The NHS will undergo significant organisational reconfiguration during 2006 just in case you hadn’t noticed! PCTs, Ambulance Trusts and SHAs will reduce significantly in number and have redefined remits. At the same time the majority of Acute NHS Trusts and Mental Health NHS Trusts will move towards Foundation status. Given the significant leadership challenges created by these major service reconfigurations, there is merit in learning from the experiences of other sectors that have undergone similar transformations.

On 9th February, HSJ published an article outlining eight best practice principles for senior leaders implementing major organisational changes and managing post-merger integration. These principles are taken from a literature review commissioned by the NHS Institute for Innovation and Improvement and produced by the University of Birmingham’s Health Services Management Centre. Drawing on evidence from the NHS, the wider public sector, the voluntary sector, and private industry, the review concludes that:

• Transactional management and leadership (as opposed to transformational leadership) is crucial at times of organisational transition
• There is a need for senior managers to invest heavily of their own and others’ time in the direct management of the human side of transition.
• Relentless communication of the purpose and detail of changes is necessary.
• A range of personal, team and organisational development interventions, provided within an open and participative style of leadership, are required.
• Careful evaluation and measurement of the transition is essential, if organisations are to be able to learn from the experience and use this learning when considering organisational merger as a tool for bringing about change in the future.

The review, together with a fuller source document describing the underpinning research evidence in detail, is available at www.institute.nhs.uk.

Best practice guidance in relation to the workforce implications of the current reconfigurations will soon be available from NHS Employers. This guidance, drawn from today’s leading organizations, will include implementation checklists, technical information, employment law and other direction. A best practice guide and other support materials will be available on the NHS Employers website www.nhsemployers.org/cplnhs.


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