Annex 4 - compilation of approaches

Leading large-scale change

The guide to leading large-scale change (LSC) was developed by managers and clinicians within the NHS and is based on experience and literature around large scale change. The guide includes change management tools such as: key planning questions, driver diagrams, structure / process / pattern thinking, 30/60/90 day cycles, and stakeholder analysis.

LSC is defined as the emergent process of moving a large collection of individuals, groups, and organisations towards a vision of a fundamentally new future state, by means of: high-leverage key themes; a shift in power and a more distributed leadership; massive and active engagement of stakeholders; and mutually-reinforcing changes in multiple systems and processes. This leads to such deep changes in attitudes, beliefs and behaviours that sustainability becomes largely inherent.

Some of the key principles described in LSC may be summarised as:

  • moving towards a new vision that is better and fundamentally different from the status quo
  • identifying and communicating key themes that people can relate to and will make a big difference
  • framing the issues in ways that engage and mobilise
  • the imagination, energy and will of a large number of diverse stakeholders
  • continually refreshing the story and attracting new supporters
  • transforming mind-sets, leading to inherently
  • sustainable change.

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