The Junior Doctors’ Strike – an illustration of leading change?


January 27th, 2016

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I’m writing this blog just after the first junior doctors’ strike, when it is still unclear whether parties will return to ACAS and negotiate a deal, whether new contracts will be imposed upon junior doctors and whether further strikes will take place. Whatever your view on the rights and wrongs of the positions of the government, NHS, BMA or junior doctors, the situation seems to be a classic case study of the inherent messiness of Leading Change.

Whether you’ve only experienced being on the receiving end of an organisational change project, or whether you’re lucky (unlucky?) enough to also have led an organisational change project, we all know when we hear the word “change” it tends to trigger an emotional reaction in each of us. Sometimes that is energy, excitement, and motivation. Sometimes it is anxiety, fear, and demotivation. And often it is both. Not paying sufficient attention to this emotional response is one of the reasons (along with insufficient resources, poor change skills etc.) that contribute to the often quoted 70% failure rate for change projects.

So what advice would we give the ‘leaders’ of the junior doctors’ contracts change, or for that matter any leader of change? Would we advise a planned process, such as Lewin’s classic model (1) of unfreeze – change – freeze or John Kotter’s 8 step process (2), starting with “Creating a Sense of Urgency” through to “Institute Change”? Would we advise an emergent process, using an iterative change approach, with each step informing the next, and the end point not known at the outset? Would we advise attending to the psychological changes that lie behind our emotional reactions to change, such as William Bridges “Managing Transitions” (3)?

I could go on … and on … and on … The list of different methodologies, approaches, and mindsets about change can seem endless. I also feel approaches are sometimes presented as competing with one another, and have been guilty myself of talking about planned versus emergent change, when taking the key messages from each approach is probably more appropriate.

But that doesn’t seem to be very helpful advice for leaders of change. I seem to be saying change is messy as it is emotional, and leading change is messy because of this and because leaders need to consider a variety of methods and choose the relevant bits for a particular change. Perhaps the best advice then is slowing down and stepping back when in the middle of the complexity of change. This will help leaders attend to their own and others’ emotions, to listen to what is being said and not said about the change, and to decide what the best approach then is given that information – so a bit of an emergent process without ruling out that that may then call for more of a planned and structured phase. And hopefully when leading change we can step back and slow down without the formality of ACAS.

  • Lewin, K (1947). “Frontiers of Group Dynamics: Concept, method and reality in social science, social equilibria, and social change”. Human Relations 1: 5–41.
  • Kotter, John P. (1996). Leading Change. Harvard Business School Press
  • Bridges, W. (2009). Managing transitions: Making the most of change. Da Capo Press.