ABSTRACT
This chapter considers ways forward for change management in intellectual disability services, setting out key principles and practical possibilities while urging caution about the quality of available advice, the effectiveness of well-publicised interventions and the claims emanating from the consultancy community, which are frequently inflated and unrealistic. Change management is far from a settled subject, however, and has been blighted by a proliferation of decontextualised dictums, unrealistic yet oft-repeated assertions, crude oversimplifications, trite statements of technique, and regular bouts of sloganising about heroic ways of overcoming irrational resistance. A great deal of attention is given to classifying reasons for resistance and explaining why particular categories of worker fail to grasp or seek to challenge management decisions. There is some evidence of realist workers intervening to compensate for this, introducing organisational changes on an informal group basis, despite management processes. New management development programmes will be needed if distributed change agency is to be embedded in health organisations as routine practice.
