Leading Change – lessons from the NHS – making sure your change is properly embedded!

The Department of Health headquarters in Whitehall
The Department of Health headquarters in Whitehall (Photo credit: Wikipedia)

I’ve worked on a lot of business change programs.  But when I first started working on them that was not what they were called; around the NHS, we had lots of “reorganizations”!

The longest period of my career was spent with the UK Department of Health.  Not long after I started, the Government initiated a major re-organization of the NHS – the one that led to the first appearance of “Area Health Authorities”, if I remember it correctly.  Not long after the start of the program, victory was declared and the change was regarded as complete.

But, of course, it wasn’t complete – the change was not embedded; things started to go wrong!

Guess what? We had a further reorganization to put things right.  And, of course, victory was acclaimed again.  And again, things went wrong.

So, it became a repetitive cycle, as governments of different political colors learned the hard way that changing the NHS just ain’t easy!  It really doesn’t do a great deal for your political career and, hard as you try to, you can’t de-politicize it and give all the risk to someone else.  But that doesn’t stop the brave cavaliers in each government trying again, does it?

I spent too long as a Civil Servant to now indulge in Party Politics.  Enough to say, that it was watching those repeated failures that got me interested in large scale change in the first place.

What seemed rather grotesquely obvious to me (ex-nurse and, oh, too many years in the Department), was that none of these changes was allowed time to truly embed!

Politicians live within the election cycle – democracy in action.  Their Political survival requires quick results to convince voters.

Unfortunately, large and complex and very organizations (like the NHS), can’t be turned round quickly.  Behavior takes time to change and culture usually lags long behind behavior.

Most of us don’t have anything as complex as the NHS to change.

But we do need to make our own changes stick/embed (Kotter Stage Eight).  We need to make the change become part of the core of the organization!

What can you do to help this along?

Well you need to make efforts continuously to ensure that the change is seen in every aspect of your organization. This will help give that change a solid place in your organization’s culture.

It’s also important that your company’s leaders continue to support the change. This includes existing staff and any new leaders who are brought in. If you lose the support of these people, you could end up back where you started.

What else can you do?

  • Continue to talk about progress every chance you get. Tell success stories about the change process, and repeat other stories that you hear. Give everyone a clear picture! But DON’T talk about the change being “over”.  If you do that, some people will just sigh a sigh of relief and revert to the previous state.
  • Include the ideals and values of the change in every new corporate event.
  • Remember those ideals and values when hiring and training new staff or making deals with new contractors.
  • Publicly recognize the achievement so far.  Make much of those who have worked so hard to get you this far!
  • Recognize and reward publicly those who truly demonstrate the change in their behavior – even if that recognition has to be quite modest in the present climate
  • Don’t throw up your hands and declare a failure just because the outcome isn’t perfect – no change is perfect – good enough is what it needs to be..
  • Create plans to replace key leaders of change as they move on. This will help ensure that their legacy is not lost or forgotten.

I would love to hear about your own experience of large scale change. As for the NHS, well it belongs to all of us in the UK and everyone of us has a view – talk about Soccer Mums!

Kotter Reading List for you;

Related articles

  • Leading Change and the virtue of patience (wisewolftalking.com)
  • Leading Change – dealing with fears and facing up to resistance(wisewolftalking.com)
  • Leading Change – get your vision into people’s minds and keep it there!(wisewolftalking.com)

Wendy Mason works as a personal and business coach, consultant and blogger. She has managed or advised on many different kinds of transition and she has worked with all kinds of people going through personal change. If you would like her help, email her at wendymason@wisewolfconsulting.com or ring ++44(0)2084610114 or ++44(0)7867681439 or