Doing OD in the NHS/media/Employers/Documents/Cam… · *Prepared by Dr. Patricia Oakley, Director,...

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]

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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



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? 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



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“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.



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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



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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



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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



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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



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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”



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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

Doing OD in the NHS/media/Employers/Documents/Cam… · *Prepared by Dr. Patricia Oakley, Director,...

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Transcript of Doing OD in the NHS/media/Employers/Documents/Cam… · *Prepared by Dr. Patricia Oakley, Director,...