What are the main forces for change?
Drivers will come from two main sources: Policy drivers - the national or local 'givens' and external change drivers - the factors, which will change the environment in which the service operates. Guidance on national policy is available from the Department of Health web site.
There are a variety of methods for identifying external drivers. Three of the most useful include:
- Brainstorming techniques: A good starting point is to get a collection of the main players in the planning process together in a brainstorming session to capture as many as possible of the drivers that are likely to impact on the services being planned. A good way of capturing the information is through 'post-it' clustering. Another technique, which can help ensure that all the different kinds of drivers are considered, is 'PEST' analysis. It is generally also useful to identify drivers into two clusters: policy drivers and external factors.
- Horizon scanning: A range of organisations are actively involved in researching the drivers for change and many of them describe this as 'horizon scanning'. The information gathered by these exercises is available in a variety of forms - web sites, reports, databases etc. The 'sources of information' section of the knowledge base provides information on a number of these sources. It can be useful to access this information after the initial brainstorming, both to identify factors that might have been missed and also to gain a better understanding of their likely impact.
- Analysing past changes: One of the best ways of understanding the impact of change drivers on the system is to look at the significant changes that have happened in the past and why they happened. In looking at past trends and changes it is always a good idea to go back at least as far as you intend to plan into the future. As a workshop exercise it is useful to pose the following questions:
- What are the most significant changes that have happened (to the workforce)?
- Which of these were a surprise?
- What were the key factors which brought about these changes?
- Are there any, which we don't understand?
In relation to the most important changes it may be valuable to commission or carry out research into the factors which brought about the changes, particularly if they are poorly understood.