Time for a change

THE Greek philosopher Heraclitus once noted that “Nothing endures but change”, while renowned political author Arthur Koestler remarked that “The only thing which likes change is a wet baby.” These two quotes seem to capture the general attitude to change – it’s inevitable but few people like it!

With massive changes afoot in the NHS, managers face great challenges, from increasing patient expectations, tightening budgets, changing roles within general practice and the prospect of GP commissioning.

How then does a manager steer a team through an eternally shifting environment? The first step is recognising that change is not simply an organisational transition, but a process that involves each individual within the organisation adopting those changes and modifying their day-to-day working.

As a change leader you are effectively asking each team member to engage and change, not simply running through a process of adjusting procedures around your team. Change can have a significant psychological effect on both individuals and the team as a whole. Some may start to behave differently, boundaries become fuzzy, and people often have to rediscover their identity within the team. It’s important to account for these psychological and emotional reactions rather than only planning for the hard, quantitative outcomes.

Be prepared to manage people through their experience of change. There may be resistance from some and morale may drop, but you should create an appealing vision of the future and develop a strategy for making it a reality. Consider ways of maintaining motivation within the team and be prepared to help steer them through it to give them the incentive to move forward. Individuals can sometimes find their own way but sometimes they need guidance.

Research suggests that the biggest cause of change failing is that people do not understand why they are being asked to change. Organisations will often efficiently take care of the ‘how’ element of change management – hard measures and outcomes, financial forecasting, Gantt charts coming out of their ears – but neglect the ‘why’. Team members will usually be concerned with a number of issues:

• Why are you asking me to change?

• Why are the skills that I have developed with the existing system now no longer required? • What benefits will this change bring?

• How will I gain the skills and knowledge needed to feel okay with this new system?

• Can I visualise how I will fit into the new picture?

Addressing these questions early in the change process can enable individuals to understand their thoughts surrounding the changes, the vision of where and why the organisation is changing and how they are going to cope and fit in with these changes. This involves the singularly biggest element of successful change management: communication. That means explaining where we are now, where we need to get to and why, and how we are going to get everyone there.

An inclusive way of managing change is to have managers paint the broader brushstrokes of where the practice has to get to, and in what timescale, and enlist the help of those who are directly involved in the transition to fill in the steps required to get there. This method takes some of the pressure off managers and allows the people who will be using the system to feed their invaluable knowledge into the process and understand what the end result should look like, whilst also addressing the practical day-to-day issues. This addresses another of the biggies in change management: participation. It is vital to not only plan and monitor change, but to gain the commitment of those who will be affected by it. If a team member has contributed to the new system, and has practical input, then there is more opportunity to feel engaged and have a sense of ownership over the initiative.

Another important factor in leading your team through change is understanding how you feel about it. Incremental changes which are internally generated through recognising how systems and processes can be improved will have a different impact than changes introduced through an external influence where the practice has little choice. This may be the introduction of a new IT system or the practice entering the world of GP commissioning. Understanding how you feel about it on an emotional and practical level will provide great insight into how you will lead your team through it. Be sure to address any reservations you may have before trying to promote a change to your team as it will make for a more authentic communication strategy – personally and organisationally.

Leading a team effectively through change requires an understanding of all the management ‘tools’ – effective leadership, open communication strategies, problem-solving skills and ultimately an understanding of your team and your own strengths and challenges. Change should not happen in an uncontrolled way so be sure to create a good plan, communicate your vision of change, engage individuals and recognise what needs to happen to support them – i.e. training sessions or team meetings. Make sure the change is adopted consistently by everyone in the practice – particularly those at senior levels – and above all be sure to communicate effectively with everyone involved.

Cherryl Adams is a trainer and risk facilitator with MDDUS Training and Consultancy