How can you woo the workforce into embarking on change rather than alarm them with the unknown? Dominic Walters explains

Major change is a constant within the health service: national policy developments relating to targets progress in parallel with local decisions on efficiency improvements and the development of services.

In relation to any upcoming challenge, there may be one obvious course of action for decision makers, based on solid research, analysis, costings and a careful implementation plan. But one factor can introduce much more uncertainty into the process: the people who will be facing the changes.

Organisations should not underestimate the challenge and importance of engaging staff, who understandably may feel stressed and unsettled at the prospect of change. It is estimated about two thirds of big changes do not achieve all that they set out to, and poor communication is one of the most commonly cited reasons.

The sheer quantity of change within the health service can leave people feeling exhausted and cause them to lose sight of how everything fits together. The risk then is that each subsequent change can seem arbitrary and people become jaded and cynical. An important way of counteracting this is by ensuring changes are visibly joined up and presented as part of a bigger picture for the organisation.

Change teams can become focused on how a system will work, and changes are often presented in terms of what will happen differently and what will be new. The problem is that the people to whom they are talking are often way behind them and not sharing their passion. Effective communication will link the changes with issues that are important to people in their daily life. At the heart of this should lie the way in which change will enable staff to provide a better service to customers.

Sell the need

If a change team is introducing a solution that aims to tackle staff shortages through the reorganisation of the way work is done, the team should look at how people do things now and what dissatisfies them about the current system. They should then concentrate on how the new approach will address the challenges people have day to day. Once they have sold the need for change, they can introduce ideas about solutions.

Similarly, staff will find major changes to long-standing and familiar systems easier to accept if the communication programme highlights how these will help deliver better patient care, for example. A real-life example is picture archiving and communication systems, which enable images such as x-rays to be stored digitally. Clear benefits include the fact that patients can be seen more quickly, diagnosed more effectively and treated sooner.

However, despite the strong vocation of many health service staff, it would be simplistic to focus solely on their selfless side. Any communications campaign should also include answers to the question, "What's in it for me?"

Line managers have a vital role in this. A British Association of Communicators in Business survey revealed that 70 per cent of respondents trusted their boss implicitly but only 40 per cent trusted their boss's boss. Research shows staff with an engaged line manager typically have an engagement score of around 75 per cent while employees of a disengaged line manager score only 40 per cent.

Problems will be experienced if managers see themselves as the "local protector", defending their people against encroachments from government or the top team. They cannot shield their people from what is happening for ever. Often staff resent being shielded, as it means they have less time to take on board information and make sense of what is going on.

Similarly problematic are those who just toe the party line and allow no discussion, as this leads to demotivation and limits opportunity for feedback. Ideally, line managers will help staff make sense of and deal with the changes, even if they do not personally agree with them.

The organisation should devote plenty of time to ensuring that line managers are on message and have support as communicators.

Harnessing feedback

Staff will not buy into something if they do not feel they have had their say. Even worse, failure to obtain staff feedback could lead to fundamental errors and omissions in the approach to specific developments. Again, the line manager has an important role in ensuring they ask the right questions and put staff at ease. Harnessing feedback effectively can have a striking effect on organisational performance.

Finally, it is important to give attention to the two Ps that top and tail the whole communications process. The first is planning, to ensure you are not taken by surprise by national or local developments and can prioritise appropriately in line with available resources. The second is performance measurement, that is, measurement of the desired changes in behaviour rather than how much literature has gone out or how colourful the website is.

This helps to refine future approaches, contributes to telling a powerful story of change and its positive impacts to staff and helps to promote the concrete benefits of communication to any doubters.