//Methods for effective change management in the NHS

Methods for effective change management in the NHS

Delivery of vital services are reported to be negatively effected when an organisational change is implemented. Some recommendations for managing organisational change are proposed in a paper titled A Case Study of Change Management Effectiveness within the NHS. There is also a selection of interesting literature on the subject of managing change within the NHS, which is related to the public sector environment.

An overview of change management is presented here. It aims to highlight just a few common approaches to change, amongst the vast literature of change management.

Two main models for change:
(1) planned and (2) emergent.

These two models are discusses below for the reason to highlight what the model involve. The discussion does not claim to expose strength, weaknesses or critically evaluate these models. The term psychological contracts is also discussed.



Moves from one fixed state, to another fixed state, through a series of preplanned steps.

There are many models of planned change. One such model is called the ‘Three step model’
(i) freezing — clinging to what one knows,
(ii) unfreezing—exploring ideas, issues and approaches,
(iii) refreezing — identifying, utilising and integrating values, attitudes and skills with those previously held and currently desired.



The emergent model aims to provide a model for change that is less relent on a manager outlining stages and objectives.

Understanding the complexity of the issues, and identifying a range of possible options.

An example of emergent change is a ‘bottom-up’ approach. Such that senior management become facilitators rather than controllers.


Psychological contracts

An interesting concept that is highlighted in this paper is the ‘psychological contracts’. This often referred to in the change management literature and is said to be related to ‘dignity and worth’. If we see a negative impact of change in an organisation, the psychological contract has broken down, and as a result can lead to reduced loyalty, moral and motivation.

If change mangement is of interest to you, then I suggest you delve into the vast literature on the subject. If the NHS or public sector environment is relevant, there is literature focused on managing change in the NHS.