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Task 1 1.

1 Discussing three established models of strategic change management


Strategic change management about what changes you want in your organisation to develop your company and how you deal it. In the strategic management we have total six establish models in the following. Kotters eight steps Kubler-Ross five stages transition Proscis five building block(ADKAR) McKinseys seven S framework Burke-Litwins causal change model Ansoff matrix (gap analysis) From all of this we discuss only three models. (1) McKinseys Seven S Framework: This model developed in 1980s by Tom Peters and Robert Waterman. Here we have seven internal aspects of an organisation that need to be successful. And in this model they define very easily to each other connection.

STRATEGY = How do we process to attain our objective? STRUCTURE = the way how to organize and who reports to whom SYSTEMS = The daily activities and where are the lines of communication. SHARED VALUE = What are the core value and what is the corporate? STYLE =Howeffective is the leadership? STAFF = The employee and them position. SKILL = what is the individual skills surrounded by the company?

(2) Burke-Litwins causal change model: This model developed in 1992 via Geroge H Litwin and W Warner Burke. This model saw the effect of change between 12 keys area and this area divided in four parts as following.

Input

= This loop start with external environment (1st row). This is what needschange.

Throughput = In this division they make a decision what is mission , leadership and culture.(2nd row) Throughput = In this fraction we add structure, system, management practice, work climate, skill and motivation.(3rd ,4th ,5th row)

Output

= achieve of changes on the performance. (6th row)

(3) Ansoff matrix: The ansoff matrix has given marketers and business leaders a quick and simple way of thinking about growth. There is four ways to think about risk and growth.

There is four different markets to analysis and find out growth and risk. 1) Market penetration: this name given to growth strategy, here business has to focus on selling more and more product. 2) Market development: at this point the business seeks to sell his product in new market and new area of the market. 3) Product development:here you have to sell your product by extend with different variants or packing in new way. 4) Diversification:this market is very risky. Because here new product in new market. But this not effect in

1.2 Example of applying models of strategic change management


Strategic change is very effective when an organisation actively seeks the participation of all relevant stake holders. Its effective only when all stakeholders participation. In the India Mumbai is the largest economic capital city. Now a days world growing with IT services. In the India TCS is largest company who provide IT services a, Business solution and outsourcing. In this example, seven s framework are apply 1) Strategy: TCS has great work for India. It provides full IT facilitate to business solutions. And as we know India growing faster and India need helps everywhere.

2) Structure: In TCS now a days scale up over 100,000 employees. The organisation provided into five units, The units which provide like which get new growth opportunities, they also give sharper accountability and groom new leadership in every units. 3) System: In world 142 offices in 42 countries. And TCS developed unbreakable bound with HR participate. HR basic functions are recruitment policy and process, training and developing, composition and salary function etc. 4) Shared values: TCS core values are integrity, leading changes, excellence, respect for the individual, fostering of an environment of learning and sharing. In the TCS energetic and openwork place environment. 5) Style: TCS always bounding with each other and they work like team. they give equal opportunity to every employee. 6) Staff: TCS has divided into 5 geographies like India, north America, Latin America, Europe, APAC, Affrica-middele east.30% of the workforce working in TCS Japan is locally hired 7) Skills: TCS have many skill powers. They are work together in every level. They always finding for new skill power because of that they can capable to work with changes in management. Also company help them employees to improve him skill.

1.3 Assess The Value Of The Strategic Intervention techniques In the Strategic Intervention Techniquesteach us how to work with other and in directly convey these workplace differences using effective communication skills and early intervention strategies. (According to Robbins-Madanes Training)[1] 1. The Importance of Team Building: In the N.H.S. they should make the most powerful bonding with doctors, nurses, helper and staff. That team work makes all work to easy and helpful to all patients. They have to know about that all that in which doctor below they have to work if there is no team work than help boy and nurses confused to follow every doctor instruction. It help to concentrateon your task, as u work in as team so u get knowledge in that line, if any problems arrive than u can solve it with team. And in the last make sure that everyone contributes equally. 2. Game Play: Everyone Playing game for rewarded. In every game there is main six characteristic like Challenges,rules,Interaction,Contrivance,Obstacles, Closure. Fun and entertainment are primary motivation. Trainer increases the engagement and focus on topic. As in our organisation N.H.S. they have to make them task clear and ready for new challenges.as in this organisation there is no rules but work with regularly and they have to maintain relation with patient. 3. Contingency theory: Contingency theories are a class of behaviour theory that contend that there is no one best way of organizing and that an leadership style that is effective in some situations may not be successful in others (Fiedler, 1964)

[2] As in our organisation N.H.S. have to make them system open. They have to make careful management to satisfy them patients and balance internal needs. As N.H.S is hospital so they have to maintain a natural environment when they dealing with patients. Management must concern on main focus to help ill people not on profit. 4. Autocratic Versus Participative style:

In this style you have to give some decision rights to your employer so some time in critical situation they take a decision and it helps to decrease our tension. So as in our organisation N.H.S. they have to give some decision rights to them nurses so in some cases someone come by mistake so at that time nurse can handle and tell them that they are in wrong place and also suggest a right place and that time save doctors time and money. And there is one another decision style that was make a decision with group and here in big cases they have to behaviour like a group and take decision combine. So in this style u can get everyone knowledge. 5. Proactive And Reactive: Managing resistance during any business change should include both proactive planning and reactive intervention. In Proactive resistance management you have to find where resistance might come from and what it might look. They have to identify critical gaps and possible point of resistance. In reactive resistance management you have to listen to employees and find out source of the resistance. 6. Human Process Interventions: In human process interventions there are 2 different styles 1) T-groups and 2) process consultation. In T-groups are designed for learning for dynamics, leadership and interpersonal relationships. Its about increase understand, self-awareness about ones own. And process consultation is about the communication and how to role of groups members, how to solve the problem. 7. Techno Structural Intervention: Here they help to organisation to redesigning the structure and they reengineering business process also they make total quality management (TQM). how to solve all problems about organisation. 8. Human Resource Intervention: Here they provide method about managing people in more effective and efficient way while ushering in the change process in an organisation. Here they include set goal, how to performs, also take reward system, and best thing of employee wellness.

Task 2 2.1 And 2.2 Need for Change


Need for change is the way of change in organization because of some factor which effect on our organization. That factor related to organization like economic downturn, change in global markets, customer expectation, competitive edge, budget pressures etc...Now lets see how its effect on our organization in N.H.S. 1. Economic downturn: An economic downturn suggests the economy is entering into recession. A recession is a period of negative economic growth with falling output and rising unemployment. For example, many felt we were in an economic downturn even with positive growth. This was because the growth rate was slowing down, house prices were falling and people could see the economic cycle and shifted from a boom period and we were heading towards bust. Economic Downturn effect to N.H.S. as our organization related to government so its direct effect on N.H.S. before some time N.H.S. fired 40,000 employees in one day its very big problem which arrives for that unemployment people. 2. change in global market: here changes happen to financial service sector .which helps integrate global trade activity. Its effect to financial department. NHS will face 15bn budget shortfall due to effects of recession managers warn. Customer expectation which is increases day by day. Customer wants best service ever so thats why N.H.S. has to always upgrade with new equipment and new research to help customer. Competitive edge is the key which help you to be always ready with new scheme to attract your customer so for that N.H.S. has to give good services. Many companies go through a different time during an economic or recession. This will be effect future like reduction of staff, taking loans, reduce expenditure on high-essential equipments and its very difficult to do all things with best services so manager has to work hard to make decision. Legislation is change any time and it directly effect to you so all business need to top on the legislation change. Growth is a common objective for business and larger firms have many advantages of following. They may benefit from economies of scale, may be able to expert more power, safer from takeover bids. N.H.S. growth in size is all over U.K. so they get benefit from government. Merger and acquisition is happening to make two company one and it help to increase more power of that company our N.H.S. takeover small hospital and make it N.H.S.. Restructuring operation is about give new looking to achieving new target, work with new technology. New Technologies arrives every day in world that for company have to be ready and approach this all new technologies as possible as fast. And this new technology makes communication easier between senior managers and the workforce.

Organizational change management is becoming increasingly important to the business community. The introduction of latest technology and changing customer preferences and tastes can result in companies having to redefine their business goals and objective. Some of the following factor effect to organizational change. Political factor is one of the main and very important factor to change in organizational. Whenever the political parties change at that times all the employee change and also change work style and its effect to entire organization. Financial problem when arrive at that time you go under pressure of finance. Some time new companies enter market with cheaper labour or best technology which effect to your company share and its automatically reduce. Some time many hospitals give private facility and rapidly service to customer which effect customer to leave N.H.S. New market also effect to organization when you enter with new product that time your product is new for you company for that you have to work hard to go in customer heart after that every one follows you. Loss of market is some of new changes your company loss whole market power and to recover it very difficult and its happen when new technology and system arrives as we know customer wants always new and where they got new than they easily change so for N.H.S. always ready for with new equipment otherwise it loose his customer. In science line always new research come out and it help to make your health better and thats why you have to adept advance technology as example before some year we use x-ray with x-ray you got one packet of photo. For more comfort now N.H.S. use digital imaging which is directly upload to computer and after report it send to your doctor by mail and its make very easy and fast. Transition of new chief executive that time everything change because as we know when we appoint new CEO they have their own views to work and they change all work style and its effect to do work continue. Fund cuts when we hear this word we shock that something happen in funds and its outcome to our life style. Many time many employees fill bad and they doesnt work hard for organization. And last one is need to be competitive and be first every time you have to make some changes in your organization which change your organization and be competitive in market sector.

2.3 Resources implication of not responding to change.


Human resources are man power to any organization and change need to restructuring the organization. That means you can decrease you management layers. That means you can short and fastest decision path and also help to decrease expense of manager. Interviewing and hiring is main process to N.H.S. because in this organization one small mistake takes patient live. So you have to appoint best employees and passionate. Redundancies are an unfortunate fact of modern life. No one like this but sometime allow surviving organization. You have to select very fair and transparent. Training is main thing for changes. At all levels staffs are trained to accept change to adapt. In N.H.S. every time new research arrives. For that all employee has to ready for that change in every levels. Physical Resources Main thing is equipment. Every equipment will be up to date and failure will replace at a moment. N.H.S. work to save people and if any equipment is defective than it effect to patient some time bad reaction happen so not a single mistake. Another physical resources is vehicles that is main to hospital because in emergency case any time any where you have to reach in short time so you cant compromise with vehicles. You have to provide best service also in vehicles. Last one is building that where is place which is easy to everyone to come and nearby every one, also easily to find out. So in emergency cant take more time to transport. Building is also capable to any natural damage and every facility available. Financial resources are very hard to every organization. Organization has to achieve them financial goal. Main thing is training to staff for new technology and its very costly for that every employees have to do training with work so it help to reduce cost of training. Building cost that means which building you hire that is at best place and also profitable in future. Some time alternative is very profitable like saving employee transport cost also saving time. N.H.S. every main building is on main road that help to easily find out and also help to patient in emergency. So

TASK 3 3.1 Develop system to involve stakeholders in the planning of change. The systems used to involve stakeholders in change depend on the business. In some cases, where a person has a non-voting stake in the business, their opinions will not be considered when changes are being made. However, as most stakeholders will be expecting to contribute their opinions for developing a business, its important to have a tried and tested system in place. Normally, a majority vote is used when passing controversial plans for change that have already been determined. If a company is looking for the opinion of stakeholders when plans are being established, some of the options that executives will have include raising it in a board meeting. As many stakeholders will be present, the pros and cons to certain changes can be weighed, and some directors who have experience in initiating this type of change may contribute ideas they have which are based on their previous involvement with other projects. Its important to value the perspectives of stakeholders. They should be able to have a say in the direction of a business, as if a wrong decision is made against their will, they would have lost money in a way that could have been avoided. This can result in the overall value of a business declining, with some investors withdrawing their stakes. Gradual change can be better than fast change, as stakeholders can progressively see a new plan brought into place, and the financial implications that a development may have. Through being united in business, its likely that dividends will be better and the decision making by stakeholders will be more efficient. Stakeholder is individual group or institute who is affected by a project in a positive or negative way. Key stakeholder in a business organisation includes creditors, customers, directors, employees, government, owners, etc... Although stakeholders are those who judge themselves to be stakeholders are stakeholder. All stakeholders are not equal and different stakeholders are free to different consideration. We are talking about NHS so the reason of analyse is understand your client / beneficiary interest, needs and capabilities. Also clarify all groups that might have an interest in project. For identify potential opportunity and threats to project implementation. 1. Identifying your stakeholders Identifying stakeholders requires a good deal of research. One effective way you can achieve this is by assembling a group of subject matter experts, mainly those with good networks. The experts then brainstorm a list of all the people and groups likely to be affected by the planned change. The list is recorded on a flipchart, or typed onto a laptop, for the group to see.

2. Prioritising your stakeholders Once the list of names has been generated, you should then analyse the list in terms of power, power and the level to which they are affected by the project or change. Each name is inserted into a four sector table. A useful acronym for ensuring that you have included all likely stakeholders in the health service is the 9 Cs' listed below: Commissioners: those that pay the organisation to do things Customers: those that acquire and use the organisation's products Collaborators: those with whom the organisation works to develop and deliver products Contributors: those from whom the organisation acquires content for products Channels: those who provide the organisation with a route to a market or customer Commentators: those whose opinions of the organisation are heard by customers and others Consumers: those who are served by our customers: ie patients, families, users Champions: those who believe in and will actively promote the project Competitors: those working in the same area who offer similar or alternative services

Four sector table: High Satisfy power Opinion formers. Keep them satisfied with what is happening and review your analysis of their position regularly. Low power Monitor This group may be ignored if time and resources are stretched. Manage Key stakeholders who should be fully engaged through full communication and consultation. Inform Patients often fall into this category. It may be helpful to take steps to increase their influence by organizing them into groups or taking active consultative work. High impact/stake

Low impact/stake

3. Understanding your key stakeholders We have to know more about your key stakeholders. how are they likely to feel about and react to your project? You also need to know how best to engage and communicate with them. Key questions to help you understand your stakeholders What financial or emotional interest do they have in the outcome of your work? Is it positive or negative? What motivates them most of all? What information do they want from you? How do they want to receive information from you? What is the best way of communicating your message to them? What is their current opinion of your work? Is it based on accurate information? Who influences their opinions generally, and who influences their opinion of you? Do some of these influencers therefore become important stakeholders in their own right? If they are not likely to be positive, what will win them around to support your project? If you don't think you will be able to win them around, how will you manage their opposition? Who else might be influenced by their opinions? Do these people become stakeholders in their own right?

Often the best way to answer these questions is to talk to your stakeholders directly. People are usually quite open about their views - asking their opinions can be the first step in building a successful relationship with them. 4. Managing your stakeholders:
The analysis is useless if it does not lead to action. The project team should devise actions to win round doubters, and sustain and enthuse supporters. A second model for analyzing stakeholders is to examine their degree of synergy against their level of antagonism. People with low synergy and moderate antagonism are your opponents; those with high synergy and low antagonism are your unthinking supporters. Advice on dealing with each group can be found in the document at SKILL working with stakeholders.

High Chief executive power Finance director BMA rep

Consultant medical staff Clinical coding manager Finance creditor staff Medical director Primary Care Trust Clinical governance lead Clinical coding staff Clinical audit Junior doctors IT systems manager

Medical records staff Low power Medical secretaries

Low impact/stake

High impact/stake

3.2 & 3.3 Involve stakeholder in change management. Stakeholders are a group of our company which helps us to achieve our objective and help us with the changing which we take in company to make profitable in our company. There are some steps to involve stakeholders in change management. 1. 2. 3. 4. 5. Plan strategies Team work in change management Mentoring Coaching Benefits of delegation to the managers

1. Plan strategies : Plan strategies is about to make a plan with new change and you have to involve each group and each person. Use your estimates on attitude and influence to help you to do this. Capture your strategy/action. It usually takes the form of obtaining more information, or of involving the stakeholder in the planning for the change, a low confidence rating on attitude and influence indicates a need for more information. On some occasions you will choose to approach the person concerned As we discuss in MHS we have to first think how to plan that all employees are include in new change management and its make every employee happy.4 2. Team work in change management : Team work is the main thing which we need because without team work its not easy to achieve our new objective with change management. Teamwork has become an important part of the working culture and many businesses now look at teamwork skills when evaluating a person for employment. Most companies realize that teamwork is important because either the product is sufficiently complex that it requires a team with multiple skills to produce, and a better product will result when a team approach is taken. Therefore, its important that student learn to function in a team environment so that they will have teamwork skill when they enter the workforce. Also, research tells us that student learn best from tasks that involve doing tasks and involve social interaction. The following are eight characteristics of effective teams they were identified by Lerson and LaFasto in their book titled Teamwork: What Must Go Right / What Can Go Wrong (sage publication 1989) 1. 2. 3. 4. 5. 6. 7. 8. The team must have a clear goal. The team must have a result-driven structure. The team must have competent team members. The team must have unified commitment. The team must have a collaborative climate. The team must have high standards that are understood by all. The team must have external support and encouragement. The team must have principled leadership.

In our organization we have to work as a team because every next action available in your previous steps. In NHS when any doctore provide a new test or reports than

other team which provides this all things they have to work fast and also inform the doctore about that process. 3. Mentoring : "Mentoring is to support and encourage people to manage their own learning in order that they may maximise their potential, develop their skills, improve their performance and become the person they want to be." Eric Parsloe, The Oxford School of Coaching & Mentoring A mentor is a guide who can help the mentee to find the right direction and who can help them to develop solutions to career issues. Mentors rely upon having had similar experiences to gain an empathy with the mentee and an understanding of their issues. Mentoring provides the mentee with an opportunity to think about career options and progress.

(Adopting from http://www.mentorset.org.uk/pages/mentoring.htm) Our organisation is best to mentoring work with employee. Because they give many honour who work as team work. And in NHS doctor need help of every person and everybody with them. They are always give chance to do something new if u wants to do.

4. Coaching : Coaching is a process that enables learning and development to occur and thus performance to improve. To be a successful a coach requires knowledge and understanding of process as well as the variety of styles, skills and techniques that are appropriate to the context in which the coaching takes place. Eric Parsloe, The Manager as Coach and Mentor (1999) page 8 Coaching is a shorter term role than mentoring; it tends to be task/project focused with the line manager coaching a member of staff towards achieving a specific outcome. Coaching helps individuals improve their performance and skills development, for example, helping staff with learning needs related to a task. There are many styles of coaching, below are some examples. You may wish to consider which is most suitable for your needs. Checklist: Where a coach gives guidance on what the person needs to do to improve their performance and where the person is accountable for achieving the agreed actions. Skill/will matrix: Where managers are guided on the best approach to take when coaching team members. The skill is the experience, training and understanding of the individual and the will refers to their motivation, confidence or desire to do it. The skill/will matrix is the original work of Hersey and Blanchard. Co-active: Based on the belief that a person has the answers and the coach helps to unlock that person's potential to achieve their goals. As coaching is about working in partnership, co-active coaching requires active participation from both the coach and the client. Details on this coaching model and the skills and techniques can be found in "Co-active Coaching" by Laura Whitworth et al.

5. Benefits of delegation to the managers : Some people think that delegation and abdication amount to the same thing, but this is not true. Delegation is where one person appoints another to act as a chosen representative on his or her behalf. Abdication, on the other hand, is the act of giving up power, either by abandoning it or resigning from the post (Mackenzie, 1998). It is a fundamental principle of management that there must be delegation to achieve organisational effectiveness. As an organisation grows in size, so the extent of delegation must increase for it to function and progress. The nature of the NHS and the various activities undertaken within it dictate that the workload is distributed among various members of the workforce. Delegation has, therefore, to occur at both an organisational and an individual level.

Evolution of systems to involves setting objectives for the NHS trust or organisation you are working for and creating the routes towards reaching these goals. Staff responsible for planning and implementing change would feature in this area of management. Job roles will very depending on the NHS organisation, but essentially have responsibility for the successful delivery of a range of service within the organisation certainly involve people, resource and budget management, working beside clinical colleagues and with cross-functional teams to improve the way in which services are delivered. Consulting patients and the public; and focusing on how the NHS can be modernised to meet patients needs. The role could range from being responsible for a whole service division of staff and a multi-million pound budget in a hospital trust, to managing primary care or mental health services over a wide geographical area and across many sites. Many posts at this level will therefore require experience or knowledge of a range of areas in management. This might include communications, public relations, risk management, general administration, planning, public and patient involvement, clinical governance and purchasing. Here are some examples of job roles available within strategic management.

Commissioning and development manager: This type of post would focus on developing partnership work with acute (hospital-based) and primary care sector colleagues to modernise local services, develop secondary care services in a primary care setting, and enhance well established intermediate care services; plus implementation of the Patient Choice agenda. In this example, the post holder would ideally have a clinical or operational management background. Commissioning manager (social inclusion) in this example, based within a primary care trust (PCT), this varied and challenging role would give you the opportunity to develop unique services for people often excluded from planning. Working with a range of services, the post would ensure the differing needs of the community were met efficiently. The role would involve commissioning and developing healthcare services for a variety of groups, such as HM prison, asylum seekers, black and ethnic communities as well as developing smoking cessation services. A post such as this would require background knowledge of social inclusion as well as an open-minded attitude. Evidence of experience in commissioning services and partnership service development would be required. General Manager: This example based in a new high profile directorate within one of Englands largest mental health trusts. This directorate forms a key part of the Government's plans to reform the management, assessment and treatment of high risk patients thought to be dangerous and severely personality disordered (DSPD). As a member of the Directorate Management Team this post would provide strategic support and professional guidance, while managing a budget in excess of 13 million and a staff complement, when fully operational, of over 300 people. Such a role would require a manager with senior operational management experience and a track record of managing projects, people and change. It would need an ability to consider new ways of working, an ability to handle multiple tasks, and an ability to manage in an environment at the edge of forensic psychiatry. Change manager: This post would support the development and implementation of a number of change projects, working under the direction of project leads. The post holder would need to be an analytical thinker with the ability to engage and influence a wide range of individuals and highly developed communication, presentation and interpersonal skills. Change manager again, working in a large acute (hospital-based) trust, this post would play a pivotal role in shaping and transforming the future of the trust. It would initially focus on delivering benefits in diagnostic imaging services, working with clinicians and managers. For this post, the trust would seek a results-driven individual, with experience of working with clinical teams, as well as strong project management, IT and presentation skills. Analytical skills, an ability to develop solutions, and clearly assess the benefits of alternative options would all form a part of this type of role. Experience in capacity and demand analysis, leadership and change management skills would be essential and an ability to bring others "on-board" with ideas generated.

Director of strategic development: Director of strategic development Based within a mental health trust, as an executive director of the trust management board. The post would play a major role in shaping the future mental health services and social care provision whilst contributing to the achievements of the Trusts modernisation goals. It would also include board overview for the private finance initiative (PFI) project and new developments including a child and adolescent service and regional womens forensic services. This level of post would usually require the post holder to have significant experience at a senior level within a large complex organisation with demonstrable managerial, planning and operational experience as well as project development and implementation. Chief executive: Chief executive of a mental health and learning disabilities NHS trust, to drive forward a major programme of service and capital modernisation. The challenges of a role at this level would potentially be complex and multi faceted with this post. In this example, local consultation had commenced to modernise the service with public meetings to be held imminently. The post holder would be required to have good communication skills and media experience would be desirable. They would need the capacity to think strategically and adopt a patient-focused approach. This type of role would require commitment and team management skills in order to create a performance management culture geared for success. A proven track record of significant achievement in a complex and challenging environment and is able to demonstrate the ability to provide effective leadership would be required. In addition, they would need the ability to communicate their vision for the modernisation of services and translate it into reality. Here, the priorities would be to maintain and accelerate the momentum for change. The post holder would lead a board management team; provide the strategic direction and leadership needed to maintain an efficient, supportive, creative organisation. They would need experience at board level of planning, managing and modernising patient centred services. Strong financial skills would also be important and the ability to display all the qualities needed to get the best from a large, diverse workforce and numerous external partnerships.

3.4 Strategies to manage resistance to change. Time resource is a comprehensive collection of proven quality and service improved tools, theories and technique that can be applied to a wide variety of situation. Stage of project: identifies tools that are relevant to implementing a service improvement project, e.g. starting out, diagnosing the cause etc... Type of Task: identifies tools associated with addressing specific task, e.g. mapping the process, thinking creativity etc... Type of Approach: identifies tools linked to a specific approach, e.g. Lean, Six Sigma, analytical tools etc... Seven ways to No Delays: identifies ways to improve patient flow and design delay free service in order to achieve better patient care. Patient pathways: identifies tools that relate to the seven stage of the patient pathway. (copyright NHS Institute for Innovation and Improvement 2006-2011)

There are few steps to demonstrate that you recognize that resistance to change can show different ways. 1. Resistance to change: Resistance to change is the action taken by individuals and groups when they perceive that a change that is occurring as a threat to them. Key words here are 'perceive' and 'threat'. The threat need not be real or large for resistance to occur. In its usual description it refers to change within organizations, although it also is found elsewhere in other forms. Resistance is the equivalent of objections in sales and disagreement in general discussions. Resistance may take many forms, including active or passive, overt or covert, individual or organized, aggressive or timid. The scale of responses is as follows: 1. 2. 3. 4. 5. 6. 7. 8. 9. Commitment Co-operation Support Acceptance Indifference Apathy Protest Slowdowns Sabotage

2. Individual versus collective resistance to change: Resistance to change can be defined as an individual or group engaging in acts to block or disrupt an attempt to introduce change. Resistance itself can take many different forms from subtle undermining of change initiatives or withholding of information to active resistance, for instance through strikes. Resistance to change can be considered along various dimensions: Individual versus collective Passive versus active direct versus indirect behavioral versus verbal or attitudinal Minor versus major.

Many times individual resistance is come because of change come from managers or employee. Some are unhappy with changes taking place. 3. Behavioral versus verbal resistance to change: Some time organization employee nothing to speak but they opposing change and displaying physical symptoms of their resistance such as reduces output, lateness and frequent absence. 4. Feedback strategy to manage resistance: Sometime its happen that not a single feedback come back from employee about the changing management and in one way communication you have to just sending message no any arguments. Another way is two way communications that mean you get the feedback from employee side. And last and effective communication is face to face communication. 5. Addressing needs of people resistant to change: Fear of the unknown stops us venturing into new territory, taking risks and accepting readily ideas for a change. This uncertainty contributes to resistance to change, which needs to be reduced for any change to be successfully implemented. This tool will help you to identify potential fears at individual and team level and potential responses and coping strategies to help managers overcome resistance and bring about change.

Purpose: Working through fears at an individual and team level can impact on achieving support for the change initiative, and can assist with improving the quality of work and lifestyle of all those involved in the change process. It can: Build staff morale and support for the change proposals Improve the organizations capability to change Improve quality Reduce the stress of a change situation Provide a constructive platform to reduce the resistance of some of the barriers to change

6. Getting opponents of change to focus on the benefit: To get opponents from the benefit of change process its not an easy. There is so much against but its long term view of the benefits. It is not easy to get opponents to view the benefits when there is so much they are against but it is crucial that they have a long term view of the benefits of the change process.

4.1 Develop appropriate models for changing in the selected organisation. Now days as we know NHS is going down just because of our UK government and also they decide to cut lots of part from NHS finance. So thats the reason NHS find out the way to come out from rescission. In a latest news NHS decided to leave 40,000 employee and thats why 40,000 unemployment increase. For this situation i would like to choose Mckinseys seven S Framework which is perfectly set to organisation. While some models of organizational effectiveness go in and out of fashion, one that has persisted is the McKinsey 7S framework. Developed in the early 1980s by Tom Peters and Robert Waterman, two consultants working at the McKinsey & Company consulting firm, the basic premise of the model is that there are seven internal aspects of an organization that need to be aligned if it is to be successful.

(Adopting from http://fmcg-marketing.blogspot.com)

The McKinsey 7S model involves seven interdependent factors which are categorize as either "hard" or "soft" elements: Hard Elements Strategy Structure Systems Soft Elements Shared Values Skills Style Staff

"Hard" elements are easier to define or identify and management can directly influence them: These are strategy statements; organization charts and reporting lines; and formal processes and IT systems.

"Soft" elements, on the other hand, can be more difficult to describe, and are less tangible and more influenced by culture. However, these soft elements are as important as the hard elements if the organization is going to be successful. The way the model is presented in Figure 1 below depicts the interdependency of the elements and indicates how a change in one affects all the others. 1. Strategy : The strategy of an organization shapes its structure. Likewise the behaviours and values of an organization can promote or undermine its strategy. Plans for the allocation of a firms scarce resource, over time, to reach identified goals. Environment, competition, customers. As in organisation are joint to government. As per economy down government also cut in NHS budget and they fired many people from NHS and thats very difficult situation for UK. For that NHS has decide to stop unemployment by team work and its only possible if all employees are agree. We are planning to decrease high level managers and employees salary and that part goes to that people who are going to fired. 2. Structure : The basic organization of the company. its departments, reporting lines, areas of expertise, and responsibility. Refers to the way in which an organisations business units relate to each other. For example, a company may use a centralised system where all key decisions Everyone knows that some of person which are not important at that level than we have to remove that person and because of that we can save salary. As in organisation in between to doctor and patient there are many stages. So just remove extra stage to save money. 3. System : System are the practices and procedures that an organisation uses to get things done, e.g. financial systems, information systems, recruitment and performance review systems, etc. formal and informal procedures that govern everyday activity, covering everything from management information systems, through to the systems at the point of contact with the customer As we know our organisation is not in good position so we have to think about who is in NHS from last many years. And we have to stop new recruitment and start transfer people where we need from we dont need.

4. Shared Value : If you discover the passion of the CEO, you will discover the organizations real priorities. Is there fundamental passion towards? Making money? Staff relationships? Customer orientation?

These are important issues to get to the bottom of. What measures are used in reward systems? This often shows the reality of what is important to the organization Shared values are commonly held beliefs, mindsets, and assumption that shape how an organisation behaves its corporate culture. Shared values are what engender trust. They are in interconnecting centre of the 7S model. Value are the identity by which a company is known throughout its business areas, what the organisation stands for and what it believes in, it central beliefs and attitude. 5. Style : How leaders behave influences the behaviours of their staff. The most effective leaders are those who are sensitive to people's needs. When senior managers? career paths have been via specialist or technical functions, for example, they may well fail to appreciate the need for a holistic approach to change. Typically where this style prevails, quantitative measures are set for operational delivery. Little attention is paid to the qualitative aspects of service such as creating rapport and being empathetic to the customer. Senior managers are often pre-occupied with other influences such as competitors, shareholders, the City, government and regulatory bodies. Customers compete against these other preoccupations for their share of airtime and often lose. Senior managers can all too easily become cocooned in a world far removed from the customer and the company people who work at the sharp end. One acid test of how removed your senior people may be from customers is: Who replies when a customer writes to the CEO? This remoteness frequently leads managers to: Become hooked into the internal politics of the organization Shut off from honest feedback Rarely see the customer face-to-face This can all add up to management decisions which are far from customerfriendly such as rules and regulations that work well for the organization but not the customer.

6. Staff : We are increasingly engaged within organizations to move front line employees from a dependent, compliant and rule bound style towards one where they freely take risks and confidently exercise good judgment. The answer frequently starts with the very senior managers who bemoan the lack of initiative in their staff. People working for 'task master' style managers who are directive and autocratic develop into terrorists hesitant or opposed to to change, or spectators who take a back seat when it comes to resolving a customer problem. This is because people often become resentful or discouraged to take initiative when they are constantly told what to do and when the only feedback they receive is negative. New recruits soak up culture like sponges they may have been recruited for their winning qualities, but they are influenced strongly by other's behaviours. In our organisation we only need a person who work with freshness and always behave well with patient. And in any kind of depression situation he handle very easily and not lose his pamper. 7. Skill : Customer orientated organizations such emphasize the attitude and interpersonal skills needed to interact effectively with customers. Role, skills and knowledge can be taught, whereas many of the less tangible, feeling interpersonal skills involve being able to create critical rapport with customers. Distinctive capabilities of key staff, but can be interpreted as specific skill sets of team members. NHS want always skill man who attaint too many work alone so its easy that its helpful to decrees the cost of NHS.

4.2 Implement a model for change. As we choose McKinseys seven S framework for our NHS organisation we going to implement a model for new changes arrived. Because NHS is in very difficult situation than we make a strategy to reduce a costing of NHS and with reduce jobs in NHS. 1. The Learning Organisation: The essence of organisational learning is the organisations ability to use the amazing mental capacity of all its members to create the kind of processes that will improve its own (Nancy Dixon 1994) organisation where people continually expand their capacity to create the results they truly desire, where new and expansive patterns of thinking are natured, where collective aspiration is set free, and where people are continually learning to learn together (Peter senge, 1990) From the above definition we can see that organisation need always new and find out more and more different style to achieve organisation goal. There are some characteristics for organisation. 1. Values individual and organisational learning as a prime means of delivering the organisational mission. 2. Involves all its members through continuous reflection in a process of continual review and improvement. 3. Structure work in such a way that work activities are used as opportunities for continuous learning. So in NHS we have to learn about new strategic plan and also ready to think how we decrease a cost of organisation. For that stop using finance anywhere. Also finding donation for our organisation.

2. Transformational Leadership: The concept of transformational leadership was initially introduced by leadership expert and presidential biographer James MacGregor Burns. According to Burns, transformational leadership can be seen when leaders and followers make each other to advance to a higher level of moral and motivation." Through the strength of their vision and personality, transformational leaders are able to inspire followers to change expectations, perceptions and motivations to work towards common goals. Later, researcher Bernard M. Bass expanded upon Burns original ideas to develop what is today referred to as Bass Transformational Leadership Theory. According to Bass, transformational leadership can be defined based on the impact that it has on followers. Transformational leaders, Bass suggested, garner trust, respect and admiration from their followers. The Components of Transformational Leadership Bass also suggested that there were four different components of transformational leadership. 1. Intellectual Stimulation : Transformational leaders not only challenge the status quo; they also encourage creativity among followers. The leader encourages followers to explore new ways of doing things and new opportunities to learn. 2. Individualized Consideration: Transformational leadership also involves offering support and encouragement to individual followers. In order to foster supportive relationships, transformational leaders keep lines of communication open so that followers feel free to share ideas and so that leaders can offer direct recognition of each followers unique contributions. 3. Inspirational Motivation: Transformational leaders have a clear vision that they are able to articulate to followers. These leaders are also able to help followers experience the same passion and motivation to fulfill these goals. 4. Idealized Influence: The transformational leaders serve as a role model for followers. Because followers trust and respect the leader, they emulate the leader and internalize his or her ideals. Sources: Burns, J.M. (1978). Leadership. N.Y: Harper and Raw. Bass,B. M,(1985). Leadership and Performance. N. Y,: Free Press. Riggio, R.E. (2009, March 24). Are you a transformational leader. Psychology Today. Found online at http://blogs.psychologytoday.com/blog/cutting-edge-leadership/200903/are-youtransformational-leader

3. Virtual Organisation: This section of the module will examine the concept of the virtual organisation as strategic vision. It will examine some of the contrasting views concerning what virtual organisation are what their supposed benefits might be and they might be classified and differentiated Organisation always tried their organisation structure to suit their organisation strategy. So our organisation strategy is to cut down costing so thats why they structure also with costing down. They try to make a minimum level of organisation. 4. Kaizen: Kaizen was created in Japan following World War II. The word Kaizen means "continuous improvement". It comes from the Japanese words ("kai") which means "change" or "to correct" and ("zen") which means "good". (http://www.graphicproducts.com/tutorials/kaizen/index.php) Kaizen is a system that involves every employee - from upper management to the cleaning crew. Everyone is encouraged to come up with small improvement suggestions on a regular basis. This is not a once a month or once a year activity. It is continuous. Japanese companies, such as Toyota and Canon, a total of 60 to 70 suggestions per employee per year are written down, shared and implemented. Kaizen, meaning continuous improvement in Japanese, is a fundamental shift in how we work and think. Christina Saint Martin, our in house expert when it comes to implementing the Kaizen system within healthcare organisations, explains the principles behind it, It is a method of working which will help us all to identify and eliminate waste and improve the quality of the processes that are part of the healthcare experience. It also ensures that our staffs are supported to deliver the highest quality and safest patient care. As Chief Executive, Len Richards, says, Kaizen is not another flavour of the month we are going to change the way we do things. The implementation of Kaizen is essential to maintaining and surpassing the level of care which our patients expect from us. Ive already witnessed at first hand the fantastic benefits that implementing its methods have had and, as Kaizen is introduced into more areas of our Trust, you will all be able to take steps to continually improve so that we can provide Excellence in Healthcare to all our patients.

5. Change consultancy: Change is the main them of the every organisation. The change consultancy team needs the following skills capabilities: Ability to develop rapport with clients Positioning with clients Influencing clients and managing client relationship Situation appraisal Team working Data collection Problem solving Solution generation Managing change This change a organisation better and clients like to you because of good and fast service. 6. Learning organisation: The NHS is developing as a learning organisation in which learning is integral to service planning and management processes.

18 NHS 'branded learning centres' that have met the strict quality assurance criteria of Sufi / Learn direct with another 2 on the way Access for NHS staff to over 300 Learn direct centres. Access to a national database of over 60,000 learning opportunities. 3,000 NHS Personal Learning Credits for staff to be used to support uptake of WEA/UNISON development programmes and SVQs.

One that promotes and supports learning by all its staff, as part of a continuous process of development. It encourages self-development at all levels of the organisation, giving staff the opportunity to develop their potential and have their achievements recognized. The set up of a new education and training organisation for all healthcare professions in Scotland was a key recommendation of Learning Together. NHS Education for Scotland (NES) was established as a Special Health Board in April 2002. Its aim is to contribute to the highest quality of health care in NHS Scotland by promoting best practice in the education and lifelong learning of its entire staff. The new body will build on the work of the National Board for Nursing, Midwifery and Health Visiting for Scotland (NBS), the Post qualification Education Board for Health Service Pharmacists (PQEB) and the Scottish Council for Postgraduate Medical and Dental Education (SCPMDE). In time it will be extending its activities to cover all staff groups.

7. Transformational leadership: The use of experiential, dynamic group work is a critical element of the Transformational Leadership Programme (TLP). The group work is based on a combination of systems theory and interpersonal communication skills and provides an opportunity for you to learn more about what its like to be on the receiving end of you. This will build your resilience, insight and authority. The group work involves paying close attention to the unfolding dynamics of the group. Together we will observe the formation, maturation and ending of the system. Through this process, you will increase your sensitivity to the dynamics of inequality, collusion and affiliation and you will learn ways of intervening successfully to address these issues in order to build a high performing team. Alumni from the Top and Senior Manager Programmers tell us that the group work on their programmers formed the bedrock of their learning, powerfully enhancing their capacity to read and influence the dynamics of boards and groups on issues of diversity and equality. The learning trajectory The programme is structured into five weeks spread out over four months, and takes place in four different locations. We use the different learning environments as a means to deliver the educational aims and objectives of the programme, harnessing the curiosity and interest of participants as natural motivators to make the learning process fun often with startlingly effective results. What makes the learning so powerful is that participants are asked to bring themselves and their real-life experiences to the learning process; there is almost no role play or work with case studies it is all for real. Learning is therefore exciting and parallels the reality of the workplace. This kind of learning is seldom forgotten because it becomes integrated with the values and behavior of the individual.

4.3 Develop appropriate measure to monitor progress. NHS Boards must demonstrate clear leadership and reassure themselves that governance arrangements in accordance with the Staff Governance Standard are in place to enable accountability at Board level for delivery of occupational health and safety standards. This will ensure that leadership for occupational health and safety is embedded at the very top of the organisation and that occupational health and safety is an integral part of NHS Board staff governance arrangements. Boards should also recognise that clinical occupational health is a clinical specialism, and must be included within clinical governance arrangements. As part of embedding governance arrangements, NHS Boards are expected to clarify roles and responsibilities, at every level of the organisation, to ensure high standards of occupational health and safety are delivered. Boards must ensure that, where appropriate, existing local occupational health and safety strategies and plans are reviewed and revised, to ensure consistency with the approach and priorities identified in this strategic framework. They must also ensure there are appropriate monitoring and audit arrangements in place to measure progress and to ensure that risk management and governance arrangements in relation to occupational health and safety are in place and working well, for example through the utilization of a closed loop health and safety management system. At a national level, the Occupational Health and Safety Strategic Forum will play a leading role in facilitating the delivery of high standards of occupational health and safety across NHS through steering implementation, as appropriate, in relation to national delivery of actions, monitoring and evaluation of progress. This should include measuring progress against the four identified priority areas for action OHSSF or will also consider whether any additional guidance or standards are required to assist Boards with implementation, as well as reviewing and, where required, introducing systems for collecting and considering data and evidence, and for gathering good practice and disseminating to other Boards. Over time, OHSSF or will also review the priority areas for action with a view to advising Ministers and the Management Steering Group ( MSG) on whether other priority areas should be adopted. This work will be taken forward, working closely with the Scottish Workforce and Staff Governance Committee (SWAG). In addition to its continuing role as a co-chair of OHSSF or, the Scottish Government will provide the overall policy direction for occupational health and safety for NHS, and ensure that policies and approaches developed and implemented take account of broader government policy. This overarching programme of activity will lead to the delivery of a number of outcomes, such as a safer working environment, improved staff health and wellbeing, and improvements in staff attendance. This will be demonstrated through a number of measures of success, such as an increased level of staff engagement and a reduction in incidents across the four priority areas, which in turn can be measured through, for example, the staff survey, sickness absence targets, and the Occupational Health and Safety minimum dataset.

Summary and actions: NHS Boards must demonstrate clear leadership and reassure themselves that appropriate governance arrangements via the Staff Governance Standard at Board level are in place to enable accountability at local level for delivery of occupational health and safety standards. NHS Boards are expected to clarify roles and responsibilities at every level of the organisation to ensure high standards of occupational health and safety are delivered. NHS Boards must ensure that, where appropriate, existing local occupational health and safety strategies and plans are reviewed and revised, to be consistent with the approach and priorities identified in this strategic framework. NHS Boards must ensure there are appropriate monitoring and audit arrangements in place to measure progress and to ensure that governance arrangements in relation to occupational health and safety are in place and working well, for example through the utilization of a closed loop health and safety management system. NHS Boards should recognise clinical occupational health as a specialism to be included within clinical governance. The Occupational Health and Safety Strategic Forum (OHSSFor) will play a leading role in facilitating the delivery of high standards of occupational health and safety across NHS, through steering implementation, as appropriate, in relation to national delivery of actions, monitoring and evaluation of progress. OHSSFor will consider whether any additional guidance or standards are required to assist NHS Boards with implementation, as well as reviewing and, where required, introducing systems for collecting and considering data and evidence, and for gathering good practice and disseminating to other Boards. Over time, OHSSFor will review existing priority areas for action, with a view to advising Ministers and MSG on whether other priority areas should be adopted. This work will be taken forward, working closely with the Scottish Workforce and Staff Governance Committee (SWAG). The Scottish Government will provide the overall policy direction for occupational health and safety for NHS, and ensure that policies and approaches developed and implemented take account of broader government policy.

Reference: N.H.S. face 15bn budget shortfall <

http://www.telegraph.co.uk/health/healthnews/5485814/NHS-will-face-15bn-budgetst shortfall-due-to-effects-of-recession-managers-warn.html> assessed on 1 June 2011 http://www.strategicintervention.com/strategic-intervention-benefits/fosteringstronger-communications-in-the-workplace/ http://www.istheory.yorku.ca/contingencytheory.htm http://www.sehd.scot.nhs.uk/learningtogether/learningorganisation.html http://www.institute.nhs.uk/building_capability/breaking_through/faqs__transformational_leadership.html http://www.training-manager.co.uk/documents/DelegationSkills.pdf

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