www.nelacademy.nhs.

uk
0191 371 3634

Change
Management
Fundamentals

Dr David Yarrow
[email protected]
0191 289 3855
Why does change matter?

Why is ‘change’… and

change management’…
so important to us?
“Every behaviour is motivated by need. Change –
any change – may be perceived as disruptive and
potentially dangerous as the status quo becomes
unstable.”
Maureen Mackenzie

Mackenzie, Maureen (Associate Professor of Management, Dowling College, NY) (2008). Senior
Leadership's Role in the Change Process. www.dowling.edu/faculty/Mackenzie/docs/change.pdf
 What does the literature tell us
about barriers to change?

• It always takes longer than you think

• Exaggerated expectations
• Scepticism
• Impatience
• At least 70 % of change efforts fail to
bring about the desired results!
Delivering change feels complex because it is!

• Our people are intelligent

• Passionate about their work
• Trained to be analytical
• Diverse professional backgrounds
• Faced with challenge, complexity and pressure
• Human
• Stretched
Change is…

Diverse
Constant

Challenging Manageable?
Modellable

Predictable? Variable

Change Management Fundamentals

Change management fundamentals

Main Heading here

Constant

• There’s a lot of “change” about…

– In life
– At work
– In the NHS
• …and there probably always will be

Diverse
Change management fundamentals

Main Heading here Challenging

• People can be ‘good at change’… but we can

also be quite attached to the way things are
• Observing the ways in which people respond to
change ‘situations’, there are patterns, but…
– The same person will probably react differently to two
different change ‘situations’, and…
– Two people will probably react differently to the same
change ‘situation’

Predictable?
Change management fundamentals

Main Heading here

• A change ‘situation’ may be viewed as:
– Opportunity
– Threat
– Major issue
– Irrelevance
– Something I have to make happen
– Something that others are imposing (trying to impose) on me
– Both something that’s imposed on me and something that I have to
make happen

Variable
 Change management fundamentals

Modellable
Main Heading here
• There are lots (and lots!) of
models/frameworks/theories about change and
change management
– None of them are 100% ‘right’ or 100% ‘universal’
– But many of them can be useful
• There are thousands of people working on
‘change’ in healthcare, lots of help/advice
available, lots of great resources.
Manageable?
 Some ‘change models’
Bridges:
Lewin transitions

NHS
Change
Model

Johnson:
polarity
Merrill & Reid: management
personal styles

Rogers:
Diffusion Shapiro: creating
Gladwell: contagious commitment
Tipping Point
 Things they say about change

Transformational Transactional

Emergent Planned

Intrinsic motivation Extrinsic motivation

Pull Push

Soft systems Hard systems

 “Some changes are more severe and challenging than others in their
effects on the organisation and on employees. Managing change
requires you to recognise the type of change you face, then it is easier
to decide how to tackle it.” Mee-Yan Cheung-Judge & Linda Holbeche

Transformational Transactional

• major, strategic changes • smaller-scale changes

• driven by need to align shape & • fundamental nature of the
functioning of organisation with organisation remains unchanged
its strategic intent • relatively simple changes with
• and/or by demands of the reasonably predictable outcomes
external environment • e.g. changes to processes,
• profound, transformative structure, systems
change requires a formal • tends to be aimed at achieving
change model – orchestrated establishd goald in new, better
approach addressing both ways
mechanics of the change and
human/cultural aspects.
Sources: Cheung-Judge,M & Holbeche,L (2011). Organization Development: A practitioner’s guide for OD and HR. London: Kogan Page.
Pellettiere, V. (2006). “Organization Self Assessment to Determine the Readiness and Risk for a Planned Change”. Organization
Development Journal, 24(4), pp. 38-43).
 Transformational Transactional

“The challenge many strategic leaders face [when

attempting transformational change] is that it is NOT
enough to change strategies, structures and systems,
unless the thinking that produced those strategies,
structures and systems also changes.”
Mee-Yan Cheung-Judge & Linda Holbeche
 Emergent Planned

The ‘emergent’ approach The ‘planned’ approach

• outcomes cannot be • change is a step by step
predetermined process
• there is no end point • typically initiated top down
• change comes typically • objectives set in advance
'bottom up‘ • emphasis on thorough
• change can be seen planning and project control
as‘managed learning’
 Either/or…. or both/and ?
Are both the planned and emergent
approaches necessary?
• plans needed to set direction…. but need to be
flexible
• top down support is needed for bottom up change
• objectives need to be set and the team should be
congratulated when each objective is achieved…..
but improvement never ends
• correct use of improvement tools and techniques
should be planned and monitored….. but gaining
the commitment of people is vital
 Intrinsic motivation Extrinsic motivation

• motivation that is driven by • focus on achieving outcomes

interest or enjoyment in the • motivation comes from
task itself outside the individual
• exists within the individual • e.g. targets, performance
rather than relying on management, rewards, threat
external pressures or of punishment
desire for reward • competition is in an extrinsic
• people engage willingly, motivator
enjoy the intrinsic rewards
of the activity
 Push Pull

“Pull” change strategies

• Need for people to realise the connect a change to things
costs & risks of maintaining people care about and desire
status quo v risk & uncertainty of – “change attractors” e.g.
making the change
• benefits for patients &
• Push people by creating carers
discomfort in the system e.g.
educate people about consequences of • positive outcomes for the
not changing, remove buffers and individual
expose people to the consequences of
not changing. • - advantages for their
immediate (e.g.
• Assumption that intrinsic
team/department) and
motivation is not sufficient to
wider (e.g.
bring about change
organisation/profession)
environment
 Formal
Beware – only
organisation
the tip
of the iceberg! Goals, strategy,
structure, systems
& procedures etc.

Values, attitudes & beliefs,

behaviours, informal groupings,
power, politics & conflict handing
styles.

Informal
organisation
Kurt Lewin’s ideas about change

Unfreeze

Move

Refreeze

Kurt Lewin (1940s)

Kurt Lewin’s ideas about change

Force Field Analysis

Resisting Forces
Driving Forces

Current Desired
situation situation
 William Bridges
“The three phases of transition”
?  Time 

The phases are not separate stages with clear boundaries….

 William Bridges’ model of change

For every change, we go through a transition…

• The difference between individuals is the speed at

which we go through that transition, affected by a
variety of factors:
– past experience
– personal preferred style
– degree of involvement in recognising the problem and
developing possible solutions
– the extent to which someone was pushed towards a change
rather than moving towards it voluntarily.

• Change leaders help people recognise the process

and the stages of a transition as something that is
natural.
John Kotter – the eight-stage process of creating major change
 John Kotter – the eight-stage process of creating major change

1. Establishing a sense of urgency Examining the environment & ‘business’ realities

Identifying and discussing crises, potential crises, or major opportunities

2. Creating the guiding coalition Putting together a group with enough power to lead the change
Getting the group to work together like a team
3. Developing a vision and strategy Creating a vision to help direct the change effort
Developing strategies for achieving that vision
4. Communicating the change vision Using every vehicle possible to constantly communicate the new vision &
strategies
Having the guiding coalition role model the behaviour expected of employees
5. Empowering broad-based action Getting rid of obstacles
Changing systems or structures that undermine the change vision
Encouraging risk taking and non-traditional ideas, activities & actions
6. Generating short-term wins Planning for visible improvements in performance, or “wins”
Creating those wins
Visibly recognising and rewarding people who made the wins possible
7. Consolidating gains & producing Using increased credibility to change all systems, structures and policies that
don’t fit together and don’t fit the transformation vision
more change
Recruiting, promoting & developing people who can implement the change vision
Reinvigorating the process with new projects, themes and change agents

8. Anchoring new approaches in the Creating better performance through customer- and results-oriented behaviour,
more and better leadership, and more effective management
culture
Articulating the connections between new behaviours & organisational success
Developing means to ensure leadership development & succession
 John Kotter – Leading Change

Eight common errors in organisational change efforts:

• Allowing too much • Permitting obstacles to

complacency block the new vision
• Failing to create a • Failing to create short
sufficiently powerful term wins
guiding coalition • Declaring victory too soon
• Underestimating the • Neglecting to anchor
power of vision changes firmly in the
• Undercommunicating the corporate culture
vision by a factor of 10 (or
100 or even 1,000)
 John Kotter – Leading Change
Common errors
• Allowing too much complacency • Permitting obstacles to block the new vision
• Failing to create a sufficiently powerful • Failing to create short term wins
guiding coalition • Declaring victory too soon
• Underestimating the power of vision • Neglecting to anchor changes firmly in the
• Undercommunicating the vision by a factor corporate culture
of 10 (or 100 or even 1,000)

Consequences

• New strategies aren’t implemented well

• Changes don’t deliver expected improvements
• Implementation takes too long and costs too much
 References & signposting
North East Leadership Academy: http://www.nelacademy.nhs.uk

Watch out for other NELA workshops on subjects related to ‘change management’, e.g.
‘Leading Complex Change’, ‘Polarity Management’, ‘Tipping Point Workshop’,
‘Innovation and Creativity’, ‘Facilitation Skills’.

The NHS Change Model: http://www.changemodel.nhs.uk

School for Health & Care Radicals:
https://changeday.nhs.uk/healthcareradicals

Bridges, W. (2003). Managing Transitions: Making the Most of Change. 2nd edition. London:
Nicholas Brealey Publishing
Cheung-Judge, M. & Holbeche, L. (2011). Organization Development: A practitioner’s
guide for OD and HR. London: Kogan Page
Gladwell M. (2001). The Tipping Point: How little things make a big difference. London:
Abacus
Johnson, B. (1992). Polarity Management: Identifying and Managing Unsolvable Problems.
Amherst, MA: HRD Press
Kotter, J.P. (1996). Leading Change. Boston, MA: Harvard Busines School Press.
Lewin, K. (1951) Field theory in social science: selected theoretical papers. D. Cartwright
(ed.), New York, Harper & Row.
Merrill, D.W. & Reid, R.H. (1999). Personal Styles and Effective Performance. Boca
Raton, FL: CRC Press
Piderit A.K. (2000). Rethinking resistance and recognizing ambivalence ; a multidimensional
view of attitudes towards an organizational change, Academy of Management Review,
www.findarticles.com
Rogers, E. M. (2003). Diffusion of Innovations.
Shapiro, A. (2010). Creating Contagious Commitment: Applying the Tipping Point to
Organizational Change (2nd edition). Hillsborough, NC: Strategy Perspective