1. Lisa Burt-FrostQ12188352 MAN125
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A reflective essay looking at the changes and development in my own Management
skills and style whilst actioning a rapid response change within my team.
Module title: Concepts of Management 2 / Intermediate Management
Unit code: MAN125
Intake: October 2014
Level: 5
Submission date: 09.02.2015
Word Count: 2,186
Student Number: Q12188352

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Change is essential within all areas of the NHS to enable continued development
and delivery of high quality, safe and effective care whilst delivering cost
improvement.
This reflective essay will explore the changes in my management style and
development of skills required to implement change.
When taking on a new role as Admin Manager I became responsible for a mixed
group of admin staff who were isolated with no support or guidance, had little sense
of value or ownership of their role and very little chance of being in a position to offer
a high level of service delivery or develop their skills further.
I will explore and explain how the use of various leadership styles helped to develop,
support and guide me not only through the early stages of my own role but also
through the changes required within my teams and concluding at a stage where they
are now, working as an effective team, meeting role objectives and most importantly
able to provide and continue developing a high level of service delivery.
I have worked for the Trust since 2003, starting as a band 2 ward clerk and within 3
months promoted to band 3 supervisor but this essay focuses on my role as Admin
Manager for Emergency Care which I have held since April 2013.
I had two immediate issues to face:
• I found myself in a new role with no handover and very little support to guide
me through the early days, not only did I have a deficit in my own knowledge
and skills I soon realized I didn’t even know what it was that I needed to
know, at this point if I had matched this to a Johari’s window my unknown and
blind spot areas were massive, I had little management style of my own that I
could explain, the initial development of my leadership style occurred over the
next few months during this process, the situation surrounding the post
becoming available meant that this would require my use of initiative and
ability to source knowledge and information to be tested from day one.
• My next challenge was to action a rapid change initiative that would quickly
impact on the overall effectiveness of the admin team described above within
3 months and provide an improvement in service, they had to that point been
employed and managed by individual wards and had not worked as a team
before.

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Although I had to acknowledge a deficit in my own knowledge my priority was to
focus on forming an effective team that would be able to deliver on the three month
rapid change request, I knew that just through actioning the required changes and
delivering on the targets set I would be changing and developing my own skills and
style so where to start?.
Initially I spent some time with the individuals in my team to get a better idea of their
strengths/weakness, role requirements, the dynamics of the groups and where I
needed to focus. I soon realised that I would need some support and guidance on
how to action change, I was confident that I had the basics of a very good team and
just needed to make some changes rather than starting from scratch. Looking at
existing systems and making modifications to them are just as innovative and
likely to succeed as developing completely new ideas (Adair, 2009).
I started by creating a SWOT analysis (Appendix 1) my next move was to meet with
the clinical teams to get an understanding of their requirements and priorities and
also discuss any concerns they had around changes to practice being put in place,
this was followed by meeting with each team and discussing my findings and vision
of where I would like us all to aim towards but as I required them to take the journey
with me I needed to make it clear from day one that this was a team effort and we
could only achieve this if we worked together. During the initial meetings the team
were encouraged to participate in suggesting ideas on how to create the team and
develop the service by giving them a sense of ownership of the new model.
Appendix 1
STRENGTHS:
- Individually the basic elements of a
good team were already in place.
- Most of the team genuinely enjoyed
their role and already took ownership
of the admin support they provided
to their own ward.
- Dedication to own areas were
obvious.
- Good working relationships within
each area.
WEAKNESSES:
- Fear of change.
- No support for the admin team with
current system.
- Increased pressure on individuals
following any period of leave.
- No cover for wards during clerk
absence which had a direct affect on
the clinical teams who were then
required to provide a higher level of
admin support to the ward taking
time away from their clinical role
and ultimately patient care.

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OPPORTUNITIES:
- To create a team able to provide
support to each other.
-With improved cover during absence
this would have a positive reduction
in admin responsibilities for the
clinical team.
- Increase in morale and shared
vision for continuous improvement to
service delivery.
THREATS:
- Staff unwilling to use change.
- Ward Managers concern due to
change in Management.
- New Management unknown.
- Loss of control.
-Some staff not fully engaged with
service improvement could have a
negative affect on others.
Understanding the SWOT analysis was vital, it highlighted what I already had, what
we could achieve and issues that could prevent success, throughout this process I
referred back to this for guidance, it’s a very simple but effective support tool.
I had several teams equating to over 40 staff and soon realised I couldn't do
everything, delegating some of the tasks to other members of the team was vital not
only to ensure they felt involved but also an important step for their own
development, this also allowed me to focus on the bigger picture.
Although most of the team agreed change was needed not everyone was engaged,
During any changes in processes some staff, despite efforts to engage with
them all, will always be resistance to change (Paton and McCalman, 2000).
The transition from old ways of working to new is often the hardest part for the staff
to accept and it's only after the initial stage of change that some staff are able to start
to see the benefits and feel more confident to move forward and become engaged
with the changes. In order to be an effective leader I needed to find a way to get the
best out of my team, I had to influence, inspire and motivate them whilst providing a
safe environment for them to put their own ideas forward and develop.
It is important for any leader to ensure effective communication is maintained during
any change process and a shared goal is the main focus, engaging with the team,
communicating with them the plan, the aim and sharing ideas on how the changes
will be implemented will help to ensure full cooperation. Good clear communication
is required at all times in healthcare but during a period of change
communication is a priority (Ellis and Abbott, 2010).

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The type of leadership styles used may also influence the outcome of change so
having a good insight and knowledge of different theories can help determine which
approach to take, I don’t have an academic bone in my body even so I needed to
find a leadership style that I could understand, would support me through this
process and give me a better chance of being the leader that my team needed me to
be. After doing some research I decided to use Kurt Lewin's 3 step change theory,
for two reasons: 1, it made sense to me without being to complicated for me to follow
during the early stages of my own role, 2, it was a simple method that could easily
translate the changes and processes required to my team.
Lewin (1951) identified three phases, unfreezing, changing and re-freezing, I have
found several versions of this using different phrases but this suits my requirements,
can be easily understood and explained:
Unfreezing - this phase focused on creating and sharing the vision, a shared
vision is something that is an attractive, credible future and can be very
motivating (Holmes, 2011) by meeting with my team and local service users,
engaging them with the idea of putting in place some changes, creating an
interest, motivating by explaining the positives that could be achieved and
discussing concerns and fears.
Clear, open and honest communication with all involved at this stage was
critical mainly to ensure clarity and understanding, it was important to
maintain two way communication ensuring all involved felt confident that I
listened to them and had the flexibility to adjust if needed, at this early stage I
had to be both a good leader and an effective manager, showing a good level
of interpersonal skills and an ability to co-ordinate the resources required to
support the team in order to meet our shared objectives and goals.
Changing - Once the idea of change is out there and the team are becoming
motivated and engaged they need to be provided with the information and
tools required to meet those changes, during meetings at this stage we
focused on providing an opportunity to give feedback, opinions, asking
questions, problem solving, creating an action plan and continuously
encouraging involvement. Engaging staff will ultimately lead to a greater

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commitment to the plan and will promote new ideas being brought
forward to the project, leading to greater success (Adair, 2009).
It is important to remember that although through this process the individuals
will naturally be brought together to form an effective team which was one of
my target requirements, some individuals respond to change differently and
have their own individual requirements to move through this stage, some work
better by being given the opportunity to reach the shared vision, within
boundaries, their own way as they are more self motivated, others require
more support and guidance whilst they gain the confidence to deliver on the
changes, both ways will, with appropriate leadership, reach the same place.
Refreezing - At this point the majority of changes that have been
implemented have become imbedded into practice and part of daily routine,
those that have struggled with the changes will not take to this so naturally
and will need a longer period of adjustment with continued guidance either
from the leader or at this point another member of the team who has settled
into the new ways of working, continued available support, praise and
encouragement is still required.
Changes need to be regularly evaluated by reviewing reports and meeting
with those involved to discuss both the positives and negatives and any
adjustments required to be implemented, flexibility throughout all stages is
essential. It is thought that most changes fail because individuals are
not given the time and support required to adjust emotionally to new
ways of working (Holbeche, 2006)
When reviewing the changes, especially during the refreezing stage, it was essential
that continuous feedback was given to and sought from everyone affected and to
discuss all the positives that were being achieved along the way with
acknowledgment to those involved, It is important to give feedback, show
recognition and give praise when due as this will promote motivation in staff
(Adair, 2009).
This was done throughout the process by regularly meeting with the various groups
discussing how the changes were affecting them, did they find the changes
positive/negative? changes are only sustainable if everyone has been engaged

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during all key stages and knowing that they could suggest changes during the whole
process made everyone feel involved and motivated. The benefits where soon felt by
all levels of staff and any initial issues that the staff had were soon outweighed by
these benefits.
There is always the possibility that something can go wrong so during any change
flexibility and the ability to deal with the unexpected is vital, during this process I had
one member of my team who was struggling with creating an effective working
relationship with the Ward Manager. I met with the individuals separately and then
together to discuss issues and set some requirements from both sides and followed
this with a review period, this process was repeated but very quickly acknowledged
that there was no improvement, there was no failing in performance on either side, it
was a basic clash of personalities, a relationship that had irrevocably broken down.
My only option was to relocate the ward clerk to a different area, although I am a firm
believer in solving problems rather than moving them in this case there were no
issues with the performance of the ward clerk and I also had a vacancy within
another team, after meeting with the Ward Manager on the vacant ward to discuss
the possibility of relocating the individual to her ward and assuring her that there
were no issues that would cause concern, they met and the move took place.
This was a positive move for all, the ward clerk has now settled in on the new ward
and has a good relationship with the Manager and the original ward was provided
with a new member of staff and they also have a very good relationship.
Despite the need for a Rapid Change initiative within 3 months monitoring the
changes in process's initiated did not stop at the end of this time frame and has
continued to this day, It is important to continue to monitor any change after it has
been completed, this is essential as there is always the possibility that if left
unchecked, staff may revert back to old habits (Marquis and Huston, 2006).
Upon reflection my main aim during this process has been two fold:
Firstly - to develop my own leadership skills, although Lewin's three step change
theory has been described as and criticised for being too simplistic it was a perfect
support tool at this point in my career, anything else more in-depth and complicated

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would have been confusing and distracting as other more popular leadership
theories actually require a higher level of experience.
Secondly - to utilise my developing leadership skills to ensure an improvement in
service delivery, this was achieved by engaging the team in a shared vision for
improvement, throughout this process I had to set goals, give direction, influence and
inspire others to take ownership in delivering individual improved performance in
productivity at the same time becoming an effective team, not only to support each
other but their ward clinical teams and ultimately all our service users, the NHS
change model (2012) leadership for change component states that commitment, role
modelling, ambition and empowering others are all attributes that can maximise a
leaders ability to successfully implement change.
It is clear that in the current financial and political climate everyone within the NHS
needs to continuously find new and innovative ways to make changes to existing
practices in order to meet cost improvement targets, provide ongoing development to
service delivery and aim to meet all the needs of the service users.
Ongoing development of leadership skills are also vital to keep up with and support
the ever changing environment that we work in, the strength of this project however
was based in the whole team’s engagement and the motivation to improve.

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References:
Adair, J (2009) Leadership for Innovation. 3rd ed. London. Kogan Page Limited
Ellis, P and Abbott, J (2010) Leadership and management skills in health care. 5 (4 )
200-203
Holmes,H. (2011) Look to the future to create an effective vision. Leadership
academy. Times.net.
http://www.changemodel.nhs.uk/ps/dashboard accessed 13.01.2015
Holbeche, L (2006) Understanding change, theory, implementation and success.
Oxford. Elsevier.
Lewin, K (1951) Field Theory in Social Science. New York. Harper and Row.
Marquis, B and Huston,C (2006) Leadership roles and management functions in
nursing: Theory and Application. 5th Ed. Philadelphia, Lippincott Williams & Wilkins.
Paton, R and McCalman, J (2000) Change management: A guide to effective
implementation.2nd ed. London. Sage Publications Limited.
Schira, M., (2007) Leadership : a Peak and Perk of Professional Development.
Nephrology Nursing Journal. 34(3) 289-294.