Healthcare Improvement Scotland is currently developing a Scottish Approach to Change for health and social care. This website provides the first draft and we are actively seeking feedback on how we can improve and refine it.

The aim of a Scottish Approach to Change for health and social care is to articulate the steps that are needed for successful change to happen and the essentials that underpin the change process. Following this approach to change will help achieve high quality, effective, safe and person-centred services.

The Scottish Approach to Change will support people to understand why each element of the process is needed to achieve high quality change and how this can be achieved. Importantly, it will not replace any of the existing methodologies used in change – like improvement, design and engagement – but instead will show how they can be used together to deliver high quality change. Bringing together these different methodologies into a single approach is what makes the Scottish Approach to Change unique.

A high-level overview of change which will provide the framework for developing the detailed Scottish Approach to Change is below. You can also click here to download a larger image. You can also download a pdf version of the content of this website here.

This draft framework is described within the context of operating a Quality Management System. Continuous delivery of high-quality change is more achievable in organisations that operate a Quality Management System, however, the steps of change described in this framework could be delivered without a full Quality Management System being in place. The draft Scottish Approach to Change is set out in three stages:

1. Current state: on the left-hand side of the framework is the “current state” before the change takes place. Operating a Quality Management System enables the need for change to be identified, whether that is through an internal trigger such as quality control monitoring, or through recognition of an external trigger through quality planning or quality assurance.
2. Change cycle: in the centre of the framework is the “change cycle” when the change is taking place. Six steps of change are identified within the cycle, with each of them being aligned to a part of the Quality Management System. The change cycle is underpinned by eight essentials for change, all of which need to be in place for successful change to happen. At the centre is a Learning System to underline the need for continual learning and reflection during and between every step of change.
3. Future state: on the right-hand side of the framework is the “future state” for after the active change process has taken place and the change is being sustained. Operating a Quality Management System supports the sustaining of the change and also the potential to review the changed status to consider whether it is appropriate to spread to further situations/locations.

To clearly align the steps of change with the domains of the Quality Management System, a simplified graphic showing the four core domains has been used within the framework.

This toolkit provides a brief description of each of the steps of change and essentials for change. To find out more please click on the boxes below.