Saturday, 13 February 2016

Junior Doctors, the EU Referendum and procurement change management lessons

I honestly don't know who is right in the current NHS change management crisis with the Junior Doctors. Imposing the new contracts can only be viewed as a failure but it is also a symptom of the bigger failure of change management or mis-management. I suppose there are questions as to whether imposing contracts is even legal; like many of you, I have been the victim of having changed employment and pension contracts imposed on me - that did not make me feel good. There is of course no doubt that the NHS is in a crisis and the resolution of the Junior Doctors issue will set a precedent for future negotiations way beyond those with the Junior Doctors.

There is also a precedent for the current chaos - remember the communications debacle relating to The system was to improve service but the communications management was lousy.

The reason why I do not know whether Hunt or the Junior Doctors are right is very similar to the debacle - the NHS communications setting out the current 'As-Is' and the future 'To-Be' has been abysmal. Those 'anti-change' have usefully played on emotion and fear. They have also managed to successfully infiltrate almost every one of the discussions on BBC Question Time for some weeks - the equivalent of the Greek Agora, the Roman Forum, and the works' canteen - the dessenters voice is very definitely the clearest and the loudest.  I ask myself why the NHS have not set out, in very simplistic terms, their case for change, perhaps on a webpage, a full page advertorial, or even a televised debate - that also needs to debunk the supposed myths of the BMA.  If that happened I could make an informed decision. If they really wanted to be aggressive they could also 'un-deify' the Junior Doctors - easy enough if you started to discuss the various NHS failures and how they could be linked to the problems the new contracts will overcome.

Of course the NHS' 'Junior Doctors' communications fiasco are only a warm-up for the EU debate - we can expect emotion and fear to dominate. We can expect communications to be poor - they already are.

So what about lessons for procurement? Well, if you want to bring about procurement change, the Junior Doctors crisis may serve as a useful warning:
  1. Make clear, again, and again, and again, what the benefits of the 'To-Be' and how they address the problems of the 'As-Is';
  2. Understand the negotiating power of those involved;
  3. Understand the fears of those who will and could be impacted;
  4. Address head-on the criticisms of the dessenters - some of their concerns will be justified, some will be nonsense, and some just scaremongering;
  5. Remember that new systems and processes are not inanimate, they are concerned with people and it is people who will determine the effectiveness of the outcome;
  6. Bring people with you, including those right on the periphery.

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