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information and contacts. Tis level of involvement is far beyond that usually found in L&D programmes and means champions never have to start from a blank page or work in isolation.

Impact and feedback

In terms of the impact of the programme, this has exceeded all expectations and there are multiple examples of directly

correlated change. Tese include: ` `

Reducing medication errors in hospital (46.9% to 26.7%).

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Reducing instances of serious hypoglycaemic episodes in hospital (15.5% to 6.9%).

Implementing new care guidelines.

Increasing the number of limb screenings (18.2% to 34.4%).

Securing funding for a new role of Schools Educator in Wales.

Designing new staff training initiatives.

Delivering training to schools. Reducing call-out numbers.

Participants consistently comment that, since becoming a champion, they have the credibility and potential to affect change. Dr Deborah Wake from University of Dundee/NHS Tayside explains that “the programme enables people to achieve things they never thought they could in terms of diabetes care improvement”. Diabetes specialist nurse Debora Brown said she had “a say in service planning implementation”, and Dr Justin Warner says that, in addressing a serious problem in schools for children living with diabetes, “the initiative literally opened doors to meetings with Assembly members and civil servants within the government”. “Te NHS is so complex. In

many instances nobody knows who has the right to make decisions. By conferring on somebody a title, changes can be owned, led and most importantly, accepted and followed,” says Amy Rylance, head of Healthcare Professional Engagement, Diabetes UK. Champions also report having the

authority and skills to immediately react to ‘threats to care’ as they occur, and for their role as change agents and leaders to expand beyond their specific change initiatives. One example of this was the reversing of a decision made due to funding

miscalculations and lack of knowledge to take people off insulin pumps – a very serious situation condemning patients to worse health outcomes. Widening the scope of impact fur-

ther, champions have become involved in engaging policy decision-makers in national and local government and in being the expert voice within Diabetes UK campaigning activities. For example, champions attend meetings

from the partners are pooled. ``

Te creation of a community of learners who share examples of innovation and struggles, as well as advice and support.

With the support, vision and development offered, participants begin to believe in new possibilities and imagine a different reality. Healthcare professionals acquire a new authority, a strong sense of responsibility and the role of leader. From this, momentum and drive

Every aspect of the programme emerged in collaboration and from talking boldly about the failings

at parliament where they raise local issues with MPs relating to diabetes, and host MPs in their local clinics to highlight pressing diabetes care issues. When there is a big national news item, champions are also offering themselves up to Diabetes UK without hesitation, helping to get important messages out to the public. Te knock-on effect supports the overall programme goals by further enhancing champions’ credibility and strengthening their impact within their local health system.

How and why the model works

Te goal of improving healthcare delivery has been made a reality by a partnership outside the system galvanising those within it to make the

changes needed. Crucial factors are: ``

Tat the partnership understood the complexity and scale of the challenge but are detached enough not to be overwhelmed by it.

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Tat the power of a title is utilised to give power where needed to those within the system with the expertise.

Tat recruitment is according to frontline experience and passion, rather than hierarchical position, and is completely voluntary – there is no personal gain or formal promotion for participants.

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Tat each cohort is multi-disciplinary – bringing in the ‘whole system’ and uniting, for the first time, all elements in the diabetes pathway. Tat resources, expertise and contacts

follows. As Diabetes UK champions they start approaching their CEOs not with more problems, but with solutions and concrete plans. On being listened to, for many for the first time, the action escalates. Another important factor is

that every aspect of the programme emerged in collaboration and from talking boldly about the failings. Programme content and direction was only set once participants had been met and worked with, and their needs and focus areas identified. Participating diabetes healthcare specialists (65 to date/four cohorts) now have, through the programme and association with Diabetes UK, the credibility and the authority to ensure diabetes is taken seriously and kept high on the agenda, and the skills and understanding to influence others across organisational boundaries, tackle threats to care and deliver change. Te snowball effect to emerge only

serves to enhance the work. As changes are experienced by professionals and patients up and down the country, the energy, credibility and leadership of champions for affecting positive change also grows, with the result that more is being achieved daily. Te model has galvanised and em-

powered healthcare professionals to own the challenge, embrace the complexity, commit to addressing threats to care and deliver the changes needed.

Guy Lubitsh is Client Director at Ashridge Executive Education and Amy Rylance is Head of Healthcare Professional Engagement, Diabetes UK. Organisations wishing to find out more can read an extended case study about this programme at

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