The Leaders for Change award scheme aims to equip health professionals working in service improvement with the necessary skills and knowledge to lead change projects that improve the quality of local health care services.
Debbie Smith, a Leaders for Change award holder, is Patient and Public Involvement Lead for West Cheshire Primary Care Trust. She is working to improve local services for teenage patients in the area, where there have been major problems with non-attendance.
Youth focus
The main change Debbie wanted to make was to make services for young people more responsive to their needs. “We focused on service users aged between 16 and 19, where we knew we had huge problems with non-attendance,” she explains. “I held focus groups with them in pizza restaurants – on their own turf – and asked them what got in the way of coming to clinics.”
“Some obstacles should probably have been obvious,” she continues. “Like scheduling clinics on weekdays in June - when they’re going to be in exams. The teenagers felt our clinics weren’t relevant to their lives and lifestyles. There were important access issues, like some of them didn’t know where the clinic was! Some relied on their parents to organise transport, who couldn’t or didn’t do that.”
Having listened to the teenager’s concerns, Debbie moved swiftly to make improvements. “We piloted changes to the clinic,” she says. “We changed timings, looked at more relevant lifestyle and diet advice and developed a website with information on what the clinic offers.”
Personal development
Debbie says that the Leaders for Change scheme helped her realise her own personal influence and leadership ability. “Previously, I never saw myself as a leader or influencer,” she says. “I’d always gone about change in my own way, and wondered whether my way was right!”
“I wanted to be challenged in my way of thinking about change – but I didn’t expect it to have so huge an impact,” she continues. “Few available programmes offer the Health Foundation’s academic background in change management, which is really useful, and participants use these ideas on a real project.”
She explains how the experience has changed her perception of what is and isn’t possible. “Previously I might have thought, ‘this service redesign problem is too big, we can’t do it’,” she says. “But doing the Health Foundation course gave me a background and reassurance to try the changes I wanted to make.”
Improving services
Debbie also says that the course has changed her thinking about quality. “It’s widened it,” she explains. “Previously, I saw quality in terms of clinical outcomes and evidence-based practice – improving services to meet targets. This scheme helped me to see the role of patients in facilitating change and improving services as important too.”
She highlights the importance of getting the right people on board. “We had one consultant who was passionate about moving things forward: his engagement was crucial,” she says. “You also need a change agent to facilitate change. This doesn’t happen by itself – it needs a set of skills and knowledge about change.”
“Part of it is about communication about process of change before it happens,” she adds. “As a change agent, you’ve got to keep driving things forwards, and get and keep people on board. It takes a lot of energy. Also, expect the unexpected: things crop up you’d not foreseen. That’s the nature of change!”
Time out
Finally, Debbie emphasises the value of taking time out from the daily routine. “We’re all so busy and there’s so much change in the NHS, that a time out to plan change is crucial,” she says. “The Health Foundation scheme gives you 20 days away from the work environment, with funding for cover for your job during that time. That’s hugely important.”
01 November 2006