Why do it
It is vital to understand both the need for change and the context in which the change is happening so that you choose the right solution and use the right approach. If you do not understand your challenge or opportunity, you might solve the wrong problem, focus on a symptom of another issue, or even create new problems.
What is it
Understanding involves exploring the opportunities, barriers and enablers of the change you are planning. It is important to think about the wider system you are working in and consider both the impact of the wider system on the part being changed, and the impact of the change on the wider system.
A key source of information to help with the understand step is data. It is essential to thoroughly consider what the data tell you: this is covered in measurement, monitoring and evaluation.
Understanding the issue from many angles by combining information from data, evidence, policies, personal experiences, staff opinions and insights from other services.
Engaging a wide range of different stakeholders is key. This includes:
- service users (people with lived experience, families and communities)
- service providers (the people who provide the service directly to the service users)
- service enablers (the supporting functions like administration, equipment or transport)
This helps you understand the issue and build agreement. People feeling involved from the early stages can lead to greater support and action during implementation.
Understand your readiness for change
Do you feel you have all the enablers of quality and change in place that you feel are needed to see change?
Do you have:
- the right leadership and culture to support changes in your organisation and partner organisations?
- access to strong governance, data and measurement, project management and commissioning support?
- opportunities to engage with people and help your change to be people-led?
- a clear vision and purpose in your organisation? This clarity helps you know what to change and how to do it
- a culture that encourages sharing knowledge among people, staff and organisations? This can help you make better decisions
Understand what you need to do to plan and deliver change
What kind of change are you looking at?
Consider if this is about:
- a point of care or process improvement change to improve a part of how a service works
- designing a new service, model, or approach
- changing services for a health condition
- a group that needs different teams or organizations to work together for change
- changing how care is provided by an organisation or a group, this may be a transformational change. It will need big investments and time to succeed
Who might you need to involve
It can be helpful to think about who you might need to involve or get help from during this step.
Think about:
- what skills, knowledge, and experience do you need
- what roles and responsibilities do you need in the room to think together and make decisions
- who might you need to support your work to get agreement
The skills and professions you might need to have involved in the change include:
- health and social care clinicians and professionals
- people with lived experience
- third and independent sector staff
- support staff (like data analysts, project managers, service designers, quality improvers, engagement experts, strategic planners, and organisational development professionals)
Practical support
Project management activities to be undertaken during this step of change. In addition, you can access further practical support below.
Taking the next step
Once you’ve understood more deeply the significant challenge or promising opportunity, you’re ready to advance to the develop and design step, where collaboration, building support, and iterating on change ideas can begin.
In some instances, you may not always follow the steps in order, and it may be necessary to revisit a previous step as new insights or evolving circumstances emerge.