As a senior lecturer in healthcare leadership I have long been intrigued by power, influence and different models of leadership.

Of the leadership gems that I quote, my favourite comes from The Chinese philosopher Lao Tzu who explained:

The wicked leader is he whom the people despise. The good leader is he whom the people revere. The great leader is he of whom the people say, “We did it ourselves".

Ironically it is this quote from 2,500 years ago that perfectly encapsulates what would now be called New Power values. This is a philosophy of leadership that opposes the “Heroic leader” paradigm and recognises power not as a limited currency but an electric current coursing through the veins of an organisation.

But, as Heimans and Timms the authors of New Power describe in the compass below, these values on their own are not enough to liberate colleagues or cause transformational change. There also needs to be the right structure to enable this. As in the examples of Airbnb or Gumtree, genuine coproduction needs to be enabled through an effective infrastructure.

Below: The "New Power Compass"

The new power compass

Increasingly I was seeing examples of what Heimans and Timms described as co-opters - old power values in a new power model. In these organisations at the top left of this chart, power is still held by the few as encapsulated by the “Facebook Farms” where users are considered units of resource without intrinsic value or worth.

This attitude is betrayed in the “You said, we did” notice boards that flourished across NHS organisation a few years ago. These were heralded as examples of staff empowerment but actually implied that the doing was still doable but only by those above you in the organisation.

My frustration with this model is that too often this propagates the status quo with only tinkering around the edges and, as the crisis in healthcare rumbles on, it is akin to moving the deckchairs on the Titanic.

More fundamental change is needed and that could only come through those at the bottom of the organisational pyramid who have the greatest contact with patients and service users.


I co-founded Hexitime with John Lodge as a healthcare skill exchange and timebank with a vision to address this by rocketing us towards the crowd base model at the top right of the graph. One that could be paraphrased by improvement notice boards that emblazon “We said, we did.

At the core of Hexitime is an operating model that believes that we all have something important to contribute to healthcare improvement and that this can be realised when everyone’s time is valued equally.

A guiding principle in Timebanking is that you give an hour and you get one back. An hour of work gives you one credit, irrespective of your band, gender, ethnicity or pay point. You are then free to use that credit on the platform as you wish, or even donate it to someone else.

Moreover, anyone can launch or contribute to a campaign which then has national exposure. If you post an idea, then it will be judged on its merits and others can contribute towards it and make it even better than you had envisaged.

Walsall Together

Following our pitch to the Walsall Together partnership board; I'm delighted to announce that my local Integrated Care Partnership has bought into Hexitime as a platform for staff to share ideas, share expertise and support improvement campaigns.

Walsall together is the name for an alliance of healthcare organisations including local GP practices, Walsall Council, Walsall Healthcare NHS Trust, Dudley & Walsall Mental Health NHS Trust, local commissioners, and local not for profit organisations such under one banner.

In partnering with Hexitime, the Alliance aims to harness the skills, ideas and passion of Walsall Together’s staff to deliver health and social care improvement across Walsall. But don't take my word for it...

Hexitime has the potential to channel the Black Country STP’s improvement activity and campaigns and really mobilise our workforce in a radically different way.

Richard Beeken, CEO Walsall Healthcare NHS Trust and Black Country STP

Hexitime has been chosen by the Walsall Together Alliance as a transformative way to ignite collaboration across the system and connect innovative ideas.

Daren Fradgley, Interim Director of Walsall Together

Both Richard and Daren recognise that to create change and shift outcomes at the pace and scale that is needed involves deploying mass participation and peer coordination in radically different ways. By becoming partners and committing to grow the platform, Walsall Together have become pioneers in this space as healthcare enters the sharing economy and Hexitime provides the opportunity for its members to collaborate around the issues that matters to them.

My reflections on the Hexitime skill exchanges over the first few weeks is that liberating the creativity of the staff who deliver healthcare is what will save healthcare.

Exchanges have been varied and surprising, and left givers and recipients better informed, more appreciated and inspired. In every exchange current is being generated to power them individually and collectively forwards.

Another of my favourite leadership quotes from Martin Luther King (Jr) is this:

A social movement that moves people is merely a revolt. A movement that changes both people and institutions is a revolution.

As healthcare enters the sharing economy, I am delighted to announce Walsall together is on the forefront of the revolution. This partnership is the first such partnership for Hexitime.

Our vision is to facilitate improvement within health and social care across a variety of member, organisation, special interest, regional, national and system levels.

If you want to be join the Hexitime movement, please post an offer, request or idea or run a Hexithon to engage your team.

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View member profile "Hesham Abdalla"

Hesham Abdalla

Clinical Lead for Quality Improvement

As a consultant paediatrician, I understand how giving can be more fulfilling than getting and have...

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