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A taste of leadershipLeading change
effectivelyWhat is change?Types of changeA
change strategyHelping people during
changeUnderstanding and managing resistance to
change Don Garford
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What is change?
An alteration in the state or quality of anything
Substitution or succession of one thing in place
of another
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Types of change(Ackermann)
Developmental
Transformational
Transitional
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Incremental changeHow change happened in the
past in the NHS?
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Transitional change How change happens today in
the NHS
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A change strategyTransitional Change(Kurt Lewin)
Future
Present
Transition
Unfreezing
Moving
Re-freezing
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Transitional Change Identifying 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
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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
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Movement
Methods Re-structuring of organisation Staff
and management development Loads of
communication
Aim To enable the journey to new behaviours
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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
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Assessing the forces at play in a change
Force field analysis
Driving forces
Restraining forces
equilibrium
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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
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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

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Assessing the forces at play in the change
Individual commitment
Opposed Neutral Support Lead
Will oppose the change Will not oppose/will not actively support Will support if someone else takes the lead Will lead
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The change equationa quick risk assessment
Dissatisfaction with the present
The cost of the change
Vision of the future
Safe first step
D x V x F gt R
Beckhard development of David Gleicher
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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

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Allowing too much complacency
Establish a sense of urgency

• Examine the market and competitive realities
• Identify and discuss crises, potential crises, or
  major opportunities

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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

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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

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Under communicating the vision
Communicate the vision whereverwhenever

• 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?
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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

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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

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Consolidate gains and preparing for more change
Declaring victory too soon

• Use increased credibility to change systems,
  structures, and policies that dont fit the
  transformation vision.
• Hiring, promoting and developing people who can
  implement the change vision

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Anchor new approaches in the culture
Neglecting to anchor changes firmly in the
corporate culture

• Continue to support customer or productivity
  orientated behaviour,
• Maintain leadership and management development
• Articulate the connection between new behaviours
  and organisational success

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Helping people during changeThe transition curve
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Managing resistance to changeWhy people resist
change(Kotter and Schlesinger)

• Parochial self interest
• Misunderstanding and lack of trust
• Different assessments
• Low tolerance for change

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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
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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
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Leading changeSome ending hints
Have a strong and coherent vision
The journey is turbulent
Expect and plan for resistance
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New observations on your own change management?