What is change?

1. A “taste” of leadershipLeading change effectivelyWhat is change?Types of changeA change strategyHelping people during changeUnderstanding and managing resistance to changeDon Garford

2. What is change? An alteration in the state or quality of anything Substitution or succession of one thing in place of another

3. Types of change(Ackermann) Developmental Transformational Transitional

4. Incremental changeHow change happened in the past in the NHS?

5. Transitional change How change happens today in the NHS

6. A change strategyTransitional Change(Kurt Lewin) Future Present Transition Unfreezing Moving Re-freezing

7. Transitional ChangeIdentifying where we are going? Future Empowering Patient led Allowable risk Long term Open decisions Present Autocratic Professional led Safety first Short term Opaque decisions Transition

8. “Unfreezing” • Methods • Providing feedback from surveys and patients • Vividly outlining the vision of the future • Putting in place a “safety net” Aim To unlock present patterns of behaviour

9. “Movement” • Methods • Re-structuring of organisation • Staff and management development • Loads of communication Aim To enable the journey to new behaviours

10. “Re-freezing” • Methods • Introduce reward systems that reward desired behaviour • Develop feedback systems across the organisation Aim Stabilising new behaviours to make them relatively secure against change

11. Assessing the forces at play in a change “Force field analysis” Driving forces Restraining forces equilibrium

12. Purposes of a force field analysis To identify who is involved in the change To map who will help or hinder the change To inform planning To inform the likelihood of success

13. Force field analysis • Do a force field analysis for the following change Increasing the quantity and quality of collaborative working between pharmacy services and other professions • Identify 5 forces for each direction – wherever possible with individual named people

14. Assessing the forces at play in the change Individual commitment

15. The change “equation”…a quick risk assessment Dissatisfaction with the present The “cost” of the change Vision of the future Safe first step D x V x F > R Beckhard development of David Gleicher

16. A change strategy - why change fails! (adapted from John Kotter) • Allowing too much complacency • Failing to create a sufficiently powerful coalition • Underestimating the power of vision • Under communicating the vision • Permitting obstacles to block the new vision • Failing to create short-term wins • Declaring victory too soon • Neglecting to anchor changes in the corporate culture

17. Allowing too much complacency Establish a sense of urgency • Examine the market and competitive realities • Identify and discuss crises, potential crises, or major opportunities

18. Failing to create a sufficiently powerful guiding coalition Create a strong guiding coalition • Put together a group with enough power and authority to lead the change • Getting the group to work together like a team

19. Underestimating the power of vision Develop a vision and strategy • Creating a compelling and enticing vision. • Develop performance and people strategies for achieving that vision

20. Under communicating the vision Communicate the vision… wherever…whenever • Plan to use every vehicle possible to constantly communicate the new vision • Having the guiding coalition role model the behaviour expected of employees Paired discussion For your recent change what evidence was there of a communication plan?

21. Permitting obstacles to block the new vision Empower broad based action • Get rid of obstacles • Change systems or structures that undermine the change vision • Encouraging risk taking and non-traditional ideas, activities and actions

22. Failing to create short-term wins Generate short-term wins • Planning for visible improvements in performance, or “wins” • Visibly recognising and rewarding people who made the wins possible

23. Consolidate gains and preparing for more change Declaring victory too soon • Use increased credibility to change systems, structures, and policies that don’t fit the transformation vision. • Hiring, promoting and developing people who can implement the change vision

24. Neglecting to anchor changes firmly in the corporate culture Anchor new approaches in the culture • Continue to support customer or productivity orientated behaviour, • Maintain leadership and management development • Articulate the connection between new behaviours and organisational success

25. Helping people during changeThe transition curve

26. Managing resistance to changeWhy people resist change(Kotter and Schlesinger) • Parochial self interest • Misunderstanding and lack of trust • Different assessments • Low tolerance for change

27. Handling resistance Education and communication Participation and involvement Facilitation and support Negotiation and agreement Manipulation and co-option What strategies are most evident in your organisation Explicit and implicit coercion

28. How to lead changeSummary • What is change? • Types of change • A change strategy • Helping people during change • Understanding and managing resistance to change Final reflections Reflect upon what we have covered in this workshop and draw one conclusion for you as a leader of change

29. Leading changeSome ending hints Have a strong and coherent vision The journey is turbulent Expect and plan for resistance

30. New observations on your own change management?