Are you focusing on how your project supports rethinking the current delivery models?

It seems obvious to say that to address the current agenda of how you positively impact the workforce and/or workload, while supporting the development of Primary Care Networks and Integrated Care Systems, you need to rethink the current delivery model. But, unless you are clear that’s what you are doing, the risk is you slip in to doing what’s gone before, only trying a bit harder.

Please keep in mind that if you simply keep doing what you have always done, you will keep getting what you have always got! Unless you and your client are 100% happy with current outcomes, you will need to change your input to drive a new and improved outcome.

For those who do decide to rethink their delivery models you are very likely to meet resistance. Put simply, people don’t like change and they definitely don’t like change that’s been or is being imposed.

The issue is that when it comes to change, we often use a once successful management approach, where a parallel organisation exists – the steering group or subcommittee approach - with the chosen few making decisions for the many, and then only engaging with stakeholders once the direction or initial plans have been created. While this process once worked, in today’s environment it is no longer fit for purpose.

If people aren’t involved from the beginning, they are more likely to resist and obstruct change, even when the ideas are good. People recognise that they are being sold something rather than being asked for their input from the start.

With Health and Social Care in the midst of one of its most difficult periods since it came into being, managing rising patient demand and expectations, increasingly complex health and social care needs, increasing costs and falling income, the top down model is definitely not going to help.

Whether it’s changing an entire system or organisation, or something as specific as a pathway of care, there is a model that will give you a successful and sustainable outcome; one you can replicate each time you deliver future change projects.

Our approach is founded on principles of the engagement and inclusivity of all stakeholders involved in the process. We let people self-select their engagement with the programme of work, whether it’s a pathway redesign, system change, practice merger, development of a Primary Care network or Integrated Care System or any other form of change, we never impose anything top down.

Whilst challenging, this ensures that the vision created is one that has been developed by all those who have a role to play, whatever that role, leading to buy-in and ownership of what your programme creates. The group coming together will deliver a critical mass for change. Whether 9, 90 or 900 self-select, let them all play a part. There is nothing better than a self-selected group owning the problem and then the creation of the solution, to see change come to life. When people create their solution they want to implement, which means the change is implemented.

The process starts with winning hearts and minds to engage people to self-select their involvement. From there it becomes about developing the vision for your project and then agreeing how you plan on implementing. It needn’t take months; this process is designed to be short and to the point, keeping people engaged and motivated.

In any change project we keep in mind that ideally we want a group that are prepared to think differently, definitely prepared to swim against the tide (and break the cycle of but that’s the way we have always done it) and completely prepared to ignore convention and strive for remarkable outcomes.

The next time you are presented with the opportunity for a change, will you opt for the top down command and control, subcommittee led change, or will you strive for the self-selected, problem owning and solution creating group of motivated individuals that want to develop and implement their solution? I know for us, it will always be the latter, which is why we can point to so many examples of remarkable projects with the NHS and with our Pharma, Medical Technology and Devices companies that place the right patient in the right place at the right time, with the right clinical staff and with the right resources available to deliver the care required.

If you want to replicate those remarkable pathway projects, within your clients please schedule a call so we can explore your challenges and identify the solution. From there we will develop the right strategy to achieve your goals. You can then relax knowing you’re finally targeting all the right people and are equipped with the skills you need for future success.

Scott McKenzie is an independent management consultant supporting the Pharma, Med Tech and Device Companies better engage and access the NHS. Scott works within the NHS with GP Practices, GP Federations, Primary Care Networks of 30k-50k to structure them correctly to then deliver high quality patient outcomes with financially viable solutions. For more information on how we can support you please contact Frances on 0845 388 0302 or email

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