Tolerant, respectful, patient - all adjectives that we may use to describe our society, however I suspect that altruistic wouldn’t be on the list. And yet there is always an expectation of government at times of major structural change to public services that altruism will prevail and managers will wait until the end of the change before determining their own future.

Of course this naive and we are already seeing managers of primary care trusts making personal decisions about their future. And why not, in common with all staff managers also have personal and family responsibilities. The advice I always gave to people facing change was they must do what they most want to do because the employer will want them to do what’s best for the organisation. First and foremost, they must look after themselves and if the organisation can help them do that all well and good.

Announcing the end of organisations immediately disenfranchises their leverage and management. Add to this the inevitable games that some people play at times of change and managing the whole issue becomes a lot tougher. Turning to staff, they rely on boards and managers to keep them informed so that they can make decisions about their personal futures but of course those doing the communicating may have their own agenda.

When change is announced the quality of relationships between people becomes critical to the quality of managing the change. Research tells us that we interact using three roles - parent, adult and child; and persisting with one approach over the other two is doomed to failure.

Managers may behave like a parent and sift information for dissemination because they believe it’s in the best interest of staff. Not so - it’s patronising. Similarly, bad news may be withheld for the same reason or because managers may be inexperienced in giving bad news or they just don’t like to be seen to be unpopular.

Childish behaviour may also be seen. Managers may disseminate information heavily overlaid with their personal view of the future, sometimes driven by their own political views or the ongoing desire to continue to demonstrate that they are in control. Statements such as ‘Of course, these structural changes are nonsense and I believe they won’t happen,’ or ‘Parliamentary opposition will considerable weaken the proposals and we’ll all be alright’ are ill-informed views based at best on rumour and gossip with no substance. The answer is nobody knows until it happens.

Staff may want to hear personal views but only if they are informed by a realistic understanding of what the future holds - whether good or bad. If staff can see the future then they - and their families - can plan accordingly.

Above all else boards have a responsibility to demonstrate to staff that they are managing the future of their organisation even if it now has a known shelf life. It is this principle that should underpin the quality of communication about change and ensure that it is more adult than parent or child.