All Change: The Social Life of Change Management in the UK National Health Service

The UK NHS is going through what is typically referred to as an unprecedented period of change, marked by key priorities of patient choice, innovation, quality, innovation and the minimisation of bureaucracy. These processes are associated with a plethora of paradigms, initiatives and tools designed to support the management of change, including strategies for developing the learning organisation and the role of change agents, predictive change tools, models and processes of personal change, and the rejection of ‘old-style paternalistic’ theories of organisation and culture.

This paper will explore the rise of the change management agenda in the NHS, and the organisational and psychosocial theories and values which underpin it, before moving on to consider how and why we might trace its articulation in the practices of NHS managers, drawing on preliminary data from exploratory discussions and observations with NHS managers working in a large soon to be Foundation Trust Hospital in the North of England.  We consider how and why we might go about understanding the social life of change management in organisations by focusing upon manager’s practices and accounts of their experiences of and rationale for change, especially the productive character of change mantras and devices. We end with some critical reflections on the importance and the difficulties of tracking, understanding and articulating the activities and the actants of change in organisations-in-flux and in managing the ways in which we ourselves as researchers are enrolled in the processes of change we seek to study.