Leadership and Change Management in Hull University Teaching Hospitals NHS Trust

This paper focuses on the current leadership management and change management in the organization, Hull University Teaching Hospitals NHS Trust. It highlights the possible changes that can be made to achieve organizational goals and the challenges faced. The study includes primary research and analysis of ongoing activities in the organization.

Running head: LEADERSHIP AND CHANGE MANAGEMENT
LEADERSHIP AND CHANGE MANAGEMENT
Name of the Student
Name of the University
Author Note

1LEADERSHIP AND CHANGE MANAGEMENT
ABSTRACT
The following paper focuses on the current leadership management and
change management in the organization, Hull University Teaching Hospitals
NHS Trust. The paper highlights all the possible changes that can be made in
order to achieve the organization goal and the challenges faced by the
organization. The following study has focused on the primary research in
order to get a deep analysis of the on-going activities in Hull University
Teaching Hospitals NHS Trust. The analysis showed all the possible changes
that can be made by the management of the organization and would
provoke the leaders to build a healthy, strong relation with the employees.

2LEADERSHIP AND CHANGE MANAGEMENT
Table of Contents
Introduction.....................................................................................................2
Discussion........................................................................................................3
Overview of the Organization.......................................................................3
Management of the Organization.................................................................3
Overview of Leadership in NHS....................................................................4
The Changing nature of the NHS and its Leadership....................................5
Change Management...................................................................................5
Individual Change Management................................................................7
Organizational Change Management........................................................7
Enterprise Change Management Capability..............................................8
ADKAR Model.............................................................................................8
Research Methods......................................................................................12
Present and Future Challenges...................................................................13
Self-Realization and Conclusion.....................................................................16
References.....................................................................................................18
Appendix........................................................................................................22

3LEADERSHIP AND CHANGE MANAGEMENT
Introduction
Nowadays organization adapts various modern changes in order to
cope up with the new challenges in the market. This following report focuses
on the contemporary leadership and change management with reference to
an organization, Hull University Teaching Hospitals NHS (NHS Leadership
Academy 2019). Leadership is a dynamic approach of building relation between
the collaborators and leaders which provides both the parties a morale
development and higher level of motivation as they try to provoke a real
change in the organization (Obholzer 2018). There are different types of
leadership style practiced in organizations, but this paper aims at
contemporary leadership in the selected organization Bartunek and Woodman
2015). The study also focuses on change management and future change
management challenges, in order to ensure that the standardized procedure
and methods used for prompt and effective handling of the changes, this is
done to minimize the effect of change-related incidents on day-to-day
operation and service quality of the organization (Blackie 2019). As the senior
management team reports that the organization Hull University Teaching
Hospital NHS,, has been experiencing higher level challenges regarding the
current and future prospects of the organization where the management is
trying to handle everything by leadership and change management
concepts(Bejinariu et al. 2017). In order to find out the leadership and change
management practiced in their workplace and their impact in the

4LEADERSHIP AND CHANGE MANAGEMENT
organization, primary research has been carried out. The primary research is
done by preparing questionnaire and conducting interviews.

5LEADERSHIP AND CHANGE MANAGEMENT
Discussion
Overview of the Organization
The Hull University Teaching Hospital NHS Trust (HEYT) is a trust in
East Riding of Yorkshire, England which provides acute care to the local
population of 600,000 and over 1.2 million people for tertiary services. The
trust is formed by the merger of the East Yorkshire Hospitals and the Royal
Hull Hospitals National Health Service Trusts. The organization has annual
turnover of £500 million. The Hull University Teaching Hospitals NHS Trust is
popularly called as NHS Foundation Trust. It is headquartered at Hull and it
also serves the region of East Riding of Yorkshire. The merge of the Royal
Hull Hospitals National Health Service Trusts and East Yorkshire Hospitals led
to the formation of this organization in the 1st of October, 1999. This is one of
the top five largest trusts in England. The Chairman of the organization is
Terry Moran and the Chief Executive Officer is Christopher Long. The
organization has around 8500 employees working with it and hence
Leadership and Change Management is one of the most important things
that are required to be taken care of. The vision of the company for the year
2016-2021 is to employ great staff, provide great care and have a great
future. The organization wants to create an extraordinary place for
remarkable services by the employees (Rosenbaum, More and Steane 2018).

6LEADERSHIP AND CHANGE MANAGEMENT
Management of the Organization
The current Chief Executive Officer at Hull University Teaching
Hospitals NHS Trust is Christopher Long and he has been since 2014. The
trust plays these organizations with very small number and hence
implementing Lorenzo patient record systems which has accepted a financial
support package but later it was stated that the record system is unrealistic
and has insufficient funding and insufficient funding to support the project
(Ellis 2018).
Overview of Leadership in NHS
Throughout the history, management has deliberately focused on two
dimensions of leadership, the traditional leadership and the other is
contemporary leadership. The traditional definition states that leadership is
the interpersonal influence which is directed towards achieving the goal and
objectives of the organization. However, the contemporary definition states
that it is a dynamic relationship between the collaborators and leaders which
help both the parties two increase their level of moral development and the
level of motivation as they provoke to make real change in the organization.
In simple words the contemporary leadership is the integration of
transformational leadership, authentic leadership and servant leadership
(Borich 2019)
Leadership in Hull University Teaching Hospital NHS Trust has
remained a debated topic; the organization has many insights of the

7LEADERSHIP AND CHANGE MANAGEMENT
challenges which are faced by the current and future leaders of NHS (. The
scenario in NHS indicates that NHS need that the, responsibility must be
drawn together in one person, at the successive level of organization for
various activities like planning, implementation and controlling the
performance (Frankel and PGCMS 2019). However, NHS is not in a condition of
reconstructing the organization and the organization believes that
organization can achieve much more only by making the existing
organization work in practice. Earlier the structure of the organization was
full of with regulatory and bureaucratic obstacles that limit the extent of
leadership to flourish and stifle innovation in the organization (Chon and Zoltan
2019). However, concurrent changes to the way NHS leaders can operate and
they must achieve goals without any other formal restructuring (Endovitsky,
Isaeva and Nikitina 2018).
The Changing nature of the NHS and its Leadership
The NHS organization has adapted contemporary style of leadership,
where the organization is concerned about maintaining the alignment of NHS
workforce and the operating procedure with its goals, objectives, mission and
vision. The transformational, distributive, shared and collaborative style of
leadership has enabled the current leaders to motivate performance and
improve attitude beyond their expectations (Burke and Noumair 2015)
The considerable changes were:

8LEADERSHIP AND CHANGE MANAGEMENT
A strong commitment from the higher authority, that effective leadership will
be practiced in order to achieve high quality clinical practice.
1. Considerable reduction, in regulatory and bureaucratic obligations.
2. A total new generation of clinical leaders was presented at NHS.
3. A reduction, in the total number of commissioning and provider
organizations, in order to maximize, the use of scarce leadership
resources.
4. The organization has also developed a nine dimension of Health Care
Leadership Model has been constructed through evidence based
research model which reflects the core values of the organization,
what does the organization knows about the effective leadership, what
the organization has learned from the Leadership Framework and lastly
what the communities and the patients are seeking from the leaders
(Carroll et al., 2019).
Change Management
There are many obstacles and challenges faced by all the
organizations. These challenges are not pre planned and comes to the
organization all of a sudden. Under those circumstances the organization
needs to make several changes in the policies, procedures, daily activities as
well as the short term goals. The basic aim of change management is to
create and implement certain strategies that would effect change, control
the change and also helping every other people to adapt to the changes

9LEADERSHIP AND CHANGE MANAGEMENT
(Cleary et al., 2019.). It is ultimately the employees that require undergoing the
change. The organization already has a large employee base and managing
change for those large bases is very complicated task (Cummings, Bridgman and
Brown 2016). The attitudes and behavior of each and every person differs from
each other. Conveying about the changes and adapting to it is really difficult
for both the managers as well as the employees. Change management
however can specifically handle all the challenges smoothly if properly
implemented. It includes a structured approach for managing and supporting
the individuals to move from their current state to the required future state
(Donate and de Pablo 2015).
The Hull University has been formed by the merger. It can be said that
two different cultures from two different organizations merged together and
formed this organization. This was also a change that took place. The new
organization that was formed by this process had to undergo a lot of changes
(Ellis and Abbott 2018). The two different organizations had two different
processes of work, different policies and procedures, different work
environment and different culture. The new organization altogether had a
different goals, vision and mission. This required change management that
has been efficiently done by this organization. The overall change
management has been done within the organization by dividing it into three
parts -
1. Individual Change Management

10LEADERSHIP AND CHANGE MANAGEMENT
2. Organizational Change Management
3. Enterprise Change Management Capability
Individual Change Management
It is very natural psychology of the human being to resist changing. Yet
they are quiet resilient human being. If supported at the time of change,
then there can be very good and effective results (Harmon, P., 2019). The
process of individual change management involves understanding how the
experience of people change and what is needed to be changed by them. It
involves knowing about the needs and preferences of the employees and
knowing what will help in making a successful transition (Hornstein 2015). It is
to be known by the managers that what does the people need to listen,
when, where and from whom. It involves knowing what is to be taught to the
employees, what skills are to be embedded, how to coach them and
demonstrate their new behavior (Hughes, D.L., Dwivedi, Simintiras and Rana 2016).
The main thing that is to be observed is what are the factors that make the
employees stick to their own behavior and what factor can nullify that and
ultimately make them move. Individual change management thus focuses on
human psychology and neuroscience in order to apply some actionable
frameworks to the employees for change (Howlett, 2019).
Organizational Change Management
It is very much impossible for the managers to make the changes at
individual levels that is on the basis of person by person. Thus organizational

11LEADERSHIP AND CHANGE MANAGEMENT
change management focuses on changing a group of people or team by
supporting hundreds and thousands of individual at the same time through
some specific actionable factors (Klochkov, Gazizulina and Golovin 2016). The
process of organizational change management involves identification of the
groups, teams and individuals who require change as per the changes in the
organization and identification of the process in which ways they are needed
to be changed (McCaffery 2018). This process also includes the creation of a
proper plan in order to ensure that the employees that have been impacted
because of the sudden change get the required training, help, awareness
and coaching for driving the change successfully. Successful transition of
individual must be the main focus of all the activities for implementing
organizational change management (Javanparast et al. 2018).
Enterprise Change Management Capability
The change management in the enterprise refers to increasing the
core competency level of the organization by implementing competitive
advantages that creates differentiation and the ability to adapt to changes in
a flexible manner. It refers to the effective change management skills
embedded within the organizational roles, processes, procedures, structures
including the leadership skills (Rothwell, Stavros and Sullivan 2015). The processes
of change management is effectively applied to the leadership initiatives and
skills that can enable them to guide their team throughout the change and
that would enable the employees to feel free to ask the leaders about how to
be successful within the organization (Mumford and Higgs 2019).

12LEADERSHIP AND CHANGE MANAGEMENT
The ultimate result of change management in enterprise is that the
employees adapt to changes smoothly and effectively, responses to the
changes in the market are also very quick, the organization can adapt to
strategic initiatives, adopt better and new technologies in a smooth way
with lesser impact in the overall productivity.
ADKAR Model
ADKAR Model is one of the models formed by Prosci for efficiently
handing the change. It is one of the universally accepted frameworks. The
full form of ADKAR is Awareness about the change of needs, Desire for
supporting the change, Knowledge about the change, Ability of
demonstrating behavior, skills and attitude, Reinforcements for making the
employees stick to the changes. This model is a goal oriented model of
change management. The model was first developed in the year 1998. It
reflects the necessary processes for building individual changes. The model
is based on two basic foundations –
1. It is the people who actually changes and not the organization.
2. Change is successful when the individual change is equivalent to that
of the organizational change.
In order to make the organizational change a successful one, the
individual changes need to progress at the same rate to that of the business
dimension. Thus ADKAR is a goal oriented process that helps in the
management of changes by making the managers focus on the activities

13LEADERSHIP AND CHANGE MANAGEMENT
related to specific business results. It is a very useful framework for the
change management in teams as it helps in planning and execution of the
work efficiently. This model helps the manager to identify any gaps in the
process of change management and bridge them by providing effective
training and coaching to the employees. This mode is used to identify the
resistance of the employees to any change, help and support employees
throughout the change management process, creation of a successful and
proper plan for professional and personal development during the change
process and development of the change management plan for every
employee as a whole. Thus, this model has the ability to understand and
identify why certain changes do not work and ultimately helps in taking the
necessary actions for implementing successful change.
It has been already said that the organization considered in the report
that is the Hull University Teaching Hospitals NHS Trust is a merger of two
companies. The organization has followed all the above mentioned change
management process and is one of the very successful hospital providing a
number of services. All these services involve the life of a patient and hence
proper change management process is always one of the major concerns for
this organization. This organization has adapted to all the challenges faced
during the merger with ease because of the competency of the organization
as a whole as well as the competency of the employees involved. This
organization provides very strong training and development skills to all its
employees and keeps them up to date that helps them in being flexible to

14LEADERSHIP AND CHANGE MANAGEMENT
the changes. The vision and the mission of the organization itself include
providing greater future for the employees and hence the organization is
ready to take any changes and manage them smoothly. Health care and
health IT are very much prone to changes and are considered as two of the
most change oriented industries. It undergoes a number of regulatory
changes like new payment modules, new transaction system, new patient
admission process and other business model changes. These changes affect
the health care professionals at each and every level starting from the
dealings of the physicians with new reimbursement models, alterations in
the flow of work, strategy evaluations, profitability as well as the satisfaction
of the patients. Change in this industry is inevitable and it is very essential
for these kinds of organizations to manage the impact of these changes and
convert them into benefits. There can be numerous changes like
development of the IT, shift in the needs and preferences of the patients,
change in consumer behaviour, consolidations and others that are required
to be taken care by the leaders. The several changes that the organization
can face have been discussed afterwards, where the data has been taken
after interviewing several employees related to this industry. However, these
sudden changes can be taken care also by implementing the Lewin’s Change
Model. This is a very simple and easy model of change management that
consists of three phases –
1. Unfreeze
2. Change

15LEADERSHIP AND CHANGE MANAGEMENT
3. Freeze
Unfreezing refers to the motivation to change. It means determining
what is needed to be changed, surveying the organization for understanding
the on-going state and understanding why does the change needs to take
place. It must be ensured that there is a strong support from the upper
management under these circumstances. The application of stakeholder
analysis and stakeholder management must be applied in order to recognize
and get the support of the important people within the organization. The
manager must create a powerful and attractive message that seems
compelling to the employees. The message should clarify why the change is
necessary by providing strong evidences. Emphasis must be given on the
“WHY” factor in order to clearly communicate the message to the employees
without any objections. After the message is being communicated it must be
ensured if there are any doubts or concerns that require further clarification.
The actions should be taken accordingly.
The second stage is the Change. The change must be communicated
often to the employees. The benefits of the changes must always be
communicated and how the changes will affect everyone must also be very
much clear to every employees. Everyone must be made prepared for what
is about to come. All the questions of the employees must be answered
honestly and all their problems must be dealt immediately. Employee
involvement in the change management process must be appreciated and

16LEADERSHIP AND CHANGE MANAGEMENT
opportunities for the same must always be available. All the employees must
be involved in the process and everyone must be negotiated properly about
everything (Smither, Houston and McIntire 2016).
The third stage talks about Refreeze. The acceptors and the barriers
of the change must be determined properly. What are the factors that are
making the employees accept the changes and what are the factors that are
obstructing the changes must be thoroughly analysed. The leadership
support must be provided accordingly (Tyack, 2019). A reward system can be
organised where people accepting the changes will be rewarded with several
other development opportunities. A proper feedback system will be an extra
benefit for the manager in understanding the change management progress.
Proper training and development programs must be created in order to boost
the confidence of the employees and everyone must be kept informed about
every details. All these will ultimately lead to a long term success of the
organizations.
Research Methods
All the information provided in the report contains both primary and
secondary research methods. The change management processes that can
be applied are the secondary research works. The changes that can take
place, the obstacles and the employee reactions are however based on
primary data and are discussed in the following lines. The primary research
method that has been used in this case is the interview method. The

17LEADERSHIP AND CHANGE MANAGEMENT
interview method of collection of data involves collecting data from a
number of people by using oral or verbal stimuli. The method can be
personal interview and telephonic interview. The report contains both these
methods as visiting a number of organizations in a short limit is not always
possible and hence telephonic interview has also been used. The personal
interview was based on certain structured manner that consisted of some
pre-determined question. The telephonic interview was also similar but
however telephonic interviews were shorter in duration. The primary
research area focuses on the identification of sample leadership behavior at
the successive levels of sophistication and intensity by interviewing with the
people. Strategic interview was taken with those people who have good
experience of leadership qualities in Hull University Teaching Hospital NHS
Trust. Interviews with the leaders across Hull University, at the various level
in order to gather detailed evidence of the way they lead and what is the
result of this leading.
Present and Future Challenges
The interview has helped in assessing the various kinds of changes
that can take place in the health care industries, especially the hospitals. The
changes that are being observed are-
1. Change into value based model of payments from fee for services
model.

18LEADERSHIP AND CHANGE MANAGEMENT
2. Introduction of various health related applications that helps in
contacting and conversing with the doctors by sitting from home at
any time. One time registration is necessary and minimum payment is
required. The doctors can see the messages and either call backs the
patient or replies through the application and prescriptions are also
provided through online accordingly by charging the doctor fee
through online money transfer.
3. There are introduction of various health gadgets that can help in
tracking the pulse, heartbeat, sugar and pressure. This is affecting the
health care in terms of customer footfall.
4. Changes in the insurance systems, whether children will be covered
under their parent’s insurance, who will be insured and who will not be.
5. There are also changes relate to the reimbursement policies,
consolidation policies, that has been observed from the interviews.
6. The consumers are demanding for more information, education, more
value based options as well as more transparency now a days. There
are several hospitals and other health care facilities that have arrived
and in order to get the best service the consumers are always
demanding for authentic information and seeking for transparency.
7. There are always changes related to the process that is admission
procedures, discharge procedures, patient treatment procedures, and
emergency procedures and so on.

19LEADERSHIP AND CHANGE MANAGEMENT
These are the basic challenges that have been faced by the health
care organization and according to the employees there can be many more
challenges that can arise in the future because of the rapid technological
advancements and the change in the consumer preferences (Western 2019).
The leaders and the managers are always looking for processes that would
reduce the cost of operations of the company and there after they are
always trying to substitute the employees with machines. The health care
organizations however require human beings and machines as well. The
efficiency of the human brain cannot be substituted by any machine. But
certain substitutions can arise.
1. There can be more innovation and new health products can arrive in
the market that would let the patients do their regular check-ups just
by sitting at home.
2. The devices proliferate and their capabilities are scaled and hence we
can see increase in the attempts to submit FDA labelling certain
mixture of pills with devices and additional services. It will completely
create a new life for the pharmaceutical industries and the health care
industries.
3. There are chances of various partnerships and collaborations with the
Fintech companies for improvement of patient outcomes.
4. The evolution of the technology will dismantle the physician’s office in
the coming future as there can be advancements in the field of
telemedicine.

20LEADERSHIP AND CHANGE MANAGEMENT
5. There will be numerous changes in the incentive rates and penalties in
terms of the EMR adoption and on the basis of the saturated market
there are chances that the rate of adopting the EMRs will slow down
gradually and become nil.
6. There are chances of rise in decentralised health care systems and
decline of the hospitals.

21LEADERSHIP AND CHANGE MANAGEMENT
Self-Realization and Conclusion
It can be inferred from the above paragraphs that every organization
undergo changes. These changes can be either positive or negative for the
organization, but as a change manager I should be aware of converting the
negatives into the positive and yield more advantages for all the employees.
As I have observed in the interview, the Hull University Teaching Hospitals is
not much worried about the upcoming challenges. It is only possible because
of the efficient change management techniques that they have. The hospital
provides numerous services and all the processes cannot be substituted
technologically (Mumford and Higgs 2019). The efficiency can however be
increased and the organization must always be ready for any kind of
challenges. As an effective leader and a manager it should be kept in mind
that if my hospital can provide with good customer service then no matter
what the customers will prefer the hospital than technology. The internet can
say symptoms and precautions but proper medicines can always be given by
a proper doctor. Satisfaction of a check-up can be obtained only when there
is a face to face interaction. So if these changes that are about to happen in
the future and happening at the present can be managed effectively then
there are no disadvantages. As a manager I can face the challenges by
following the steps given below:
1. Targeting the audience that can be impacted as a result of the change.
2. Using proper communication tools for reaching the audiences.

22LEADERSHIP AND CHANGE MANAGEMENT
3. Planning in advance about the information to be provided and
maintaining transparency and stating the benefits.
4. Identifying the risk barriers and the positive factors as well.
5. Communicating the activity structures properly.
6. Providing samples, giving proper training and development as well as
regular counselling.
7. Changing the team roles and responsibilities and decentralisation in
change management.
8. Providing regular support.

23LEADERSHIP AND CHANGE MANAGEMENT
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28LEADERSHIP AND CHANGE MANAGEMENT
Appendix
Questionnaires based on Leadership and Change Management in Hull
University Teaching Hospital NHS Trust:
Change
Readiness
Questions
When to Ask Readiness
Befor
e
Chang
e
Durin
g
Chang
e
After
Change
Yes May
be
N
O
N/A
Change Plan: Is
there a
requirement of
change in the
organization?
Does the
management
team ready to
support the
changes?

29LEADERSHIP AND CHANGE MANAGEMENT
Do the employees
have trust in them
Can people of the
organization be
held accountable
for making or not
making the
change?
Is there clear
understanding of
adaptive changes
people will have
to make?
Is there is a need
of reconstructing
the leadership
style in HULL
The new
leadership styles
would bring
positive effect in
the organization
Leaders

30LEADERSHIP AND CHANGE MANAGEMENT
understand the
problem of
employees and
properly take
actions
Do all the
checkpoints of the
leaders is followed
sincerely by the
leaders?
Is the latter
change in
leadership style is
found to be
positive?