Change – this time it’s personal! Sue Price Head of Service Improvement Shropshire and Staffordshire Strategic Health Authority

“while the primary stimulus for change remains those forces in the external environment, the primary motivator for how change is accomplished resides with the people within the organisation” Benjamin and Mabey Facilitating Radical Change (1993)

Background “Change may be an imprecise science, but evidence is available on what works and what does not, and the NHS must make use of this.” White Paper - “A First Class Service”

Challenges and opportunities for the NHS Changing pressures of the environment Multiple stakeholders ~ internal/external Changing technologies Complex organisations ~ interdependence People ~ experience of change interventions ~unforeseen/unintended consequences

Why do we need to change hearts and minds? If we only change hearts people accept changes but do not understand them If we only change minds then people are not committed to the changes

‘Any improvement is a change, not every change is an improvement, but we cannot improve anything unless we change it’ Goldratt, Theory of Constraints (1990)

Change means doing things differently! It creeps up on people…... They nod happily about need for change They vigorously agree with the new ideas but.. They become nervous when they realise that they need to do think differently, not just other people

How comfortable are you? Do you find the idea of change exciting or uncomfortable?

Change and learning Comfort Zone Panic Zone people close up they freeze they don’t learn Comfort Zone P.Senge (2000) 12

Change and learning Panic Zone Comfort Zone Discomfort Zone Uncertainty Learning 13

Helping People to get to the Discomfort Zone Encourage them to trial new things (even if they don’t work) Create systems and processes that encourage a habit of experimentation Provide support It is OK to say “I don’t know” Understand process of loss and bereavement Don’t impose change Create ownership and involvement 16

“It” is not Change - “It” is Transition Change is a “doddle” –it happens – its external Transition is an internal process of adjustment Help people to: Let go of the old Move through the neutral zone Accept the challenge of the new IT is not change , this is external IT is transition and how people handle it internally Help people through the process – its part of your responsibility William Bridges

Three phases of transition Ending Neutral Zone Beginning Describe diagram TIME

Help people to understand why ‘it’ is happening “People responsible for planning & implementing change forget that while the first task of change management is to understand the destination and how to get there. The first task of transition management is to convince people to leave home. You’ll save yourself a lot of grief if you remember that”. William Bridges Leaving home

How well do you know yourself? Are you ready to get to know yourself better?

Personal Styles ANALYTICAL DRIVER AMIABLE EXPRESSIVE Task focus Aggressive Passive Combinations along the polarities – give us our motivational drives AMIABLE EXPRESSIVE People focus Merrill & Reid, Personal Styles and Effective Performance (1999)

How To Decide on your Personal Style Quick questionnaire Don’t over analyse Check with other people Work and home styles may be different Most people will have a predominant and back up style but will be able to adopt approaches from other styles A small number will not be able to identify a predominant style

Personal Styles Analytical Driver Amiable Expressive formal measured + systematic seek accuracy Driver business like fast + decisive seek control Amiable conforming less rushed + easy going seek appreciation Expressive flamboyant fast + spontaneous seek recognition Not everyone has 100% of one style Identify your main style

Working with others What are the strengths and weaknesses of this personal style? How can others best communicate with this personal style

Analytical Driver Amiable Expressive under stress: fears: Consider yourself in a situation of change: How do you behave under stress? What are your fears about change? Analytical under stress: fears: Driver Amiable Expressive

Under Stress Driver Analytical Amiable Expressive will become autocratic Analytical will withdraw Amiable will submit Expressive will become offensive or sarcastic

Fears Analytical Driver Amiable Expressive not enough information making a wrong decision being forced to decide Driver loss of control failure lack of purpose Amiable not being liked not fitting lack of social status not being recognised for efforts Expressive being ignored being asked for detail being linked with failure

Finding the balance Task focus ANALYTICAL DRIVER Get it right Get it done Aggressive Passive Get along Get appreciation Combinations along the polarities – give us our motivational drives AMIABLE EXPRESSIVE People focus

It’s all about balance To get it done You need to get it right To get it right you need to get along This shows we need to work in all quadrants To get along you need to make people feel appreciated

Three Phases of Transition and Personal Styles AMIABLE Ending ANALYTICAL Neutral Zone DRIVER Describe diagram EXPRESSIVE Beginning TIME

“If you always do what you do, you will always get what you got”. So do something different Albert Einstein Any questions about what has been covered in this section?

Have you ever resisted a change? Tell us about it and why you resisted

Why do people resist change? Even the most well thought out, positive change will be a threat to some existing thing of value to some people. “Every act of creation is first and foremost an act of destruction” Pablo Picasso STOP! – let us think – why do people resist change What is change? – view quotation – creation out destruction Rhetorical Question:-What do people “really” value?

Resistance is “feedback” A “resistor” – term applied to someone who “makes your life difficult” or “gets in the way” of the plan If your starting point is something wrong with the person & their resistance is “an illness to be cured” Better to see resistance as An attempt Maybe poorly communicated, emotive, even hostile To tell you something about the change how it is being managed What is a resistor? Ask people to define Look at resistance as a form of communication, no matter how difficult it is.

Common reasons for resistance – the “vital few” A desire not to give up something of value A misunderstanding of the change and its implications A belief that the change does not make sense to the organisation A low tolerance to change The Vital Few – are the key change reasons researchers have found people give for them resisting John Kotter & Leonard Schlesiger – Harvard Business Review 1979

Variation in response Normal distribution curve of reaction to change in organisations Distribution curve within the organisation Where are you operating the most? Active resistors Wait & see Enthusiasts

Do not use all your energy on active resistors Use your energy to shift distribution Consider which key players are in which category & manage them accordingly Use your time and energy wisely Active resistors Wait & see Enthusiasts

Characteristics of Opinion Leaders Higher social status More years formal education Greater literacy Higher aspirations and ambitions Tend to belong to larger groups Demonstrate empathy, rationality Exposed to and use variety of media Greater knowledge of innovation E. Rogers

You cannot always take everyone with you True of large scale changes in the way an organisation works and behaves Invitation Ignoring Coercion Expulsion In project of the scale most of you are operating – this is important to remember On this scale: Are you operating all the way along the range or in a specific area You may have to use some or all of these! Involves actively removing people who do not work with the requirements of the change Maximises the likelihood of people wanting to take part in the change Focuses on achieving a critical mass Uses organisational power to force people to accept change

Look for Motivators and Attractors

So… the next time you encounter resistance Take time to engage in dialogue Display genuine curiosity Help them explain Remember their viewpoint Identify the assumptions Show your position Test – using various “what if” cases If it does not work – slow the process down Professor Sarah Fraser 1. With the presumed resistors – recognising your point of view may not be the “right” one. 2. About others feelings & views 3. The reasons for rejecting change 4. Is rational to them – try to understand their point of view 5. That both sides are holding – bring these into the open and discuss them 6. In a way others can see it 7. To see whether the resistors are ready to accept change 8. Keeping the dialogue open & honest

Go to the people Live amongst them Start with what they have Build on what they know And when the deed is done And the mission accomplished Of the best leaders The people will say “We have done it ourselves”. Lao Tzu