OD in the NHS II: The Sequel ‘Celebrate, Consolidate, Challenge’ Follow the conversations on Twitter: @ODintheNHS @NHSE_DoOD & @NHSLeadership
OD in the NHS II: The Sequel
‘Celebrate, Consolidate, Challenge’
Follow the conversations on Twitter:
@ODintheNHS
@NHSE_DoOD & @NHSLeadership
Dr Pat Oakley
Director
Practices Made Perfect
Sarah Akhtar
Head of Organisational Development
Chesterfield Royal Hospital NHS Foundation Trust
Monday 7th July 2014
POLITICS, COMPLEXITY AND STRATEGY
NAVIGATING CHANGE
OD in the NHS II: The Sequel
Dr Patricia Oakley
Director, Practices made Perfect Ltd.
Teaching and Research Fellow
Public Policy and Management
King’s College, London
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
The Deliverable: 7 Day Services and Joined-up
Community-Based Care
The Big OD Agenda
The Protagonists: Professional Staff and External Forces
Managing Change: Culture & Politics
The Front and Backstage Approaches
The Political Strategies
The “OD” Supermarket
POLITICS, COMPLEXITY & STRATEGY
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
? Local Diagnostic Services?
? Local Imaging Services?
? Local Genomics Services?
“The Place in the Middle”
High Street
Social Care Services
Hospice and Hospital
at Home Services
Community Pharmacy
and Medicines Services
GP Surgeries and
Out of Hours Services
Community Nursing and
Midwifery and Therapy
Services
? Regional Diagnostic Services?
? Regional Imaging Services?
? Regional Genomics Centres and Predictive Analytics Services?
? The Home Tests?
? The Gym Tests?
? Point of Testing
Services?
Maternity &
Neonatology
Care Services
(including children’s
trauma service)
(includes current A&E “minors” service)
Regional
Trauma
Services
Urgent
Care
Services
Cancer, Cardiac,
Stroke
Care Services
Mental Health
Care Services
(inpatients)
• Convalescent, Observation and
Place of Safety Beds and
Services.
• Minor Injuries and “Off-legs”
Front Door Services.
• Planned Care and
Rehabilitation Services.
• Outpatients and Long Term
Care Support Programmes
including Self-Care Workshops
and Self-Help Networks
Support Programmes.
• End of Life Services.
Local Care Services (including mental health and
planned care services)
Genetics
Services
Social &
Probation
and Police
Services
(including children’s
urgent care service)
Paramedic/Blue
Light Service
Services
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
“Many organisations are paralysed by situations in which
people appeal for direction, feeling immobilised and
disorganised by the sense that they are not being led. Yet
other organisations are plagued by the opposite situation
characterised in organisational vernacular as one of “all
chiefs, and no Indians” – the situation where the majority
aspire to lead and few to follow.”
Leadership and Direction, and Followers’
Receptivity and Responsiveness
Smircich, L. and Morgan, G. (1982) “Leadership: the Management of
Meaning,” The Journal of Applied Behavioural Science, 18 (3), 257-273.
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
The formation of a profession – body of knowledge;
education and language; controlled entry; inculcation
with collective values; control of jurisdiction.
Understanding the role of the external forces that control
the OD Agenda and professional staff’s values and
behaviours.
Working with in and out group dynamics.
Using peer groups and data to manage change.
Underpinning change with practice audit, education and
training and reflective practice.
Professional Staff and External Forces
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
Technical aspects of change – mostly OK.
Cultural change – seen as too difficult, too time-
consuming and too long-winded.
Political change – seen as too nasty, too costly, and too
emotional.
Stunted change programmes at best.
Bun-fight and worse when change programmes unravel
and wheels come off the change train.
Managing Change: Culture & Politics
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
Political School
• Power players
and barons,
gangs and
warfare.
• Goal =
alignment of
power systems
and conflict
management.
• Pfeffer and
Mintzberg.
Learning School
• People are learning
animals.
• Goal = personal based
development and growth
thru’ “double-loop
learning”.
• Argyris and Schon.
Groups/Teams School
• People are social
animals and need to
belong to groups and
teams.
• Goal = group based
change and
development.
• Brown and West.
Cultures School
• Collective signals and
behaviours that bind
individuals together.
• Goal = collective change
based on historical
perspectives.
• Deal and Kennedy.
Humanist School
• People with feelings and
attitudes.
• Goal = personal based
development and growth
thru’ support.
• Mayo and Hertzberg.
Rational Scientific
• Organisations and
people are rational.
• Goal = organisational
based change thru’
task realignment.
• Taylor and Fayol.
Decision Sciences
School
• Organisations are
systems of complex
informatics.
• Goal = organisational
based change thru’
improved decision
making.
• Simon.
BACKSTAGE FRONTSTAGE
Grounded Theory to Support Organisational Development
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
Machiavellian manipulative strategies
Participative management power equalisation strategies
Politically
organic
Politically
mixed
Politically
mechanistic
Democratic
strategies
Coercive
strategies
Politically
mechanistic
Politically
organic
Tichy’s (1983)* Political Change Strategies
*Tichy, N. (1983). Managing Strategic Change – Technical, Political & Cultural Dynamics. Chichester: Wiley & Sons.
Autocracy Democracy
MANAGING COMPLEX CHANGE
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
Generating O.D.
Body of Research
Human Resource Management
Strategic Change Management
Organisational AND Occupational
Psychology
Organisational Design and
Development
Performance Management
Design and Metrics
Organisational Ethics and
Standards
Groups and Team
Psychodynamics
Organisational Conflict and
Resolution
Organisational Power and
Authority
Organisational Learning and
Knowledge Management
Getting O.D.
Research Practice to
support strategic change
Organisational Development
Specialists
Diagnostic/Assessment and
Preparing a specific
Intervention/Development Plan(s)
Designing Training/Education/
Development Programme(s)/
Intervention/Support
Designing Training/Education/
Development/Intervention/
Support Tool(s) eg. Case
Studies.
Designing and Preparing General
“Generic” Programmes/Kits for
local specialists to use on
contract.
Designing Evaluation and Project
Management Programme(s).
Project Managers who manage
a complex matrix of
development projects
Specialist High Level Facilitators
who facilitate
meetings/processes for specific
problems.
Specialist Coaches who support
specific individuals eg. Co-
councillors for psychologists,
career planning specialists.
Specialist Tutors/Educators who
deliver specific specialist
programmes.
Fire Fighting Specialists who
manage “runaways” and
arbitrate/reconcile serious
conflicts and dysfunctional
teams and organisations.
The Organisational Development (OD) “Supermarket”
© Practices Made Perfect Ltd.
*Prepared by Dr. Patricia Oakley, Director, Practices made Perfect Ltd., 131-133 Cannon Street, London EC4N 5AX . Tel: 0845 862 0372 . Fax: 0845 862 0373 . E-mail: [email protected]
14g0362so1
Clear “top people”
sponsors and time
allocations
1 20
Clear time plan &
permission
parameters
1 20
Clear budget and
work programmes
1 20 1 20
Clear project brief
and SRO
Clear goals and
change objectives
1 20
The Change management Dashboard
TECHNICAL PROGRAMME
Clear arbitration and
“Runaway” exit
strategy
1 20
Clear internal political
stakeholders’
management strategy
1 20
Clear external political
stakeholders’
management strategy
1 20
1 20
Clear Force Field
Analyses and map of
political alliances
Clear diagnosis of
political groups and
power barons
1 20
Clear culture development
and investment plan with
key stakeholders’ sign-up
1 20
Clear identification of
intra + inter-group
rivalries & boundary
disputes 1 20
Clear identification
of groups’ generals
and lieutenants and
their needs
1 20
1 20
Clear identification of
groups and how they
do business
Clear diagnosis of
cultural issues and
needs 1 20
CULTURAL PROGRAMME
POLITICAL PROGRAMME
Fail Succeed
OK
100 1
50
Fail Succeed
OK
100 1
50
Fail Succeed
OK
100 1
50
Paul Taylor
Assistant Director Organisational Development
NHS Employers
@NHSE_PaulT
Karen Dumain
Programme Lead Organisational Development
NHS Leadership Academy
@KarenDumain1