Facilitator Handbook 2005 - PRIMIS

Facilitation Skills
PRIMIS Facilitator Handbook
Facilitation Skills
Background
“Managers are under increasing pressure to implement major structural reform in the NHS
as well as achieving demanding national performance targets. At the same time they are
expected to deliver changes in the culture of NHS organisations - changes which some
regard as fundamental if real improvements are to be sustained.
“The political imperative to deliver rapid objective change can lead managers to adopt an
increasingly authoritarian style. Such an approach may be effective in producing short term
measurable change, but it is likely to bring managers into direct conflict with doctors who
value their professional autonomy and resist current attempts to ‘manage’ their
performance. Management styles that make doctors unhappy may adversely affect both the
quality of care and patients’ satisfaction.
“Tension exists between the performance management role of managers and their
responsibilities to produce changes in the culture of the NHS. This tension is becoming
increasingly important for managers who work in primary care trusts - relatively new
organisations that are expected to lead the reform of the NHS.”
Marshall et al. Managing change in the culture of general practice: qualitative case studies
in primary care trusts. British Medical Journal. 2003; 327:599-602.
Facilitated change is key to helping organisations meet the demands of the current NHS. The
input of a facilitator can have a very positive effect in smoothing the transition from one way of
working to another. The facilitator works, either formally or informally, with the practice team to
create a climate of trust and confidence where barriers to change can be acknowledged,
discussed and addressed.
It is recognised that when most changes go
wrong, it is because too little time is spent
exploring the background and the context for
change, and helping people recognise the
imperative for change. An effective change
programme tends to adopt certain key
characteristics as outlined in the box on the right.
The facilitator is there to ensure a productive
group process, whether this is brainstorming new
ideas or improving existing processes. The role
of the facilitator is to help and support the group
to work as a constructive and cohesive unit and
to enable them to take ownership of the process
and undertake the task to achieve the objectives.
Characteristics of a successful
change programme
• A clear understanding of the context
and external factors driving change
• Recognition of the implications for
the organisation resulting in the
recognition that the status quo will
not do
• A well devised change plan which
highlights the application of change
and how it will be delivered
• An opportunity to be engaged in the
implementation
PRIMIS 39