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Chapter 14
Tools to help you plan and
support self care
Tool 14
Moving through change
Why you should use this
People tend to resist change, especially when they work in a busy NHS setting. By understanding the current difficulties and the new vision, people will be pulled towards a change.
When to use this
When you are planning tomake a change such as promoting a self care culture in your
PCT or practice.
What to do
Look at the equation below. Work through what you can do about the four factors on the left hand side of the equation:
Dissatisfaction x Vision x Capacity x First steps > Lower resistance
Factor 1: dissatisfaction
- How satisfied is the person/the people who will be affected by the change, with the
current state of things?
- Is any dissatisfaction shared with their colleagues?
- How is the dissatisfaction understood and experienced?
Factor 2: vision
- What do they want for their patients, themselves and their colleagues?
- What are their values and beliefs, goals and desires?
- What could the new system look like?
Factor 3: capacity
- What resources are needed to achieve the change?
- How can resources be generated or shared?
- Have people shown in the past that they are willing to try out new ideas?
- Is there anyone who has demonstrated the energy and capability to make changes?
Factor 4: first steps
- What first steps could people undertake which everyone agrees would be moving in the right direction?
How it works (insight)
Generally, it is better to pull people towards a change rather than push people into it. Realise that the costs and risks of maintaining the status quo may outweigh the risks and uncertainty of making the change.
Whom to engage
Any individual or team involved in planning for and making change happen.
How much time you should allow
An hour initially, with ongoing review in the course of the change process.
What a facilitator should do
Facilitate the initial discussion, and keep tabs on progress at and between the intermittent reviews while the change is underway.
What to do next
Organise review meetings as the change gets underway, looking for positive drivers to
keep up the momentum for change.
What makes it work better
Find role models to enthuse people affected by change.
What can go wrong
Change is so dramatic and sudden that there is insufficient time or positive momentum
to create the climate for change to happen naturally.