Strong Leadership is the Key to Successful Change - NHS

The NHS is tirelessly continuing to evolve through The Agenda For Change and the more recent changes to the structure of PCTs and Commissioning Branches. Throughout these enormous shifts, thousands of diligent employees are expected to deliver world class healthcare services to an ever demanding public. How will the NHS continue to deliver throughout these changes? How will its employees cope on a day to day basis?

Organisational Change is normally delivered from the top down and this is the case with the NHS. So the power and therefore the responsibility is with those who lead people in the NHS. The higher up the hierarchy you are the more of a difference between ‘successful change' or ‘stressful bungle' you can make. (A ‘Leader' in this context is anyone who has staff report to them, or look to them for guidance).

There are two types of major organisational change:
A - Operational Change (the structure of the NHS is changing and so WHAT people do to deliver the services will change).
B - Cultural Change (this is more about HOW employees behave towards each other and towards customers which also affects how well the services are delivered).

To accomplish A, the strong leader will know what the ‘new' NHS will look like once the changes have been made and will share this picture with everyone else (The Vision). They will also share the roadmap of the steps that need to be taken to get there (The Strategy). If we don't understand the Vision (where we are going) and the Strategy (how we are getting there) then change feels like we are being blind folded and asked to take 10 steps forward. No wonder people are resistant to change! Good Leaders will also know that being expected to climb a mountain with no rest is just too daunting! So to keep up morale, they will have frequent milestones of achievement on the roadmap and earned rest stops.

To accomplish B is much harder, because Cultural Change is about changing attitudes and behaviours. Human brains are designed to copy, we see this clearly in children who copy what we do and say. As adults, this function of the brain is still working to help us ‘fit in'. We unconsciously copy those around us. This is how cultures are created.

If Leaders at the highest levels of organisations are arrogant or bullying, then this behaviour is seen as ‘acceptable' or even a good way to behave to get promoted! It is copied like a waterfall effect by Leaders further down the hierarchy. To effectively change the culture, the Leaders need to change those behaviours and attitudes that are not conducive to high performance. It becomes a matter of WHO you are not so much WHAT you do. After all would you follow someone who cannot even control their own emotions?

The difficulty is, that often we become Leaders but are given no access to understanding WHO we are and HOW we instinctively behave. We may not really know what High Performance Leadership looks like. We stay unaware of our ‘bad habits' or simply don't know how to change them even if we've tried.

It's possible to create high performing sub-cultures with strong Leaders and their teams at any level within an organisation. As Mahatma Ghandi said "you must be the change you want to see in the world".

Rebecca Watson specialises in Organisational Development and Change. She has worked with a wide variety of coaching organisations and leaders to empower them to deliver through high performing teams.