Thursday 5 June 2008

How to get people to embrace change

One of the most common questions I get, after one of my speeches on creating a great workplace, is "My people are so resistant to change, how do I get them to accept it?". In answer I like to give the story of my friend Marion Janner how she has enabled a remarkable programme of change in the NHS mental health sector.

I saw the effect at first hand when I spoke at her conference last year. Present were 150 staff from mental health hospitals across the country, all enthusiastic and positive about the changes they were introducing to improve the life of their patients.

Example: Changing the Mental Health System
Marion is not an NHS manager and is not even an NHS employee. Her experience was as a 'service user'. In the summer of 2005 she was sectioned and spent a month in a North London mental health hospital. This left her full of ideas of how mental health wards could be made into places that really engage their patients, and therefore better helped their recovery.

She came up with a set of 75 practical, easy to implement ideas, created the term Star Wards for the project and published a guidebook for trusts. These range from patients starting to manage their own medication to having pets on the ward. A recent newsletter reported from a ward arranging design competitions and space hopper races.

18 months after its launch, over half the mental health wards in the country are taking part in Star Wards. What staff, patients, managers, commissioners and regulators have found so heartening is the speed with which small changes are being introduced and having a substantial impact on patients’ experiences. And on staff morale. This creates a virtuous cycle of motivation, energy and creativity.

Now Mental Health Today publishes a 4 page supplement on the project every 2 months, Marion has been praised in a Guardian editorial and was one of 3 finalists in the Daily Telegraph Great Briton awards, (Public Life and Campaigning category). All this because one person, with no ostensible power, had an idea that things could be better.

Contrast this with how the government would have approached such a change. They would have started by attacking the work currently being done (as they have with teachers, police etc), and talk about the number of staff not doing a proper job. They would then prescribe a specific set of actions every trust must follow, set targets, introduce league tables and name and shame those not doing well. And then they would wonder why the changes were not being eagerly embraced.

Change Based on Respect
Marion did not prescribe, she suggested. Reading Marion's newsletters you find examples only of the great work certain wards are doing. There is total respect for the professionals involved. There is no set way of doing it, just a range of ideas to try out with people encouraged to come up with new approaches. (Star Wards II will describe the many great pieces of work going on.)


A core belief at Happy is that people work best when they feel good about themselves. Marion's work is a living embodiment of that, and shows the effect of praise, support and encouragement. Questions for YouMy questions to those who want to get their people to change:
  • Are you seeking to impose the change you want or actively engaging your people in the change?
  • How can you involve your people in deciding what needs to happen?
  • Are you focusing on praising the good developments or criticising the problems that remain?
  • Is it a top-down or bottom-up approach?

It isn't change that people resist, but change imposed from above. I'd love to hear your stories of change. Email me on henry@happy.co.uk or ring on 07870 682442

More from Marion:
Here are some of Marion's further thoughts after reading this piece:

“Some of the other things that contribute to Star Wards’ popularity are:
It is a very collaborative project. At ward level, the structure (or lack of one!) is very conducive to patients and staff, and also staff from different professions working together. Nationally, Star Wards’ members not only share resources and ideas but have an ‘open source’ approach, adapting and then sharing each others’ ideas and practical resources, such as benchmarking toolkit is so flexible.

Wards which are already providing excellent services can find or adapt (as well as contribute) complex ideas for improvements. And wards which are functioning at a much more basic level, discover that even very simple ‘innovations’, such as having a ‘film night’ (with a chosen DVD + popcorn) can make a real difference to ward dynamics and culture. It is very visible.

The improvements themselves are all very tangible and because most ward members chose to carry out regular benchmarking exercises against the 75 ideas, everyone can measure and savour the progress.”

(If you would like to contact Marion, drop me an email.)

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