Considering the number of major organisational changes that have happened in the NHS, you would think that we would all by default be change experts.
No doubt some of us are, or believe we are. Most practices heave a collective sigh, crack on with the necessary work and get there in the end, while at the same time continuing to offer a comprehensive service to patients.
But what if we could get better at looking after our most precious resource, our staff, during the change process? Wouldn't that mean that we both navigate the change itself and keep individuals and the team as a whole on track during and after the change?
Key to successful change management is getting the people bit right. Without that, you may find yourself trying to work in the new way surrounded by a lot of very unhappy, stressed people who are not performing at their best.
What steps should your practice follow in order to manage its people through a major change?
Have a leader
Change is never successful if there is not an effective leader, equipped with the necessary skills and understanding. You may need to free up the time of the right individual if the change is major enough and important enough.
Plan for people
It is important to plan for people as well as processes. In addition to identifying what the new structure will look like, physical changes, communications, systems and so on, the leader must plan to understand what people will experience as a result of the change process.
What will actually be different? Think through the change in detail so that you can tell people specifically what will be different for them.
Again at the individual level, think through what the impact will be. Who will have to move to a different post? Change their hours? Sit with someone else? Move to a different part of the building? Take on work they might not enjoy?
However altruistic and dedicated to the practice, the minute you impact on elements of the working day that matter to people, they become self-centred and who can blame them? Change feels difficult. Things that look unimportant in the 'big picture' of moving forward can become gigantic personal issues and it is the leader's responsibility to acknowledge and take care of this.
Change is also a good opportunity for troublemakers. Plan for the obstructive or destructive behaviours you know will arise and take action if necessary.
Listen to concerns
As leader, whether GP or manager, you have probably been considering this change, how to manage it and the impact it will have for months. Not everyone else has. It may well be news to quite a surprising proportion of the team. While they are digesting the news (and wondering what its impact will be on them), you are way ahead.
Stop and come back. Think about the following. You may have managed change in the past in a way that has made people suspect that this change will not be a pleasant experience. It is human nature to have a big and possibly angry initial reaction. Recent economic pressures on the health service and jobs market have made even seemingly secure jobs feel insecure.
Consider a feedback mechanism so that people can voice their feelings, concerns and ideas throughout the change process. This may take the form of a forum on the intranet, a notebook at the front desk, emails to the manager or a Team Morale group. The important thing is that you do not ignore what is fed back.
Inform members of staff
Inform people about:
- Steps in the plan.
- Setbacks and solutions.
Importantly, identify multiple ways to communicate with team members. If you do everything by email, then you run the danger of falsely reassuring yourself that everyone has understood what is happening.
Information gaps are filled by gossip and conjecture, most of which will be inaccurate and some of which may be harmful.
You need to find a variety of methods. In addition to emails and minuted meetings, consider the following ways to communicate: a notice board in a prominent place which everyone can add to, a snazzy, eye-catching newsletter and the practice intranet.
Give everyone a role
Find ways of involving everyone in the change in some way. This reduces the sense of being a 'victim' and enhances a feeling of control and influence over what is happening. Staff could get involved in the following ways:
- Being in a working group.
- Looking after a particular task.
- Investigating a new piece of equipment.
- Suggesting a solution to a problem.
- Making a presentation to the team about an aspect of the change.
Finally, look for an opportunity to have a celebration. You may not fully have moved into the new method of working, but at some point you will be almost there and marking the occasion is a good way of saying thank you.
- Fiona Dalziel is a practice management consultant, www.dlpractice management.co.uk