A model for change in the NHS

Rowena Keleher and Carol Cole set the scene for change with a brief description of the current rapidly developing internal and external environment of the NHS. They then identify a range of "supports" used to facilitate such change, explore how they are selected and examine their apparent advantages and disadvantages. Common themes leading to effective change are drawn out. Finally, a four-factor model for effective change is presented; deficiencies in current change efforts identified and recommendations for improvements suggested.