Christine Adams' article has a familiar ring. How many people finding themselves at the wrong end of any aspect of organisational change would share these emotions? And with all the NHS changes taking place, will our planning automatically cover all the issues that may be directly affecting individuals?

It is very sad that this has happened to Ms Adams, but it doesn't have to be so. From my experience of working with organisations facing major change, the enlightened - which properly support their staff through change - increase continuously in both private and public sectors, with the NHS no exception to this trend.

One insight into an individual's needs already adopted by many organisations is improving employer-employee relationships, making them stronger and more satisfying from both perspectives. Managing our career has to be our own responsibility, but when did we last devote quality time to thinking about our future? A recent Harvest research report shows that 39 per cent of NHS chief executives did not know what their next career move would be.

Timely thought-processing, and planning the campaign from the individual's perspective, often occurs at a point of no return. It is beneficial when jobs are at risk or being lost, when career advice, real support and practical help can do wonders for repairing damaged esteem and self-confidence, but wouldn't it be wonderful if this was part of joint career management?

Lynn Bird

Senior executive

Harvest Ltd