ABSTRACT
This chapter explores the many changing demands faced by the National Health Service (NHS). Many studies have demonstrated that health services deal with only a small proportion of the health problems present in a given population. The term ‘system iceberg’ was coined to draw attention to this fact. Health problems are passed through a series of filters starting with the individual judging whether the problem should be presented to health services. The process of change is about helping people within an organisation or a system change the way they work and interact with others in the system. The ability to plan and manage change is an essential leadership skill. Fundamental to change is the management of people, and an understanding of how they will react is invaluable. Individuals’ change type’ may depend on the particular change they are adopting. Changes to systems, structures and culture are underpinned by changes in the way people within the organisation behave.
