


The big idea is the vertical slice team, and this is something I first came across in the world of healthcare.

In particular, researchers wanted to know to what extent evidence-based practice - gold standard, best practice - is actually being practiced out in the world. So these researchers went into hundreds of hospitals and healthcare centres and looked across a wide range of health disciplines.


And they found that on average, it takes 17 years for a piece of evidence-informed practice to achieve 14% coverage across the healthcare system as a whole.

Which is terrible, obviously. Both of those are bad numbers.


What this means is that should you find yourself in a hospital, there's a surprisingly high chance that you’ll receive a suboptimal treatment, despite the evidence being available that other treatments may be more effective.


And so these researchers thought “well this is ridiculous, how can we fix this?” And one idea they had was to use a Vertical Slice Team.

In a Vertical Slice Team, you take a cross-section through the organisation and you get different types of people sitting around the decision-making table.


And so instead of having the big decisions made only by senior managers and clinicians, which is what usually happens, you put together a Vertical Slice Team that will include senior people, but also junior doctors and nurses, hospital administrators, patients - all the people who have a valuable perspective on the problem you're trying to solve.


And so you look at the problem through multiple lenses if you like, and then you write - and then execute - a detailed implementation plan - often over like a 3 to 5 year period. So this is not just a consultation exercise - the vertical slice team essentially becomes the executive, tasked with overseeing this particular policy.


And so it's not top down, but it's not bottom up either - it's people at all levels of the community working in harmony, toward a common goal.


And we find that when you implement change in this way, we can achieve 80% coverage within 3 years.


Which is a bit more like it.

Let me give you an example of what this looks like in practice.


A few years ago, medics at the Cincinnati Children’s Hospital became concerned by the very high level of hospital admissions due to asthma.


To get to the root of this problem, they reached out into the community and assembled a Vertical Slice Team including school nurses, pharmacists and asthma patients themselves.


The school nurses said: kids are forgetful. They’re always leaving their medication at home. So they made sure that asthma medication was always available in school.


The pharmacists said: people often don't pick up their prescriptions because they work long hours, or don't have a car. So they started delivering asthma medication to people's homes.


And many of the asthma patients said: my landlord won't do anything about the damp and mould in my home. So they provided legal aid to take on the landlords.


Within 5 years, hospital admissions due to asthma had halved. In the following 3 years, readmissions reduced by a further 50%. This led to a 24% reduction in school days missed, a 30% reduction in absenteeism from work, and significant financial savings for the hospital.



This is what you might call a win-win. Win. Win-win.


This is just one of many examples of how Vertical Slice Teams can help bring about lasting, positive change in real-world contexts.


Currently however, this approach is very much the exception, rather than the norm.


Why?


This guy.

The top-down monster.


Education, health and politics are all run by a small group of people who sit at the top of the system - senior leaders, NHS directors, cabinet ministers - who make decisions about what needs to happen, and then they just kind of tell everybody else what those decisions are.


And to be clear - top-down implementation is good for some things.


Specifically - low effort, high impact things.

Things like the smoking ban, for example, which came in 15 years ago in this country. Relatively easy to introduce, huge impact on public health. Great.


But when it comes to high effort, high impact stuff - complex problems that require complex solutions - things like fixing social care, or the rapidly escalating cost of living crisis, or not sleep-walking into climate catastrophe - top-down change is hopelessly ineffectual.

Why? Three reasons.


First: initiative-itis.


We know that it takes 3-5 years to implement lasting, positive change.


But the people at the top are rarely in the same post for 3-5 years.The average cabinet minister is in post for 1.3 years.


We all know how this goes. Each person wants to make their mark. So they introduce a change initiative, which is often a bit half-baked because they're making it up on the hoof.


Then they move on, the change initiative quietly collapses behind them, the next person comes along and the whole jolly jape begins again. And again. And again.


This leads to a condition that goes by many names. Initiativitis, innovation overload, fad-tigue. This too shall pass. Teachers have this phrase that they mutter under their breath as the latest change initiative is announced: "This too shall pass".


Initiativitis is incredibly corrosive. It makes people sceptical and increasingly cynical about the possibility that lasting, positive change is even possible. Next: top-down change goes against human nature.


Put simply, people don’t like being told what to do - even when it's a good idea.


This becomes apparent at a very young age, when you do something for your child and they go "No! Me do it!"


And this hard-wired need for autonomy continues into adulthood. In the workplace, many people rank autonomy as being even more important than how much they get paid.


People just really like to feel that they have a small amount of say of what they do, when and how. And top-down change starves people of that need.


Finally, the mother of all problems - groupthink.


You may have noticed that people tend not to contradict their boss when they're wrong about something.


Partly because it would be awkward and embarrassing to do so.


But also, contradicting your boss in public is perhaps not the best way to advance your career.


Perfectly understandable.

But such groupthink - where the desire to avoid conflict leads to bad decision-making - has caused many a catastrophe over the years:


  • Plane crashes and space shuttle disasters

  • The 2008 financial crisis

  • And there was plenty of groupthink in evidence during the covid pandemic


Often, these decisions are being made by intelligent, capable, highly qualified experts.


And it's a good idea to have such people in the room when you're making big decisions.


But what you don’t want is to have ONLY intelligent, capable, highly qualified experts sitting around the decision making table.


You also need people looking at the problem through fresh eyes.


You need people who are willing to ask the so-called stupid questions.


Because when someone says “can I ask a stupid question”, what they often really mean is “is it just me, or is this a terrible idea?"


--


Vertical Slice Teams provide us with a powerful antidote to each of these problems. And as we have seen, the approach is incredibly effective.


School leaders I've worked with tell me that once you've implemented change in this way, there's no going back.


Why?

Well, firstly, you create a much better policy because you’ve looked at the change process from every angle, anticipating problems and solving them in advance.


Secondly, people throughout the organisation know that they are represented on the Vertical Slice Team - that there is someone like them who will represent their views and interests and with whom they can interact throughout the implementation period. And so you get buy-in like never before.


And thirdly, Vertical Slice Teams work with the grain of human nature, rather than against it, understanding the importance of autonomy and giving everybody a voice and a choice.


And that's the best antidote to groupthink that there is.


--


Which brings me to the question that keeps me awake at night.


In fact, it's a series of questions, and they all start with the same two words: What if?


Because we face so many high effort, high impact problems at this point in time. And I don’t know about you, but I don't see anyone in power with a clear implementation plan that will deliver us, in a step by step fashion, from where we are to the more harmonious, less hair-raising state of world affairs that we all know is possible.


There is a version of life on this planet that has the most amount of joy and the least amount of suffering. If we choose to, using the tools of implementation science, we can dial back the hands of the Doomsday Clock to half past six in the morning and transform this world of ours into becoming the happiest, most harmonious, least bad thing imaginable.


This too could be our future.


And so to the what ifs.


What if we had vertical slice politics?


What if the Department for Health and Social Care was run by a vertical slice team comprising doctors, nurses and patients in social care, for example?


What if the Department for Education was run by a vertical slice team comprising teachers and school leaders, parents and carers, and young people themselves?


What if young people were involved in making decisions around energy and climate change, working alongside engineers and business leaders and climate scientists?


What if all of these people understood how to use implementation science to bring about lasting, positive change in real-world contexts?


And what if this was happening in every country on the planet?


There are many such "What if" questions, and in each case, the answer - it seems to me at least - is that vertical slice politics - rooted in the practice of implementation science - would be infinitely preferable what we have currently.


By way of a final word, if I may.


I discussed this idea recently with a Professor of Political Science, because I wanted to know whether this has ever been tried before. To my amazement, it turns out it hasn't. Truly representative, people-powered politics. Never been tried. It seems so obvious.


Anyway, he'd been nodding along and he seemed to agree that Vertical Slice Politics would be better than what we have currently. And then I said "it's a bit ridiculous isn't it, to think that we could actually make this happen?"


And I thought he was going to agree. But instead, he said something really interesting. He said


"That's what people always say about progress. Ending slavery. Women's suffrage. Creating the NHS. At first, people say it's impossible, that it will never work, that it's naive to even suggest it. But then, something remarkable happens. One day, it doesn't seem impossible any more. Suddenly, it seems inevitable. And at that point, people will come together and make it happen."


So. What do you think?


Do you think vertical slice politics is impossible, inevitable, or are you somewhere in-between? And wherever you are on this spectrum - I'd love to hear your thoughts.


Because it's a hundred seconds to midnight folks. And the clock is ticking. And the house is on fire. Still.


We’re in a tight corner. And nobody is going to fly in to save us from ourselves.


So let’s pop the top down monster back in his box, and implementation science the shit out of it.


Having read the transcript, do you think Vertical Slice Politics is impossible, inevitable - or are you somewhere in-between? Join the conversation here - let's make this thing happen!


--


* I would like to say a HUGE thank you to the TEDxBrighton organisers, Toby Moore and Alyx Manly, for their incredible supervision and guidance. My talk was infinitely improved due to Toby's insightful feedback.

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