The NHS Change Model

Our shared purpose

• Our shared purpose is fundamental to any change and is the place to start - it holds all the other parts of the NHS Change Model together.
• This is about our values and why we joined the NHS - the NHS Constitution sets out a purpose for the NHS.
• Our shared purpose needs to be shaped by everyone involved in or affected by the change. This helps to define what needs to be achieved and how it relates to the things we all really care about.
• It is important to keep revisiting our shared purpose – to ensure that it continues to connect us with our vision for improving people’s lives.

Read more: bit.ly/1oLcwPb

Engagement to mobilise

• Think about who you need to talk to and what you would say.
• Understanding who is involved in and affected by our change means more than just holding a list of names of people involved in or affected by the change.
• We need to understand what motivates them to support the change, so we need to ask questions.
• Our questions need to help us connect with their values - and find out what values we share.
• We are more likely to gain commitment to our change through a discussion about our shared purpose, rather than targets.
• Our engagement efforts must fit with other parts of the NHS Change Model: for instance we must be rigorous in managing the delivery of our change without demotivating people.

Read more: bit.ly/1oLcpmP

Leadership for change

• You can build commitment to a shared purpose from wherever you sit in the hierarchy - we all have a leadership role in delivering change.
• By creating a deeper meaning for the change we can expect our leaders to be role-models of effective behaviours, skills and attributes and set a high ambition for performance; empowering others to commit to action - we can also expect this of ourselves.
• The evidence suggests that the leadership style most likely to deliver large scale change is one that generates a commitment to a shared purpose through collaboration.
• Successful leaders of change will need to bring together all parts of the NHS Change Model to deliver successful and sustainable change.

Read more: bit.ly/1oLcerQ

Spread of innovation

• The NHS has a unique opportunity to spread and adopt good practice between and within its teams and organisations.
• We need to accelerate the spread of innovative solutions to deliver the cost savings required while improving the quality of care.
• This means all of us sharing, learning about and adopting successful innovations from within and outside the NHS Research shows these seven factors that help or hinder spread and adoption of innovation in healthcare: risk taking, resources, tools, information, relationships and rewards.
• There is a wealth of knowledge, tools and approaches that will help us rigorously deliver the spread of innovation and measure our success.

Read more: bit.ly/1oLc5EI

Improvement methodology

• An evidence-based improvement methodology ensures that our change will be delivered in a planned way that follows tried-and tested methods for assuring success.
• The improvement methodology is the game plan - but large scale change across systems will demand different approaches to small scale process improvements.
• Different methodologies are available to support different kinds of change.
• A carefully chosen improvement methodology provides a solid platform for rigorous delivery of the change.
• It will also support the adoption and systematic spread of change.
• There are lots of methodologies e.g. Lean, Total Quality Management, Model for Large Scale Change - choose the one most appropriate for your change.

Read more: bit.ly/1oLbSBt

Rigorous delivery

• Project management (or portfolio programming) is fundamental for delivering a change successfully.
• It involves identifying planned benefits that are of strategic importance, monitoring progress towards planned objectives, clarifying roles and responsibilities and controlling finances and quality.
• Having shared and clear accountabilities will enhance the scale and pace of change.
• A rigorous approach requires discipline and focus and is not optional - without rigorous delivery other elements of the change model will fail.
• It should reinforce activities undertaken within the other parts of the NHS Change Model.

Read more: bit.ly/1oLbDGB

Transparent measurement

• In healthcare, we tend to measure for three reasons: to identify whether planned improvements are taking place, to judge people’s performance on the job, or to inform research.
• Identifying and collecting the most appropriate data is often a bigger task than we anticipate it to be. It requires having a clearly defined shared purpose and this can take time to achieve.
• Making data available to the public (e.g. comparative data) creates a lever for improvement, by increasing patient power and choice.
• Measuring the return on investment from the implementation of change has become increasingly important, as we strive to meet our financial challenges.

Read more: bit.ly/1oLd9sc

System drivers

• Conditions need to be in our favour if the change we want to see is going to work and be sustained.
• Sometimes they aren’t: for instance our payment systems incentivise activity in acute hospitals whilst our policy drivers push for care closer to home.
• System drivers create the broad conditions for change – we need to consider what they are in relation to our change initiative – and whether they can be lined up to support what we are trying to do.
• System drivers might take the form of incentives for change, or specific standards to be achieved if penalties are to be avoided.
• In designing system drivers, we need to ensure that they are to be able to evolve and respond and change appropriately.

Read more: bit.ly/1oLdDP1

NHS Change Model

changemodel.nhs.uk

Do all our leaders have the skills to create transformational change?

Are we designing for the active spread of innovation from the start?

Are we engaging & mobilising all the right people?

Are we using an evidence-based improvement methodology?

Does this improvement meet our shared NHS purpose?

Are our processes, incentives & systems aligned to enable change?

Do we have an effective approach for delivering change & monitoring progress?

Click the speaker icon

to silence the narration

Are we measuring the outcome of the change continuously & transparently?