How will you produce change?

You are very likely to have a question about this under the remit of a management or leadership question.

Change is a vital cog within the NHS workplace. Even the most basic description of clinical governance specifies the importance of a culture of change; a willingness to embrace dynamic improvement is one of the three underlying characteristics of the various components of clinical governance.

Most people wouldn’t think it necessary to define change. All the same, if we were to be pedantic and seek out the definition, it gives some food for thought. Change is ‘making something different’, an ‘alteration’, a ‘substitution’.

In this context, would you agree that perhaps we would be better off referring to IMPROVEMENT as the quality we seek to espouse in the NHS, rather than just Change for the sake of it? Worth a thought?

Anyway.

As far as your interview goes, let’s proceed along the lines, for our sanity, that you have identified a situation that needs to improve, and in order to make that improvement, you have decided upon the need for change.

How would you bring that about? What are the steps that will complete a successful episode of ‘change’?

Let’s think about it logically.

1 - Assessment

you would gain clarity about where you stand now. What is the lie of the land? How much of a problem do you need to fix with ‘change’? You need the facts. You need reliable, accurate information about the status quo.

2 - Thinking

use of brain. This step seems to have been raided out and thus missing from the most often used acronym for ‘Change’. Once you’ve identified what your ‘base state’ is, you would want to give some detailed thought to how you will start fixing the problem. You need to understand the reasons for the problem. This would then help you to come up with various ways in which the problem could be fixed. Ideally, you have now arrived at a number of different options, or at least a few variations of the ideal solution, through which you can fix the problem.

3 - Consensus

Change will only succeed if everyone pulls together well, in the same direction, and in a timely manner. This usually happens best when all those pulling are convinced of their purpose. Such investment from individuals and groups is best achieved by recruiting them into the problem at the very outset. If all the stakeholders who need to work to produce change were also involved in steps (1) and (2) above, that would make this step (3) a lot easier. Often, this isn’t the case. You then have the task of ‘selling your solution’. This involves consultation, compromise and finally the formulation of a consensus. You now have a plan of action for change - one that everyone involved has agreed to go along with.

4 - Implementation

DO IT. Implement your plan. Not a lot to say here, really. If you don’t have the resources or the drive to, or anyone to hand the implementation over to instead, by this stage - well, perhaps you have just wasted a lot of time then, haven’t you?

5 - Review

Get marked. Get a score. Find out how you did. Pass, fail or neither. In other words, you should now determine whether your efforts have succeeded in remedying what you set out to fix. You should NOT just be assessing whether your implementation went through okay - no! You do need to know that, but that should be part of step (4); as in, unless you’ve carried it out properly, you should consider yourself to not have properly completed step 4. No, at this step (5), you should look to find out whether your carefully thought out, collaboratively agreed, well implemented ‘change’ has successfully fixed whatever you identified to be the problem, in step (1).

if you feel as though you need help memorising that sequence of 5 steps, try this on for size