STRATEGIC CHANGE MANAGEMENT NHS - Essay Example

? Strategic Change Management – NHS Table of contents Understand the background to organizational strategic change 1 Discuss models of strategicchange 3 1.2 Evaluate the relevance of models of strategic change to organisations in the current economy 6 1.3 Assess the value of using strategic intervention techniques in organisations 8 2. Understand issues relating to strategic change in NHS 2.1 Examine the need for strategic change in NHS 9 2.2 Assess the factors that are driving the need for strategic change in NHS 10 2.3 Assess the resource implications of NHS not responding to strategic change 11 3. Be able to plan to implement models for ensuring on going change 3.1 Develop appropriate model for change 12 3.2 Plan to implement a model for change 13 3.3 Develop appropriate measures to monitor progress 14 References 15 1. Understand the background to organizational strategic change 1.1 Discuss models of strategic change Different approaches have been used in the literature for explaining the reasons for promoting strategic change within modern organizations. Moreover, since change is related to different organizational needs, the models of change promotes within organizations cannot be identical, even if similarities cannot be avoided. Reference should be primarily made to the ‘improvisational approach’ (Smit 2000, p.1995) of strategic change. The above theory is used in a particular phase of change management: the implementation phase. The theory, which has been developed by ‘Redding and Catalanello in 1994’ (Smit 2000, p.1995) has three, key, characteristics: a) it emphasizes on experimentation, b) it promotes sanctions rather than direct interventions and c) it is based on the transformation of existing structures and the rewarding of individuals for supporting change (Smit 2000). Through a different point of view, the Open Systems theory promotes the idea that ‘all organizations are members of an open system’ (Wilson 1992, p.42). As a result, any event that occurs within each organization is considered as related to the organization’s external environment, meaning especially the open system in which the organization is incorporated. The above theory makes the implementation of changes easier at the level that all organizations are considered as parts of an integrate framework, the open system. One of the most known models of change is that developed by Lewin in 1950 (Kew and Stredwick 2005). The specific model which is presented in Figure 1, below, promotes the idea that in all organizations change is implemented in three phases: ‘unfreezing, movement and refreezing’ (Kew and Stredwick 2005, p.221). These phases could be analyzed as follows: a) unfreezing; before change is attempted it is required that awareness of the need for change exists; this phase of Lewin’s model reflects the realization of the need for change, b) movement; the particular phase refers to the actions taken for promoting change; these actions can be differentiate across organizations according to organizational goals, the market conditions and the resources available and c) refreezing; this phase of Lewin’s model shows the transition to a new organizational environment, after the implementation of change has been completed ((Kew and Stredwick 2005). Figure 1 – Lewin’s model of change management (source: http://www.web-books.com/eLibrary/NC/B0/B58/047MB58.html) Another approach for explaining organizational change is described in the study of Glynn and Woodside (2012). The above researchers refer to the model of strategic change developed by Barr and Huff in 1997. According to the particular model managers are likely to promote changes only in the following case: if changes have already appeared in the firm’s environment then measures are taken so that the organization is able to respond to these changes (Glynn and Woodside 2012). In other words, in the context of each organization changes can lead to further changes, either in the short or the long term. However, managers do not always respond to changes by suggesting changes; they can also ignore changes, if their effects on existing organizational operations are not highly affected (Glynn and Woodside 2012). In any case, change can be related to different aspects of the organization. In the study of Daft, Kendrick and Vershinina (2010) reference is made to change as a tool for aligning existing business strategies with the principles of sustainability. A model of change is proposed by the above researchers based on the processes through which the full alignment of business goals and strategies with ethics and sustainability can be achieved (Daft, Kendrick and Vershinina 2010). The particular model is based on four approaches, set in hierarchical order. These approaches are, from down to top: a) legal approach; change is promoted in order to align a firm’s practices with laws related to the protection of the environment, b) market approach; change is promoted following customers’ requests for products that are eco friendly, c) stakeholder approach; change is promoted as a result of the stakeholders’ concerns in regard to the potential effects of the firm’s operations on the environment and d) activist approach; change is promoted due to the increased interest of organizational leaders for the environment (Daft, Kendrick and Vershinina 2010). Particular emphasis should be given on Lippitt’s model for change (Figure 2 below). Figure 2 – Lippitt’s model for change (source: Bold 2011, p.874) The Lippitt’s model for change highlights the role of change agents in achieving change, but does not emphasize on the value of change, as a factor for enhancing organizational growth (Bold 2011). Latta (2009) proposes a model of change based on the value of organizational culture as a factor influencing business activities. This model is presented in Figure 3. Figure 3 – OC3 model – Model of Organizational change in Cultural Context (source: Latta 2009, p.24) 1.2 Evaluate the relevance of models of strategic change to organisations in the current economy The models of strategic change, as presented above, could be possibly used in organisations in various industries under the following term: that the conditions in the organizational environment are reviewed, ensuring that the implementation of a specific model of change is feasible. A closer review of the models of change suggested above leads to the assumption that not all of them could be relevant to organisations in the current economy. The reason is that current market is characterized by extremely strong turbulences. The implementation of changes in organizations is feasible but only if the relevant plans are flexible enough so that they can be alternated, if required, responding to the changing needs of organizations. Among the models of change presented above, the following are considered as most appropriate for organizations in current economy: a) the Lewin’s model on change; the particular model defines clearly the process of change without setting strict requirements in regard to the elements/ components of its phase, and b) the Lippitt’s model of change; the specific model highlights the relationship between various organizational elements/ activities especially in regard to their effect on promoting change; all these elements/ activities are present in modern organizations, a fact that verifies the feasibility of this model in organizations in current economy. The OC3 model of Latta is highly depended on a specific element of the organization, i.e. culture, so that its use for evaluating change in general would be problematic, at the level that culture is not equally valuable for all organizations. From the same point of view, not all organizations are equally depended on their external environment, as the Open Systems theory accepts. In addition, changes in organizational environment do not necessarily lead to changes in existing business strategies, as Barr and Huff (1997) claimed. The view of Redding and Catalanello (1994) could not be applicable in all organizations since experimentation is not feasible in all organizations; in fact, in most cases direct interventions are necessary for responding to key organizational needs, a view that it is opposed with the view of Redding and Catalanello in regard to change management. Finally, the model of change suggested by Daft, Kendrick and Vershinina (2010) could be possibly used for supporting change in modern organizations but its effectiveness cannot be estimated in advance, since not all organizational aspects are clearly regulated by the law, as the specific element is set first in the hierarchy representing the particular model. 1.3 Assess the value of using strategic intervention techniques in organisations When referring to organizational change, strategic interventions have the following role: they show the interaction between the organizational environment and the business strategies (Cummings and Worley 2009). Indeed, conditions in the organizational environment need to be reviewed periodically in order to ensure that existing strategies are able to support business operations and to guarantee the achievement of organizational goals (Cummings and Worley 2009). After reviewing the conditions in organizational environment, managers may decide to proceed to strategic interventions, i.e. to critical initiatives that will help to introduce necessary changes (Cummings and Worley 2009). In other words, strategic interventions are inevitable each time that changes are promoted within organizations (Mehta 2009). Strategic interventions can highly influence business performance, at the level that they can cause delays or even the pause of certain organizational operations, so that the implementation of change is made easier (Mehta 2009). For this reason, strategic interventions should be carefully reviewed, before being developed in practice (Mehta 2009). Another aspect of strategic interventions is highlighted in the study of Halanchini and Bouckaert (1995). According to the above researchers strategic interventions can be characterized as an indispensable part of change management (Halanchini and Bouckaert 1995). However, the ability of leaders and managers to develop appropriate strategic interventions is not guaranteed, a fact that can set a change management plan in risk (Halanchini and Bouckaert 1995). 2 Understand issues relating to strategic change in NHS 2.1 Examine the need for strategic change in NHS Change can be implemented in organizations either because of pressures in the firm’s external environment or because of the need of the organization to improve its performance in one or more of its sectors (Griffin and Moorhead 2011). In other words, change can be inevitable or it can be considered as an effective way to enhance organizational growth (Griffin and Moorhead 2011). Commonly, the need for strategic change may take a long time in order to become clear (Collins 1998). Indeed, in many cases the explanations given to various organizational failures do not refer to the need for change, as a prerequisite for controlling failures (Collins 1998). At this point, the role of leadership is critical. A successful leader is able to identify early the needs of his organization in terms of change (Sengupta and Chattacharya 2006). Still, the efforts of a leader to promote change may not be successful, at least according to the deadlines set, mostly because of employees’ resistance to the attempted changes (Sengupta and Chattacharya 2006). In other words, even if the need for change is diagnosed early, the implementation of relevant plans is related to many risks. The responses of employees have been proved to be critical for the success of such initiatives (Sengupta and Chattacharya 2006). Sharma (2006) notes that the need for strategic change in an organization should be evaluated by monitoring the changes occurring in the organization’s external environment, at the level that this environment can highly affect organizational activities. On the other hand, critical changes in one or more parts of the organization, such as leadership, place of operations, funding and so on, need to be followed by changes in the organization’s strategies in order for the latter to remain feasible (Yaeger and Sorensen 2009). The above issues should be taken into consideration in order to identify the need for strategic change in NHS, the organization under examination. In its current condition, NHS cannot respond to the actual needs of local population (Apps 2013). The availability of funds is not the most important issue in regard to the specific organization; however, the rules of operation should be changed with no delay, in order for the organization’s efficiency to be secured (Apps 2013). A recent review of NHS’s daily operations revealed an important problem: the time spent on the rehabilitation of patients is too much taking into consideration the actual needs in terms of healthcare support (Apps 2013). The need for changes in the existing practices of NHS is also highlighted by Sergeant (2013). According to Sergeant the existing failures of NHS should not be related to the increased healthcare needs of local population but rather to the decisions of the organization’s leaders (Sergeant 2013). It is explained that hiring in NHS is not based on employees’ skills but rather to the employees’ relations with politicians (Sergeant 2013). From another point of view, Triggle (2012) notes that the challenges that NHS has to face are many; the radical increase of medical costs, the increase of need for healthcare services, the aging population and the continuous advances of technology are certain of the challenges that NHS has to face in the next years (Triggle 2012). 2.2 Assess the factors that are driving the need for strategic change in NHS According to Jacobs (1997) the factors that drive change can be differentiated across organizations. Most commonly, ‘the increasing customers demands for quality and service and the introduction of new technologies’ (Jacobs 1997, p.3) are factors that can highly impact the performance of a firm’s strategies denoting the need for changes, either in the short or the long term. Among the factors that can be used for verifying the need for strategic change in NHS there are certain factors that are quite critical: the high increase of medical costs, the lack of effective planning in regard to the rehabilitation of patients and the terms of hiring, as applied in NHS. The first of the above factors, i.e. the cost of services, is related to the continuous increase of organization’s expenses but also to the inability of all patients to have access to necessary medical treatment, a condition that could not be accepted for Britain’s National Healthcare System. As for the lack of effective planning, as this problem is revealed through the lack of planning in regard to the rehabilitation of patients, this could result to a series of delays in the provision of healthcare services. It can also lead to the increase of organization’s expenses but also to the cancellation of various organizational projects. Finally, the lack of standards in the organization’s hiring process could result to the deterioration of the services provided to the public, the increase of employees’ failures and the decrease of organizational profits. Also, the above practice could harm the organization’s image as a highly credible Healthcare System. 2.3 Assess the resource implications of NHS not responding to strategic change All plans referring to organizational change are based on specific, pre-defined, resources (Cawsey, Deszca and Ingols 2011). The control over the availability of these resources is one of the key responsibilities of leaders (Cawsey, Deszca and Ingols 2011). In fact, before developing any plan for change, a leader needs to check whether the resources required, as estimated, can be available (Cawsey, Deszca and Ingols 2011). The period for which the availability of these resources would be secured should be also checked in advance otherwise any attempt for change should be avoided. In any case, when the introduction of a plan of change in a particular organization becomes unavoidable, then the form of the plan, as related to the resources required, should be reviewed (Cawsey, Deszca and Ingols 2011). It has been proved that ‘incremental plan require fewer resources’ (Cawsey, Deszca and Ingols 2011, p.160). This finding is critical for organizations that have extremely high work volume, such as NHS. In case that NHS would fail to respond to the suggested plan of change, then certain resource implications would be unavoidable: a) the resources that would be ‘locked’ in regard to the suggested plan, meaning that they should be used exclusively in the realization of the plan’s phases, could not return back to normal activities unless clear guidelines are given, b) lack of balance could be identified in regard to the resources available in various organizational departments; this would result to different performance for each organizational sector; c) resources that have been located solely for the realization of the particular plan should be appropriately distributed in the organization’s sectors; the specific problem has been avoided in this case since the plan suggested is based on the organization’s existing resources, meaning funds, technology and employees. 3. Be able to plan to implement models for ensuring on going change 3.1 Develop appropriate model for change According to the issues discussed above, the strategic change in NHS should emphasize on three factors: cost, organization of operations and employees’ skills. These factors should be changed using a model of change, as suggested below (Figure 4). The suggested model is highly based on the role of the organization’s leader in enforcing and in monitoring change. Period P Figure 4 – Suggested model for change in NHS In the above graph, the factors driving change have been included in brackets. The practices suggested for promoting change follow. There is no hierarchy of the three phases of the plan, meaning that efforts for changing all three organizational factors can take place simultaneously, if possible. One of the most important characteristic of the above plan is the following: the plan is designed and initiated by the leader while managers follow the guidelines given without having a decisive role in the plan’s structure. Still, managers could decide on the tasks assigned to employees and other individuals involved in the plan, so that change is appropriately promoted across the organization. 3.2 Plan to implement a model for change As noted above, the implementation of the above model would be characterized by the following fact: changes should be initiated in regard to all the organizational aspects that need to be changed, as analyzed earlier. This means that it is not required for each of the plan’s phases to be implemented separately. Rather after the guidelines related to the plan are given to managers, efforts for promoting change in all the areas involved should begin. It is implied that any preparation for implementing the plan is made before starting its implementation, that is during the period characterized as ‘period P’ (Preparation) in the above graph. In addition, the monitoring of the plan, in all its phases, by the leader would not be feasible. The plan would be checked by the leader after its completion, through a report of evaluation in which three aspects of the plan: time, employees and impact on organizational performance would be checked, as explained below. 3.3 Develop appropriate measures to monitor progress The progress of the plan suggested would be monitored through the following measures: a) the ability of the organization to meet deadlines in regard to the plan suggested; short delays could be justified under the terms that the specific sector is quite demanding and the volume of work involved cannot be precisely estimated in advance, b) apart from time, the employees required for the promotion of changes suggested should be also taken into consideration. The model of change suggested does not require the increase of the organization’s staff, meaning that the relevant changes should be promoted using existing workforce so that the cost of the plan is kept at low levels, c) the performance of the organization in a period of 1 year after the end of the implementation process would be another measure for estimating the progress of the organization in regard to the suggested changes. Performance, as mentioned above, would be related not only to the organization’s financial performance but also, mainly, to the ability of NHS to respond to the health needs of local population; for example, an increased rate of failure in regard to the cases handled could indicate the failure of the change management plan suggested and vice versa. References Apps, A., 2013. “Society's problems risk overwhelming the NHS.” Jan 14, 2013. The Guardian. Available at http://www.guardian.co.uk/healthcare-network/2013/jan/14/society-problems-overwhelming-nhs Bold, O., 2011. “A Perspective on Organizational Change Issue – Case Study on the Application of Two Change Models.” Review of International Comparative Management Vol 12, Issue 5, December 2011, pp. 871-882 http://www.rmci.ase.ro/no12vol5/03.pdf Cawsey, T., Deszca, G. and Ingols, C., 2011. Organizational Change: An Action-Oriented Toolkit. London: SAGE Collins, D., 1998. Organizational Change: Sociological Perspectives. London: Routledge Cummings, T. and Worley, C., 2009. Organization Development & Change. Belmont: Cengage Learning Daft, R., Kendrick, M. and Vershinina, N., 2010. Management. Belmont: Cengage Learning Glynn, M. and Woodside, A., 2012. Business-To-Business Marketing Management: Strategies, Cases and Solutions. Bingley: Emerald Group Publishing Griffin, R. and Moorehead, G., 2011. Organizational Behavior. Belmont: Cengage Learning. Halanchini, A., and Bouckaert, G., 1995. Public Productivity Through Quality and Strategic Management. Amsterdam: IOS Press. Jacobs, R., 1997. Real Time Strategic Change: How to Involve an Entire Organization in Fast and Far-Reaching Change. San Francisco: Berrett-Koehler Publishers Kew, J. an Stredwick, J., 2005. Business Environment: Managing in a Strategic Context. London: CIPD Publishing Latta, G.,2009, “A Process Model of Organizational Change in Cultural Context (OC Model). The Impact of Organizational Culture on Leading Change.” Journal of Leadership & Organizational Studies Vol 16 No 1, August 200, pp.19-37. Available at http://skat.ihmc.us/rid%3D1GSQPFH9L-D6KVCN-Q90/A%2520Process%2520Model%2520of%2520Org%2520Change%2520in%2520Cutural%2520Context.pdf Mehta, A., 2009. Organisation Development: Principles, Process & Performance. New Delhi: Global India Publications NHS, 2013. Organizational website. Available at http://www.nhs.uk/Pages/HomePage.aspx Sengupta, N. and Chattacharya, M., 2006. Managing change in organizations. New Delhi: PHI Learning Pvt. Ltd Sergeant, H., 2013. “The real problem destroying the NHS? Jobsworths who want to please politicians more than patients.” Feb 6, 2013. The Mail. Available at http://www.dailymail.co.uk/news/article-2274700/The-real-problem-destroying-NHS-Jobsworths-want-politicians-patients.html Sharma, R., 2006. Change Management. Tata McGraw-Hill Education. Smit, P., 2000. Strategy Implementation: Readings. Cape Town: Juta and Company Ltd Triggle, N., 2012. “The changing NHS.” Sep 26, 2012. BBC News. Available at http://www.bbc.co.uk/news/health-19721977 Wilson, D., 1992. A Strategy of Change: Concepts and Controversies in the Management of Change. Belmont: Cengage Learning Yaeger, T. and Sorensen, P., 2009. Strategic Organization Development: Managing Change for Success. Charlotte: IAP Read More