Why Is Change Such A Challenge In The NHS?

We need to change, transform the way we work and make service improvement.  Familiar words to anyone who works in the NHS and to the public generally.

From the outside looking in you might be thinking what’s taking so long.  In many ways it’s a fair challenge.  Yet the reality is that making change in the NHS is a lot harder than it seems.

So why is change such a challenge in the NHS?

Too Many Vested Interests

In any organisation change is hard.  In something like the NHS it is even harder.  If you are a politician, propose something that’s unpopular and your chances of getting voted in next time diminish greatly.

If an employee, change could mean job losses or having to adjust to a much more radical way of working.

The different groups of employees all look at things in different ways and from different perspectives.

Public Perceptions

About 10 years ago a lot was made of patient choice.  The principle giving patients the choice of where they are treated seemed sensible.

However, what has been identified is that in most cases people want to be treated as close to home as possible.  Usually this means their local hospital.

Try to change what is offered locally and you will see the power of public opinion and resistance to change.

A Lack of Capacity

If you look at a typical NHS organisation, whether in primary or secondary care, mental health or learning disabilities, one of the biggest things you will notice is that the demands on people’s time is huge.

If people are running at 100 miles an hour just to service demand, then there is little or no capacity to drive forward any significant change.

A Lack of Realism

Change takes time.  Mistakes will be made along the way.  There will be setbacks.

Often there is a complete lack of realism as how long it will take to make change.

Initiative Overload

Every week there seems to be something new that needs to be addressed by leaders and leadership teams.

Very quickly you can reach the point where you have too many initiatives which are at various stages of completion.

Trouble is one initiative fully completed is better than 10 initiatives all in partial completion.

A Lot of Experts

One might think a lot of experts is a good thing.  It’s fair to say there are a lot of benefits and there are drawbacks.

People who work in the NHS sometimes have limited experience of other organisations so don’t necessarily have other experiences or references to draw on.

What else would you add when it comes to the challenges of making change in the NHS?