Managing Change for Health Information Professionals (MCHIP)  

Future developments in change management: the only constant is change

Even aside from the current modernisation programme, the NHS faces constant change - new medical discoveries and scientific advances, emerging approaches to managing organisations, new legal and regulatory frameworks, changing public expectations, wider changes in society such as the impact of the internet on patients' access to health information. How does an organization (or, even more so, an individual) keep up with of all these changes? How can they revise the way things are done in response to them? How do we change the way we work so that ongoing learning and adaptation becomes the norm? The NHS Plan described the NHS as "a 1940s system operating in a 21st century world". What can be done to ensure that the NHS continues to evolve, so that in 50 years it isn’t a year 2000 system operating in the 2050s?

The answer seems to lie in getting better at creating, sharing and using knowledge and learning. In short, rather than continually responding to short-termist change, the answer is to become a 'learning organisation' - one skilled at creating, acquiring, interpreting and retaining knowledge, and then modifying its behaviour in the light of new knowledge and insights.

David Fillingham, Chief Executive of the NHS Modernisation Agency, has said:

"It is only by testing ideas, learning what works best and sharing our knowledge that we will really make things better for our patients"

and

"We will know we have succeeded when knowledge about an improvement developed anywhere in the system rapidly becomes common knowledge and is actually used everywhere".

Maybe the most important lesson is that change management is a process not an end in itself. In a world of constant ,and quite possibly increasing innovation, we must learn to “expect the unexpected.”  Prediction, although fun, is not an exact science. Shortly before the millennium people in their thirties and forties were asked to think back twenty years, and try to remember how they thought the future might unfold. The results showed:

•Some innovations like computerisation and automation were anticipated.

•Some hopes (like computers would do all the work, giving us more leisure, or manned space flights) were not realised.

•Some changes (such as reproductive technologies and global warming) took us quite by surprise.

Within the health library and information sector some work has been done on looking at emerging trends for future change by the CILIP Health Executive Advisory Group The Example of Health: A Prognosis for the Profession(URL below)

At the same time a conflicting tension, where new roles might be constrained by a more prescriptive approach to role development, is hinted at by the proposed agreement between the UK Health Departments, NHS Confederation, Unions and Professional Bodies to modernise the NHS pay system, euphemistically entitled Agenda for Change (URL below).

It remains to be seen which of these two external stimuli will have the more profound effect on the role of the health librarian and information worker. However, even if we cannot predict what challenges the twenty-first century will throw at us, using the techniques of analysis and planning which we have explored over the past five weeks, helps to provide a framework for managing the process in a controlled and pro-active way. We hope that you will find practical ways of applying them in your workplace.

WHAT YOU NEED TO DO:

Record in your portfolio your reflections on the following questions:

• What do you understand by the term “learning organisation”?

• What are the characteristics of a learning organisation?

• To what extent can your organisation already be considered a learning organisation?

SOURCES:

Knowledge Management in the NHS

http://www.nelh.nhs.uk/knowledge_management/km1/nhs.asp

Agenda for Change

http://www.dh.gov.uk/PolicyAndGuidance/HumanResourcesAndTraining/ModernisingPay/AgendaForChange/fs/en

The Example of Health: A Prognosis for the Profession

http://www.cilip.org.uk/advocacy/eags/health_workshop.html

NeLH Management Briefing – Learning Organisation

http://rms.nelh.nhs.uk//common/download.asp?resourceID=29632

Ten Indicators of a Learning Organisation

http://www.swktodc.govt.nz/lifelonglearning/lifelonglearning20.htm

Garcarz W et al. Make your Healthcare Organisation a learning organisation. Oxford: Radcliffe Medical Press, 2003.