Welcome to the team
From all of us in the HTP team–THANKYOU and a warm welcome from us.
This pack contains information which will guide you through the necessary next steps in your role as a HTP Change Agent.
We are pleased to have you on this journey with us as we navigate change, build trust, engage, communicate and all strive towards two thriving hospitals
A multi-million pound investment in our hospitals and community sites
We’re improving care for everyone through modern, purpose-built facilities as part of our Hospitals Transformation Programme.
Our doctors and nurses have led these plans to develop two thriving hospitals supported by more services in the community.
Opening in 2028, our exciting multi-million pound investment will benefit all our patients.
The clinical model
Royal Shrewsbury Hospital
Royal Shrewsbury Hospital will become the site specialising in emergency care
A modern, purpose-built Emergency Department – with separate children’s footprint
A critical care unit
Consultant led maternity care
Children’s inpatient services
Emergency Medical Specialist Services, including Cardiology, Stroke, Respiratory and Acute Medicine
Emergency and trauma surgery
Head and neck inpatient services
Radiotherapy and inpatient and day cancer care and treatment
Princess Royal Hospital
Princess Royal Hospital in Telford will become the site specialising in planned care
24/7 urgent care services
Planned inpatient surgery and medical and surgical emergency patients on a planned pathway of care
Local anaesthetic procedures
Day case surgery
Midwife led maternity unit
Enhanced rehab facilities and wards
Cancer treatment day unit – aligned to HTP
Respiratory treatment centre – future opportunity
Both sites
Most patients will continue to use their local hospital.
Adult, children’s and maternity outpatients
Endoscopy services
Urgent care services and medical Same Day Emergency Care
Diagnostics, imaging services including X-ray
Frail and elderly care services
Expected 2025 milestones
March 2025
ED1 works complete –providing new majors and resus
April 2025
Concrete frame of basement complete
May 2025
Begin works on building components that separate the indoors from the outdoors
Summer 2025
Transition workshops and transport planning with stakeholders
September 2025
ED2 works begin
Autumn 2025
Conclude workforce requirements for clinical model
March 2025
Operationalising resus and majors from 26 March
March 2025
Meeting with SLT to agree clinical space allocation
April 2025
Launching the master programme with Divisions
August 2025
Sample room completion of new healthcare facilities
September 2025
Building envelope completion (area 1)
November 2025
Concrete frame completion (Area 3)
Golden Circle Model - Simon Sinek
Simon Sinek, the author of several books around leadership, created the golden circle concept This is a model to explain how understanding your reason why and focussing on that, will help to inspire others into action. His theory, is that successfully communicating the passion behind the why, is a way to communicate with the part of the brain that processes feelings, such as trust and loyalty, as well as decision making This will ensure you have the necessary buy-in for your project by those who will be affected by it, your stakeholders.
The circle he created has the why in the centre and should always be considered first, by really understanding what your purpose is Very few people, or companies can clearly articulate why they do what they do. Remember, it is not about running a successful business or project, that is your result, but more importantly, it is about your purpose; why do you exist and why should you care?
Why do you do what you do? What’s the purpose?
How do you do what you do?
What the hell do you do?
When we start with why, we go from the inside to the outside of the circle.This can be a powerful tool in improvement, ensure you start in the centre and establish your purpose and reason for change, before working outwards and agreeing how you are going to do it and what ideas you are going to test out to achieve your purpose
Let’s look at this example around patient flow. Our purpose is to provide a safe and effective system to care for the population of the local area when they need us How we do this is by ensuring we maintain flow through the hospital to prevent delays in care and potential deterioration of patients by delaying discharge to a safer environment, such as home, or a care home
What we do is hold discharge improvement events, ensure we hold action focussed board rounds that can identify the tasks needed to maintain flow, or other interventions that will help us achieve our purpose
How Change Agents effect change
Support and influence colleagues who are struggling with change
Establishes relationship with people who influence the programme
Link in with Stakeholders
Builds trust in what the Trust are doing by communicating locally and regularly
Helps identify when/what engagement and communication is needed to satisfy the audience
Helps target people who could assist to promote the project
Identify individuals who could disrupt the process
25
reasons why it won’t work
We tried that before
Our systems are different
It cists too much
That’s beyond our responsibility
That’s not my job
We’re too busy to do that
It’s too radical a change
There’s not enough help
We’ve never done it before
We don’t have the authority
Ther’s not enough time
Let’s get back to reality
It’s not our problem
Why change? It’s still working OK
I don’t like that idea
You’re right, but ...
You’re two years ahead of your time
It isn’t in the budget
We’re not ready for that
Sounds OK but impractical
Let’s give it some more thougt
That’s my bowling day
That doesn’t affect me or my child
Nobody cares about that
We’ve always done it this way
How would you like to receive change?
Put yourself in the shoes of the receiver of the change
Assumptions we make
Change is external to people within the organisation and happens to them whether they like it or not.
There are many types of organisational change, including a merger or acquisition, creating and launching a new product, and implementing a new business strategy
Change is concerned with achieving outcomes
Transition
If change is external, then transition is internal Transition is the internal psychological process that change puts people through.
It is how people feel as they process and come to terms with the new situation that change brings about. A transition occurs in the course of every attempt to change.
Unfortunately, most leaders concentrate on change and assume that transition will happen simply because the change is happening; this, unfortunately, isn’t the case.
Change can happen very quickly, whereas transition usually takes longer.
All organisations must change to survive
Change Fails if its not managed properly
Change happens , if you like it or not (its an external process to people in the organisation)
Transition is internal , the psychological process you go through
You need to manage the transition more than the change
Bridges Transition Model
The Bridges Transition Model helps organisations manage change successfully by mapping out the human response to change over three stages. These are:
Ending, Losing, and Letting Go
Allow people to let go and say goodbye to old ways.
The Neutral Zone
The in-between time when the old is no more, but the new hasn’t arrived yet.
The New Beginning
The confusing time when people begin to engage in their new future
The three stages aren’t discreetly demarked and can coexist at the same time within a change. You can see how the relative importance of each stage changes as time goes by.
Bridges Transition Model
It’s worth noting that the greater your seniority with your organisation, the more quickly you are likely to move through the transition process.
This is often because you understand the need for change long before others in your organisation.
This means that as a senior manager, it can be easy to forget that others will take longer to transition
Bridges Transition Model
Ending, losing and letting go How people feel
People have to let go of how things were, and they also have to let go of how they were or used to be. Some things they might need to leave behind include relationships, team members, processes, etc.
This stage often percolates feelings of resistance and emotional upheaval, as employees are forced to give up something they are familiar and comfortable with Just think how you would feel if you had been happily doing the same job for twenty years and suddenly everything was changing
Common feelings for people to feel during this stage include: Denial Anger Fear Loss
Disorientation
What are people saying in this stage? How will we know they are in this stage?
Bridges Transition Model
Ending, losing and letting go
How to lead
Reflection
Allow the team time to reflect on the change What was good, what have they been proud of, what will they miss, what are they looking forward to
Recognition
Give space for the negative thoughts , as a change agent you can try and think about what these will be in advance and consider your responses for each. Don’t at this stage try and force people to be positive. Allow the negativity to be acknowledged.
Communication
Always have a clear communication plan , include the reason why in this
Vision
Create a positive vison for the future, what will be the benefits to the change
Bridges Transition Model
The neutral zone
How people feel
In this stage, people have accepted the old way has ended but find themselves unable to move forward. They are entering the neutral zone: an in-between stage full of uncertainty and confusion. This in-between state is so full of uncertainty and confusion that simply coping, not moving forward, takes almost all of people’s energy
Despite the challenges of stage two, this is the stage in which people create and try new ways of working, so it can also be a time of innovation and renewal
Common feelings for people to feel during this stage include:
Low morale
Resentment toward the change
Scepticism
What are people saying in this stage? How will we know they are in this stage?
Bridges Transition Model
The neutral zone How to lead
Planning
Planning is essential , you need everyone to know what is expected of them and how things will work
Quick wins
Aiming for some quick wins can really help with momentum and seeing the change in a positive light It can demonstrate progress
Remove blockers
Blockers and barriers can derail change, so they need to be removed as quickly as possible, planning and making sure you have the right support will help with this Put in place the structure for change, and continually check for barriers to it
Removing barriers can empower the people needed to execute the vision and it can help the change move forward.
What we can do:
Identify, or hire, change leaders whose main roles are to deliver the change
Look at the organisational structure, job descriptions, and performance and compensation systems to ensure they're in line with the vision
Recognise and reward people for making change happen
Identify people who are resisting the change, and help them see what's needed
Take action to quickly remove barriers (human or otherwise)
Communication
Communication will help remind the team why they are going through this process, what they are aiming for and what support is available for them.
Feedback
Giving constructive feedback to the team and to individuals can encourage them to talk about how they are feeling and coping with the transition.
Manage Workloads
Manage people , its not all about leadership, some people may need extra support to manage their caseloads or need management strategies to help with time and work constraints. As Change Agents you can advise people to go to their manager or seek coaching/support for this type of help
Change networks
What is a change network?
Made up of variety of different people from across the organisation
Provides insight and challenge to the Programme and support and advice to peers and colleagues
Can make the change effort a success and encourage the sustaining of the change for years to come
Why a change network?
Provides deep, trusting relationships with people the Programme team would not be able to develop such relationships with
Enables the reach of the Programme to increase exponentially across the Trust
Helps impacted users absorb the change from friendly, familiar faces
Reduces resistance through 2-way engagement
Drives consistency of messaging – what the Programme is trying to achieve and how it’s going to impact on user
Promotes a collaborative approach between digital and business users
Provides enduring support to make the change stick
How does a change network succeed?
It is impossible for the Programme Sponsors and Change Managers to gain the trust of everyone in the organisation
Establishing and maintaining trust is based on a combination of competency and caring
Focus on gaining the trust of Change Agents and Change
Champions who, in turn, have the trust of their colleagues in the organisation, allowing genuine participation to reap its benefits
Bridges Transition Model
New beginnings
How people feel
The new beginning is characterised by people embracing the new ways of working. This can be scary because people are leaving the old ways of doing things behind that they were very competent at, and starting to work in a new and unfamiliar way. This is especially true if the organisation’s culture has historically been to punish mistakes
Common feelings for people to feel during this stage include:
High energy Openness to learning Renewed commitment
Bridges Transition Model
New beginnings
How to lead
The biggest challenge for management during this phase is to sustain the change
Mechanisms the leadership team should use to navigate this stage include:
Celebration
Celebrate , keep celebrating quick wins along the way , but also celebrate with teams or the wider organisation when things have become the new normal
Communication
Communication communication communication remember the reason for the journey , where were we , where are we now, where are we going
A Quality Management System
Have a quality management system (name to be decided) as this will help individulas, teams and organstions keep on track of their targets, performance indications, training, improvements etc
Leader Standard Work
Leader standard work, allows everyone to know what their roles and responsibilities in the organisation areand how they align to the organisational vision
The management of change process
What is organisational change?
Management initiated change to the way services are organised, structured, or delivered
Creates a significant or direct impact on the employment, working arrangements or working practices of employees
Examples include; a change of hours, location, change of working practices, increase to service provision which changes the way people are expected to work
As managers we will commonly find that change occurs. Sometimes this change requires that a structured management of organisational change process is followed
To help to understand when it applies we have some examples:
The management of change process
Let’s talk policy - W24
Our policy provides:
Framework to enable fair and consistent approach to organisational change
Robust and meaningful consultation with employees and union representatives
Timely process ensuring early notification and engagement with employees
To support Managers, it provides:
Step by Step guide for managers on how to assess, prepare and deliver
Includes Flow chart, timeline, templates, roles and responsibilities
The policy and templates can be found in Managers Resources or on the intranet
The management of change process
What type of change would we anticipate under HTP?
Change of site/base
Change to service being delivered at site based at e.g. from high to low acuity
Change to cross-site working
Merging of both site teams in the specialty
Change of hours to suit new service delivery
Changes that do not qualify as a Management of Change
Change of location of the department within the same site
Change of line management
Remaining at the same site but delivering the work more remotely due to technology
The management of change process
Key principles of the MOC process
Change can cause concern and uncertainty and should therefore be managed fairly and consistently
Transparency
Meaningful consultation and engagement
Support for staff – Occupational Health, (EAP) HELP,Flexible Working Requests, Training and development to meet new skill requirements.
Personal circumstances should be discussed in individual meetings
The management of change process
Stages of managing organisational change
Scope & Assess
Workforce templates
Workforce plans
What changes are expected – does it require MOC?
Pre-consultation
Update staff and staffside on what changes are expected
How do staff feel about the changes
JNCC approval
Consultation
Start at least 6 months before change
Team briefing
Individual meetings
Consider redeployment/retraining etc
Implementation
Pre-site visit and familiarisation
Team building
Move to new area
Review
3 months post change
Team building
The management of change process
Major change consultation timeline
JNCC Approval
MOC Paper
Circulate to affected team
Consultation starts
Notification Letter of proposed change Briefings
First Briefing Additional briefings
1:1 Discussions Invite to 1:1
1:1 Discussion Script
1:1 Outcome letter
Consultation ends
Consultation end if extended
Implementation 12 weeks notice of change unless shorter timescales are agreed with staff
The management of change process
Change of site
Where an employee is in a department that is changing site, the consultation will explain why the change is happening. Through their 1-2-1 consultation meeting they will be able to raise any issues that they may have in this change
We are currently reviewing the following options to help address concerns:
Whether the Trust can provide transport between sites regularly
Whether travel expenses would be covered for the additional travel
A system for retraining and redeployment of staff
As part of the consultation the manager will explore the following options:
Whether flexible working will support them being able to get to the other site
Whether they would like to be retrained in another specialty and redeployed for suitable alternative employment to be sought
Any other support the employee identifies that the manager can arrange
The management of change process
Change of function
Where the change under HTP results in the function of the Ward/Department changing and the employee is not happy to remain in the same department the following may be explored as part of their 1-2-1 consultation:
Retraining and redeployment to another area
Facilitate a move to the site where the work they would like to continue doing exists (this is subject to there being enough posts)
Team building
There will be teams that will change due to the changes under HTP. So, we will see teams merging and sometimes teams splitting across two sites.
In these situations, the manager will ensure that they provide the support to ensure the team feel like one, this could be achieved by some of the following options:
Team Away Day
Session on Team Identity
Values and Behaviours session
Team Huddles regularly held
Bringing the new team together a few times before the change under HTP happens
Site/new area orientation
What is our redeployment policy?
Before any post is made redundant, the Trust must exhaust all potential suitable alternative employment options
Where someone cannot move site the Trust would be looking for suitable alternative employment.
A suitable alternative post will, in the first instance be at the same or one band lower than the employee’s substantive post.
A number of points will be taken into consideration including;
The individual’s personal circumstances
Location and cost of travel
Current hours of work
Skills, knowledge, experience and scope to retrain
Individuals will be kept on the redeployment list for a minimum of 12 weeks which includes their notice period with the aim of redeploying them to suitable alternative employment.
4 week trial will used when redeployed into a new post to ensure suitability.
Role
of People & OD Business Partner and People Advisory Team
Support is provided for Managers throughout the process In summary support is provided as follows:
People & OD Business Partner – will scope the management of change with Managers. They will support in any service review and workforce planning and will support writing the proposal. They will advise you on engagement with staff side and the team
People Advisory Team – once the paper has been to JNCC, managers will be supported by a member of the People Advisory team with consultation. They will advise through this process with any queries that may be raised by individuals, and they will also support with any redeployment process. The Business Partner will be updated on progress for oversight.
Support available
We can offer support to anyone who has been emotionally affected by a situation at work
If you experience something distressing in your role as a change agent, the following may be helpful:
1:1 support (face to face/telephone/online via MS Teams) with one of our of team You can self-refer or ask your manager to do this by contacting us on: sath.staffpsychology@nhs.net
If you are attending a reflective practice group that we run, this may be something you can discuss in the next session
Minute Tools Content Team, Bridges Transition Model, Minute Tools, Jan, 2022
https://expertprogrammanagement.com/2022/01/bridg es-transition-model/
William Bridges Associates | Transition Management Leaders
Transitions (40th Anniversary Edition): Making Sense of Life's Changes Paperback – Special Edition, December 17, 2019 by William Bridges (Author), Susan Bridges (Author)
Trust Library
Recommended Reading: Creating a Lean Culture (David Mann);
Lean Hospitals (Mark Graban); Journal Articles & NHSE/I publications
Improvement Hub: Limited books available to borrow; Consultancy service; Coaching
Useful links
SaTH Website
For the latest nformation on our HTP Programme. https://www.sath.nhs.uk/about-us/hospitalstransformation-programme/
Improving
hospitals Mailbox
Have a question? Need to contact the HTP Project Team? send an email to sath.improvinghospitals@nhs.net
SaTH Intranet
Hospitals Transformation Programme
Improvement Hub
Bitesize videos
Case studies
Leadership
Management of organisational change policy W24
Comunications links
Intranet news
Construction cascade
Cascade
Information Bulletin
HTP awareness events
Next steps
Familiarise yourself with supporting materials to understand the programme and its benefits for staff and patients
Identify yourself as the HTP Change Agent in your team/area – this could be done through a team meeting or more informally
Consider signing up to the construction cascade distribution list (via comms) if you are based at RSH so you can share any construction related updates with colleagues
Start to gather questions, feedback and concerns from teams – again this could be done through team meetings or more informally through conversations with colleagues
Regularly share feedback captured with HR BP/HTP Workforce lead at monthly catch up meetings
If needed, you could organise a HTP briefing session with your team and the relevant HTP lead for your area
Collect positive stories and case studies to feedback – what are people excited about?
Network with other champions to share tips and challenges