Mersey Care Health Trust: An example of distributed leadership

May 28, 2009
DIY Handbook for Action Learning

DIY Handbook for Action Learning

Mersey Care NHS Trust is developing an international reputation as a creative organization through a range of innovative projects. It also serves as an exemplar for distributed leadership processes

Mersey Care is a major National Health Service (NHS) Trust serving the sprawling region of Merseyside in North West England, and incorporating Liverpool as its major city.

Chief Executive Alan Yates realised a few years ago that a creative organisation needs more than one creative leader. In formulating and implementing a strategy for one of the country’s largest NHS institutions, he realised he would need to find ways of stimulating creativity across the organization, and out into the community. Rather that setting up a formal structure, he encouraged informal networks, giving special responsibilities to Assistant Chief Executive Mandy Chivers. Senior figures at the Trust such as Medical Director David Fearnley were to offer considerable support as the creative initiatives grew.

Liverpool: European Capital of Culture

The trust recognised special opportunities with the regional efforts to promote Liverpool as the 2008-9 European City of Culture. By working closely with other community organisations, Chivers identified a like-minded group of people interested in stimulating creativity with focus on mental health and well-being.

Julie Hanna was quick to see the benefits of such a collaboration in her role as manager for health and well-being programmes:

Creativity, arts and culture are positively impacting on people’s health and well being. Liverpool, as European Capital of Culture 2008, has acted as a catalyst bringing together artists, cultural partners, health and care practitioners. There is a willingness to explore and develop possibilities of working in partnership in a pioneering spirit of “seizing the moment” of Liverpool’s cultural significance. This is another story to tell underneath the large and crowd-pulling events. Through culture and the arts we can find meaning, make sense of our experiences, express our thoughts and emotions, make and sustain relationships, discover skills and qualities in our selves and others. These experiences provide an opportunity to integrate body, mind and spirit; to learn and to make changes in lifestyle

The work included a variety of local and regional events, and an international partnership with Stavager in Norway.

The Creativity Network

Chivers began to find like-minded individuals in and beyond her own organisation, and encouraged a range of creative initiatives grounded in the professional activities of the trust. With strong leadership from Judith Mawer, an informal creativity network developed through which individual efforts were encouraged and supported. In the period of a few years over fifty people became associated with the informal network, sharing ideas, and offering various public events.

The Action Learning Initiatives

Externally, links with Universities were strengthened, and projects sponsored. The focus was to achieve learning through doing, innovative achievements as well as spin-off staff development gains.

The involvement with the Liverpool Year of Culture projects enhanced the strategic efforts both of the trust and the Culture initiative itself.

A similar mutual reinforcement occurred when Mersey Care became involved in another regional initiative, this time around action learning. The heirs to the work of action learning pioneer Reg Revans had being trying to establish a Revans Institute. The trust was to play a major part in the formation of the institute through the efforts of an international network of action learning practitioners which established a home base at Manchester Business School.

Chivers had obtained her doctorate within an active action learning group at nearby Salford University which still houses extensive archives of the papers of Reg Revans. The Trust helped advance the cause of Action Learning substantially, and has produced a practical handbook to initiate action learning efforts.

As indicated on the Mersey Care website:

Action Learning is a simple but powerful approach and a discipline that supports transformational change. It is an effective way that people can learn with and from each other. Groups or sets as they are sometimes called, work through questions and challenge to understand and develop insight in order to take actions that progress complex issues [applying] a rigorous blend of critical thinking, questioning, practical action and emotional intelligence. It does not work instantly or because of something clever outside of ourselves, but because we commit to this discipline and take personal responsibility to act.

Creativity, Health and well-being

The multiplicity of activities under the creativity initiatives were captured in a document by Judith Mawer which lists no fewer than seventeen projects each demonstrating creativity being applied within the context of health and well-being.

Among them, LWD was particularly fascinated by the therapeutic applications of creativity such as the work with Judith of Lynn King and Julie Hannah. The powerful image of a treasure chest as a means of capturing creative ideas is one particularly vivid illustration of a creative methodology.

The creative organization and its leadership

Can we learn something from Mersey Care about the creative organization and creative leadership? Something interesting and rather special is emerging there. The close links between action, innovation and learning mirror the case reports of the celebrated creative organization Ideo.

Both Mersey Care and Ideo have informal structures (as well as the necessary formal ones, required by Health Service statute in the Mersey Care case) . The informal activities enable individuals to introduce creative changes within their individual professional responsibilities, from clinical dispensing innovations to imaginative ways of delivery of service care

Overall, the work of The Trust is increasingly and rightfully being recognised internationally, winning awards, and earning recognition for Mersey Care as a creative organization.

Action learning and leadership

November 30, 2008
MBS Harold Hankins Building

MBS Harold Hankins Building

An inaugural event took place on Nov 26th 2008 at Manchester Business School to celebrate plans for closer links between the regional action learning community and the Reg Revans foundation. The issues discussed show connections between action learning and the processes of creative leadership

Leaders we deserve had an invitation to participate at the event, but managed to miss significant chunks of it. This is therefore in the nature of a personal view. A more detailed commentary can be found on the Revans Academy web-site.

My fragmentary experience suggested a considerable overlap between the processes of creative leadership and action learning.

Power and influence

Kiran Treharn, co-editor of Action Learning: Research and Practice, made a convincing case for the need for a more critical examination of power and influence forces operating within action learning sets. From outside of that community I would extend the point to other types of work group.

For example, research colleagues Susan Moger, Abdullah Al-Bereidi and Ming-Huei Chen have been examining the dynamics of MBA project teams over a period of more than a decade. The research has been reported elsewhere, and I will confine my remarks here to its findings.

Our results suggest that even after a shared training and instructional experience, some groups are more successful than others in avoiding the problems of status and dysfuntional behaviours. This finding challenges a piece of conventional wisdom, namely that teams follow a universal path through the hallowed stages laid down by Bruce Tuckman: form, storm, norm, perform …

Our view, based on a considerable body of evidence, is that a range of factors influence the success of groups we have worked with. We believe that a team’s success is partly determined by supportive (‘creative’) team leadership, and partly by team factors such as willingness to espouse new ideas, and resilience in the face of difficulties.

At the Revans event, Mike Pedler’s contribution suggested that the practice of action learning sets may also be encountering various ‘contingent’ factors influencing success and failure.

The magic number six

Another area which struck me as worthy of a reflective critique, is group size. Action learning practitioners seem to have settled for a standard size of learning set. The reverence for a constant group size across different contexts seems worthy of more challenge than it may be receiving. The mystical significance of the number six may be minimising experience with other sizes of set.

I seem to recall that the quality movement also circled around the magic number six, and Belbin team role enthusiasts favour a rather similar group size to accommodate eight or nine team roles including two leadership styles.

Research on brainstorming suggests that ideational productivity drops off with groups larger than six. Earlier, its pioneer Alex Osborn took a more ‘whatever it takes’ approach, to overcome what he saw at the destructive impact of status differentials in business meetings.

The size of a project team, (and public sector boards) are often far removed from the magic number six.. Size is largely determined by the scale, complexity, and inter-dependencies of the tasks which tend to result in chunking into smaller team units. It should also be noted that even if custom and practice of small-group work points to the benefits to a ‘set’ of a membership of six, we are moving to an era of more virtual teams.

Worker bees have always able to construct marvellous hexagonal structures for their hives, a determined outcome of the geometrics of form. But need we be quite so locked into a neo-Darwinian functionalism in our preference for six as an ideal size for small group activities?

Reg Revans. Lest I forget

November 22, 2008


Some years ago, when giants stalked the land, I tracked Reg Revans down to his lair. I wanted to see whether he could be persuaded of the fact that Action Learning and Manchester Business School might have a shared future. The meeting was not a total success

Reg, with what I now believe to be typical bluntness, explained his beliefs about the irredeemable wrong-headedness of Business Schools in general, and Manchester Business School in particular.

I had been warned that there was a history of missed opportunities for rapprochement from the time of the School’s inception in the 1960s. He did not dwell so much on that, as on the folly of trying to achieve effective management education using traditional pedagogic approaches.

We talked for a few hours. Or, to be more precise, I suspect I listened for most of the time. I can not date the meeting particularly well, but it was most likely to have taken place in the late 1970s or early 1980s. My big idea was that if Reg Revans had not been accepted at Manchester Business School, then he must have been misunderstood. Everything I had heard and read about his action learning approach made it utterly compatible with ideas that were bubbling up in the School at the time. He was spoken of with some reverence by senior figures there, such as John Morris, and also by emerging junior faculty. Surely when I explained, he would see how John’s ideas of joint development activities were close to the work of the burgeoning Action Learning community? And anyway, he would be bound to warm to efforts I was making at the time to introduce creative problem-solving into projects within the MBA curriculum. He would see how the Manchester Experiment (and subsequently The Manchester Method) were far closer to Action Learning than they were to the traditional Business School curriculum.

As far as I could remember, after a frosty start, the emotional climate of the meeting warmed up, but not a great deal. If I had come bearing an olive branch, I seemed to have stuck it right up the nose of the great man. I doubt if he ever set foot in Manchester Business School thereafter.

Time passes

Time passes. Reg Revans completes a fulfilled and long life. With one of those ironic turns, The Revans Institute elects to accept an invitation to make its home at Manchester Business School.

At the introductory event [26th Nov 2008], I was invited to share a concluding session with Mike Pedler. Another irony. Mike had been one of those figures who first enthused me about the potential of Action Learning, all those years ago.

Reg Revans: Action Learning Pioneer

November 8, 2007


William Reginald Revans (14 May 1907 – 8 January 2003) was arguably one of the most influential of British educationalists of the twentieth century. He pioneered Action Learning, which today is among a handful of educational innovations which has survived and developed as a theory of action, and a theory in action

In the course of a lengthy and illustrious life, a mythology built up around this remarkable man. However, in late 2007, definitive biographic materials remained hard to find. For example, in Wikipedia, there was no entry on Revans. You have to explore wikipedia for Action Learning, his professional legacy.

One excellent but brief biographic account provides a glimpse of a remarkable professional career. There are the early critical incidents: a childhood recollection of attending the memorial service of Florence Nightingale (perhaps the story became replicated through his later distinguished efforts within the National Health Service). A discussion with his father, a maritime surveyor who had become involved in the enquiry into the sinking of the Titanic, provided another critical incident. Revans was introduced to the notion that ‘we must learn to distinguish between cleverness and wisdom’, a principle he retained throughout his life.

Revans was trained as a physicist at London and Emmanuel College Cambridge, later working with Rutherford’s Nobel-winning team at The Cavendish laboratories (1932-1935). Rutherford’s approach and team meetings could be taken as exemplars for action-centred learning. At that time Revans had also gained distinction as a gifted athlete, competing to Olympic level.

The Rise of Action Learning

In the 1930s, Reg Revans began his career as a senior manager, initially as Director of Education at Essex County Council, where he also began a long association with the Health Service. These experiences along with emergency service in the London Blitz of 1940, confirmed his growing philosophy (and practice) of learning by doing.

There followed a decade as an academic at The University of Manchester (1955-1965). He had become the first Professor of Industrial Management and he continued to diffuse his innovative ideas of action learning. But it was after he left his University post, that his ideas were to gain international recognition.

The most impressive, and often repeated claim is that his work, through an extensive cluster of active learning projects in Belgium, directly improved that nation’s industrial productivity over the period 1971-1981.

One article summarised the workings of Action Learning as follows:

People learn most effectively not from books or lectures but from sharing real problems/projects. The [action] learning process may be expressed as:

Learning (L) = Programmed knowledge (P) + the ability to ask “insightful” Questions (Q)
Programmed knowledge (P) is conveyed through books, lectures, and other structured learning mechanisms. Insightful questions (Q) are those questions that are asked at the right time and are based on experiences or an attitude about ongoing work projects.
• The learning context must be a real working/project
• Scheduled input of theory knowledge /lectures should be kept to a minimum and more time for time for workshops, meetings and questions
• Commitment from top management and team members with No hidden agendas
• An independent adviser needs to be present from the life of the team to facilitate, help or guide when needed.
• An atmosphere of and openness to confronting sensitive internal issues.
• Flexibility in terms of scheduling

‘Moral Bankruptcy Assured’

Reg enjoyed creating learning aphorisms. One of his favorites summed up his view of the emerging Business School methods and the MBA degree, which he liked to describe as Moral Bankruptcy Assured.

It was an irony that his penetrating insights into the dominant educational model was directed from a member of a University whose Business School prided itself in its own version of learning by doing, the so-called Manchester Method, and whose academics included several international figures such as Stafford Beer, Enid Mumford, John Morris, and Teddy Chester, who were contributing to a non-traditional educational approach. Professor John Morris was but one who became an active participant in the advancement of Action Learning subsequently.

However, we have the nearby University of Salford to thank for keeping alive Action Learning within a vibrant North-West England group of action researchers. By another irony, leading figures have more recently rejoined the University of Manchester, with plans to develop further the theory-in-practice ideas of Reg Revans.