The Changing NHS

A few weeks ago I wrote about DVF>R - a change formula that I often find helpful as a way of framing what’s going on and helping me find a focus for what needs attention.

On reflection, within the NHS, when seeking to bring about significant change, I think managers:

• tend to spend relatively too much time and energy on D and V - helping people to accept the need for change and painting a picture of a desirable future) and
• not nearly enough time and energy on F and R  - helping people take the first steps towards a new ‘state’ and seeking to reduce the strength of resistance to the changes being proposed.

The relative lack of attention to F is particularly puzzling to me because, as consumers, we are all bombarded with ‘ease of first steps’ offers. Take yesterday as an example for me:

First, a letter from Barclaycard offering me 0% for 3 months on balance transfers. Nothing unusual here but the letter goes on to say that the 0% rate will be extended to 9 months if I spend at least £50 per month for the first 3 months after taking up the offer. This very nearly worked. I nearly took the first step.

Second. A few hours later I’m working at my PC. I needed to insert a Venn diagram into a paper and I Google lots of drawing software that can help. One, Smart Draw, offers a free 7 day trial, so I download and use it. I almost buy it on the spot. Almost certainly I will buy this package when I feel I need regular access to this type of drawing software. I’m already a service user!

Some questions:

1. Does the NHS offer enough First Step moments when managing change?
2. Are First Step moments mainly focused internally, on making it easier for staff to take the first steps towards a new way of working?
3. If yes, is offering First Step moments to customers (patients, local communities etc) something that is counter-cultural?
4. Could more First Step moments be offered to NHS customers when managing service change programmes?

Steve

www.stevepashley.co.uk

nhs

change management