This was a four-year project begun in 2017. It was funded by the Health Foundation and led by CORU (The Clinical Operations Research Unit) at UCL and worked with North East London NHS Foundation Trust (NELFT), the London Boroughs of Redbridge and Barking & Dagenham and the innovation test bed CareCity.
The aim of the project was to identify workforce changes that could improve the efficiency and effectiveness of the delivery of community healthcare to older residents in the two London Boroughs. CORU used their OR expertise to identify eight candidate changes in service delivery that could offer significant benefits and the Institute examined the ‘readiness to change’ in the boroughs to understand the issues that would need to be addressed if these changes were to become embedded as regular practice in the delivery of community healthcare.
In the project we reviewed 16 change programmes that have been undertaken in community healthcare in recent years in order to understand how changes were made and the outcomes that were achieved. There were several examples of major structural changes and of the implementation of significant new technical systems.
All of these changes were successful although each required considerable resources to implement them. There were also many attempts to make role changes and changes to local work practices. These all involved behavioural change and have so far been less successful. The aim of the project was to carry forward the lessons from these change programmes to examine what would need to happen if the OR changes identified were to be successfully implemented.
In the course of the project we developed a toolkit to assist local staff in the identification of the issues to be addressed in making changes. It is particularly useful for the early identification of unanticipated implications of a change programme for the local work system. The toolkit called the Planning for Change Framework (PfCF) can be downloaded from here.