Lean practitioners have always been very passionate about sharing their experiences and knowledge so others also can benefit from better processes and reduced waste. When lean practitioners get together to discuss and spread knowledge, the 'implementation of lean' is often at the core of the conversation. How do we get others to understand the nature of lean and how do we get them to implement it? Despite clearly documented, positive outcomes and strong business cases, we still encounter resistance and it can be challenging to even get our own colleagues to be engaged with lean.This paper explores what motivates individuals with different project roles to work with lean, when some research shows that knowledge and will is not enough to change. It considers why incentive measures and a focus on time and cost savings could have a negative impact on the motivation to change for some groups. This discussion is supported with survey data and experiences from a major infrastructure project and within the organisation of the client, Highways England.

Background Little interaction between managers across different directorates No sense of ‘team’ amongst managers Lack of consistent approach and varying degrees of management experience Aim Set standard for leadership & management amongst middle managers Raise confidence of managers in dealing with staff performance Develop team working across departments Enable managers to contribute to and deliver the Hospice 5 year plan Approach Used Researched suitable providers, developed partnership with Lancashire Teaching Hospitals NHS Foundation Trust Leadership and Organisational Development Team Training Needs Analysis - rated confidence across different leadership and management areas and then prioritised for development. Key components: 7.5 days of group training Leadership & Management Situational Judgement Test Self-assessment against NHS Leadership Framework 1–2-1 with advisor Group project work / presentation Impact evaluation (due June 2013) ILM Level 5 qualification Outcomes ‘The difference in the first Management Team meeting following the course was tangible and exciting. Colleagues were more confident, open and prepared to actively challenge and contribute. I came away greatly encouraged by the credible difference which entirely justifies the investment that we made into establishing an Education Team that can sharpen our business effectiveness at every level just at a time when we need it most!’ – Stephen Greenhalgh, CEO In my directorate, confidence in their own ability springs to mind, they have been committed to the appraisal scheme and cascading from the business plan to performance plans” – Lorraine Charlesworth, Director of Income Generation “My attendance on the Management course assisted me to reflect on my Management style and enabled me to increase delegation to my staff. It also improved my working relationship with my line Manager and other Managers on the programme.” - Cheryl Scott, FamilySupportTeam Manager “One of the most practically useful courses I’ve ever been on - combined theoretical and applied knowledge made the content easily transferable to the workplace. I have already implemented many changes within my team." Katie Russell-Paddison , HeadofAdmin Key Operating Principles Developing leadership for a new era Developing the hospice workforce

Pioneering development that blends informality, self-help, peer support, information and sustainability in a unique mix of charitable and commercial income generation alongside community development.BackgroundVision: That all in Central Lancashire facing life shortening illness have quality of life and dignity in death.Our current model cannot deliver this.InfluencesDying for Change – Charles Leadbeater, 2010‘support will be impossible unless we encourage conversations … so people are more able to shape what happens’Commission into the Future of Hospice Care – Help the Hospices, 2013people want ‘easy access to information and regular conversations’the future lies in ‘maximising the potential that consumers and the community have’Local discussion with patients and families about their experiences of end of life carePracticalitiesRenovation of a dilapidated barn into Café and Community Palliative Care Centre50% funded by Capital Grant12 month building projectOpened 24th November 2014Project aimsServing the whole population by empowering people to help each otherOpening up to reach outSocial enterprise through commercial and community developmentSustainable income to support the main hospiceKey featuresWelcoming café serving high quality, wholesome mealsVolunteers providing basic emotional support to bereaved, lonely, worried, anxious peopleInformation sessions with experts to plan for end of life e.g. local solicitors, civil serviceAn informal ‘introduction’ to the hospiceA range of activities to attract new groups of supporters – craft workshops, light exercise classes, room hire to businessesImpactCafé sales 278% up on forecast56 people supported through advisor service Dec 14 to Mar 1553% of those that answered the question ‘had no previous connexion with the hospice’What would they have done if they hadn’t spoken to an advisor, of those that answered the question40% would have done nothing or had ongoing stress/anxiety54% said that they would have sought help from a health professional