This important book examines issues affecting the sustainability and spread of new working practices. The question of why good ideas do not spread, ‘the best practices puzzle’, has been widely recognized. But the ‘improvement evaporation effect’, where successful changes are discontinued, has attracted less attention. Keeping things the way they are has been seen as an organizational problem to be resolved, not a condition to be achieved. This is one of the first major studies of the sustainability of change focusing on the example of the NHS, by a unique team of health service and academic researchers. The findings may apply to a variety of other settings.

The agenda set out in 2000 in The NHS Plan is perhaps the largest organization development programme ever undertaken, in any sector, anywhere. The NHS thus offers a valuable ‘living laboratory’ for the study of change. This text shows that sustainability and spread are influenced by a range of issues - contextual, managerial, political, individual, and temporal. Developing a processual perspective, this fresh analysis considers policy implications, and strategies for managing sustainability and spread. This book will be essential reading for students, managers, and researchers concerned with the effective implementation of organizational change.

part |2 pages

Part I Context

chapter 1|19 pages

Changing by numbers

ByDiane Ketley, Helen Bevan

chapter 2|19 pages

Improvement evaporation: why do successful changes decay?

ByDavid A. Buchanan, Louise Fitzgerald

chapter 3|20 pages

The best practices puzzle: why are new methods contained and not spread?

ByDavid A. Buchanan, Louise Fitzgerald

part |2 pages

Part II Experience

chapter 4|22 pages

View from the top: opening the box on sustainability and spread

ByJane Louise Jones, Elaine Whitby, Rose Gollop

chapter 5|18 pages

Shades of resistance: understanding and addressing scepticism

ByRose Gollop, Diane Ketley

chapter 6|23 pages

Tracking sustainability: lessons from the patient booking timeline

ByAnnette Neath

chapter 7|24 pages

Sustaining and spreading change: the patient booking case experience

ByJane Louise Jones

chapter 8|19 pages

Layers of leadership: hidden influencers of healthcare

ByAnnette Neath

chapter 9|20 pages

Sustaining and spreading change: the cancer collaborative case experience

ByElaine Whitby, Rose Gollop

chapter 10|19 pages

High impact: key changes in cancer care

ByRose Gollop, Sharon Saint Lamont

chapter 11|17 pages

Spreading can be easy: the ‘see and treat’ experiment

BySharon Saint Lamont

part |2 pages

Part III Implications

chapter 12|22 pages

The sustainability and spread story: theoretical developments

ByLouise Fitzgerald, David A. Buchanan

chapter 13|23 pages

Sustaining change and avoiding containment: practice and policy

ByDavid A. Buchanan, Louise Fitzgerald, Diane Ketley

chapter 14|11 pages

Researching major change: issues and dilemmas

ByElaine Whitby, Rose Gollop, David A. Buchanan