Managing change

“The only thing that is constant is change” (Heraclitis, 500 BC)

Having experienced extensive change over the last few years – in response to political, economic, social and environmental imperatives – health and social care practitioners will recognise the truth in this statement.

The COVID-19 pandemic further accelerated the pace of change in health and social care organisations and increased the challenges experienced by the sector. Although some degree of change is essential to avoid stagnation and ensure improvement, people also need predictability and order.

The Labour Force Survey (Health and Safety Executive, 2023) highlights change as a major source of work-related stress. People often react to change with feelings of uncertainty, anxiety and fear, and their motivation and engagement can be reduced (Oreg et al., 2011). Managing and communicating proposals for change effectively is therefore integral to a resilient organisation.

Leaders may be familiar with Kotter’s 8-Step Change Model (see below), which sets out key principles for the effective management of change; more information on its use can be found here. However, Kotter’s approach may not fully capture the complexities of managing change in health and social care organisations, where several change processes may be occurring simultaneously.

1. Create a sense of urgency

2. Build a guiding coalition

3.Form a strategic vision & initiatives

4. Enlist a volunteer army

5. Enable action by removing barriers

6. Generate short-term wins

7. Sustain acceleration

8. Institute change

The Big Opportunity

As outlined below, for any change initiative to succeed it is crucial to manage the whole organisational system. The Health and Safety Executive (HSE) provides guidance to help organisations manage and communicate change, which is summarised below:

• The organisation provides employees with timely information to enable them to understand the reasons for proposed changes.

• The organisation ensures adequate employee consultation on changes and sufficient opportunities for employees to influence proposals.

• Employees are aware of the probable impact of any changes to their job. If necessary, they are given training to support this.

• Employees are aware of timetables for change.

• Employees have access to relevant support during changes.

See here for more information.

The HSE’s approach to managing work-related stress recognises the importance of assessing practitioners’ perceptions of the effectiveness of change management and having conversations about the impact. They also provide guidance on the competencies that leaders need to manage change successfully (see KFP5 Wellbeing for more information).

Although the HSE guidance can help leaders implement organisational change effectively, it is important to consider the specific needs of different types of organisations. Leaders of health and social care organisations may find the following tips useful when planning change initiatives.

Achieving effective change

• Develop a communication strategy to support practitioners to understand why the change is necessary and how this will benefit teams and services.

• Communicate clearly and transparently the motivation for change and inspire commitment to the reasons and potential benefits of the change.

• Identify how others may receive the change; carefully consider the impact of feelings of loss, uncertainty and anxiety, and manage this in an emotionally sensitive but constructive way.