10 top tips for managing difficult service change

“It constantly surprises me that my colleagues don’t recognise the power of personal leadership”.

This is one of the quotes from a study of successful service reconfigurations. All across the economy leaders have to change services – often asking users to accept different modes of delivery for financial reasons. But across the NHS, some manage it well, whereas others effectively blow their toes off one by one with a shotgun.

Why? One is assuming that the public and colleagues are rational, and once they realise the basis of your sensible arguments, they will go along with them. Ipsos MORI have looked at a range of service reconfigurations, and identified what really matters.

Emotional intelligence, authenticity and effective personal and mass communications stand out as key. What the evidence confirms is that very clever people can easily trip up if they lack empathy.

Across the NHS, some manage it [reconfigurations] well, whereas others effectively blow their toes off one by one with a shotgun

These are 10 common features of the most successful reconfigurations of services from interviews with people who led them:

1. Visibility with the public – be in the room; personal leadership matters. Great leaders “show” themselves as the figurehead for the process;

2. Visibility with colleagues – people running the exercise are going to be under pressure and your support will be vital; they need to know you have confidence in them;

3. Setting clear standards around process to provide consistency and build confidence – and stop people who oppose any change at all and want to argue about it;

4. Target who matters – make sure MPs, senior colleagues, technical experts are all talked to before you start any work;

5. Get the narrative right – a key point is the need to talk “gain before loss”. For example, what will the new service look like and in what ways will it offer more flexibility?

6. Don’t dig your heels in – some effective reconfigurations have seen leaders change their plans during the process, giving ground on some aspects as part of a negotiation. Be prepared and identify red lines clearly;

7. Risk taking – conspiracy theories can abound during periods of change. By putting all the documents and minutes in the public domain, there is nothing to FOI, taking the wind out of the sails of people who see the worst in everything, and building confidence that you have nothing to hide;

8. Look for opportunities to co-create – creating public reference groups to review plans allows you to have independent scrutiny from people without an axe to grind (i.e. opposition politicians);

9. Emotional intelligence – manage the relationships; above all, the most successful are people who understand anger, fear and disinterest – and manage them all;

10. Tipping points and moments of truth – think hard about those key moments when you will have to demonstrate sincerity and authenticity, and where the pressure is at its peak: manage them perfectly.

Whoever wins the election is going to have to think hard about delivering services differently. Some will succeed with innovative changes. Others will fail offering very similar services. The difference will often be “how” the changes are undertaken – not “what” the changes are.

Ben Page is Chief Executive at Ipsos MORI. Please note that the views expressed in guest blogs on the Nuffield Trust website are the authors’ own.