2021 – 2022

Supporting Diabetes UK to understand and strengthen the impact of their leadership programmes on systems change, and to create a learning culture of ongoing improvement.

The Backdrop

Without significant change in policy and programming, 5.5 million people will have diabetes in the UK by 2030, some suffering life threatening consequences, including premature death. Successful prevention and care is a whole system challenge requiring the empowerment of patients, mobilisation of resources and joined up and culturally appropriate services that tackle root causes and help people manage the condition.  

Transformative leadership is needed to marshall all stakeholders and major programmes of work to address a challenge of this scale. Health care professionals are positioned well to lead, yet they receive insufficient training in the skills to navigate and collaboratively shape complex organisational environments. In recent years, Diabetes UK has made efforts to meet this challenge by launching leadership training programmes for health care professionals as part of its mission to transform diabetes care. 

Diabetes UK asked Collaborate to help them understand the impact of the leadership training and build on successes, with a particular focus on systems leadership.

What we did

Working closely with the team over a period of three months in a series of participatory online workshops, we used a qualitative and participatory approach to evaluation called Most Significant Change (MSC). The method generates and analyses personal accounts of change, enabling us to discern the impact of the Healthcare Improvement Team programmes. 

Using the MSC methodology we interviewed programme participants, developing powerful and engaging stories and discussing the significance of these in regards to the programme design and delivery. This process revealed that while participants gained valuable interpersonal skills and confidence from the programmes, they were not equipped to recognise the systems they worked in or to identify where they could most effectively intervene. It highlighted significant changes to date and illuminated the shifts needed to achieve the team’s ambition of developing systems leaders for diabetes prevention and care.

Impact and Learning

The DUK team and healthcare professionals engaged positively with the Most Significant Change methodology. In bringing these stories back to the team through reflective discussions and exercises, we were able to pinpoint the changes the team most valued, and explore how future impact evaluation could help improve the programmes iteratively. 

We combined the case-specific findings from the DUK project with our own experience of delivering best practise systems leadership programmes in other contexts. This resulted in the development of seven shifts, ranging from a traditional organisational-focused leadership approach towards system leadership, that are required of leaders working in diabetes care, whatever their role. Among the seven shifts are ones in mindset and behaviours.

Having explored these shifts with the team, we turned them into a set of design principles.

The design principles describe the qualities of the leaders that DUK aspire to nurture with their programmes—leaders who are equipped to change systems and therefore transform outcomes for people. These will be used to design future leadership programmes, and to help understand the impact of these programmes on future participants and, in turn, the wider conditions that lead to better outcomes for diabetes patients.

It’s been such a pleasure working with you and we really appreciate the obvious time and effort that’s gone into this from your end. I’ve particularly appreciated how collaborative the process felt and how much you listened to us, even when we’ve not always known what we’re trying to get to! I know this will be transformational for our work.

Tamsyn Nichol
Senior Healthcare Improvement Consultant, DUK