Of course, the Government was free to consult any number of management consultancies about how to implement this complicated strategic change management. A recent ‘Mail on Sunday’ investigation based on hundreds of official documents disclosed under the Freedom of Information Act, has revealed the full extent of McKinsey’s links to the controversial Health and Social Care Bill. This newspaper alleges that many of the Bill’s proposals were drawn up by McKinsey, and outlines a number of other specific allegations. The irony is that the NHS has its own specialist unit which produces excellent advice about how to manage change in the NHS.
The NHS has in fact a specialist ‘Institute for Innovation and Improvement’. which is geared up to conduct change management throughout the NHS. Most independent experts feel that the way in which this strategic change has been implemented has been a disaster, and whoever advised on it does not appear to have acknowledged the advice from the NHS’ own change management unit as given on this webpage by Dr Helen Bevan. According to elsewhere on the website, “Helen has led change initiatives at local and national level which have created improvements for millions of patients. Her current role is to keep NHS improvement knowledge fresh, relevant, impactful at the leading edge.” It appears that the unit is heavily influenced by a paper from Harvard Business Review in October 2005 by Sirkin, Keenan and Jackson entitled, “The hard side of change management”.
Here are specific sections of Dr Bevan’s views on change management, and you can easily see why the NHS reforms will run into disaster.
The first factor is duration. An underpinning belief in many NHS change programmes is that we need to execute change quickly. Not necessarily so, say the authors. What really matters is having formal, senior management-led, review processes. A long project that is reviewed frequently and effectively is more likely to succeed than a short project that isn’t reviewed. The second factor is performance integrity. This means selecting the right mix of team members to deliver the change; the most results-orientated people with credibility and influence and effective change skills.
Today, a summit was held where a number of key stakeholders were not even invited. including the Royal College of General Practitioners, Royal College of Nurses, British Medical Association, Royal College of Psychiatrists, and the Faculty of Public Health. As Ben Goldacre has alluded to on his secondary blog, there appears to be a good correlation between those who were not invited to the emergency summit and called for the NHS Bill to be dropped. A recent headline in the Telegraph has provided, “Prime Minister David Cameron today insisted he was “committed” to pushing through the Government’s reforms to the NHS, as he met healthcare professionals in Downing Street.”
The next factor is commitment. The authors focus on two critical categories. There must be active, visible backing for the change from the most influential senior leaders. They say that if, as a senior leader, you feel you are talking up the change initiative at least three times as much as you need to, your organisation will feel you are backing the transformation. In addition, the change is unlikely to succeed if it is not enthusiastically supported by the people who will have to operate within the new structures and systems that it creates. Staff need to understand the reasons for the change and believe it is worthwhile.
This change does not have the backing of the majority of doctors and nurses, and there is absolutely no sense that the medical profession is backing this change. In fact, this BBC webpage gives details of who stands where on the change, and many professional bodies would like to “kill the bill”.
When an issue matters so much to the public, why has the Government accidentally or wilfully turned a blind eye to sound change management advice from its own unit?
