Change Leadership.
Prosci, the globally recognised change management authority, has consistently found the number one determinant of successful change is active and visible executive leadership. In the context of an EPR implementation, executives have numerous opportunities to demonstrate this leadership. Simply selecting an executive SRO, attending programme board meetings, and participating in go-live activities is necessary, but not enough. Instead, executive teams must take an active role from the outset—aligning around a central vision, articulating its strategic importance, and ensuring the EPR programme is prioritised over non-essential initiatives.
As implementation progresses, executive involvement remains critical. Given the scale and complexity of an EPR programme, assigning specific executives to key areas such as Training, Operational Readiness, System Configuration, Communications, and Infrastructure strengthens decision-making and reinforces the programme’s importance. A hands-on leadership approach, combined with oversight from Non-Executive Directors and potentially and Assurance Partner, not only ensures a smoother transition but also signals the organisation’s commitment to success, helping to balance implementation with the ongoing delivery of health and care services .
Communication and engagement
This is essential in any project or programme, especially in EPR initiatives, which are often the first step in service transformation. From the outset, there must be a clear and consistent vision, key messages, timelines, and stakeholder analysis, with a strong focus on what each stakeholder gains. Since EPR implementation typically spans 18 months or more, a well-structured communication strategy should gradually build awareness, desire, knowledge, and ability rather than relying on an initial burst of messaging.
Equally important is who delivers the message. Employees are most influenced by executives, direct managers, and field experts, making it crucial to involve the right voices at every stage. While executive communication is vital, CxIOs and subject matter experts, regardless of seniority, should actively participate. Effective engagement means articulating “What’s in it for you?” using real examples from within the organisation. Lastly, communication efforts must be regularly evaluated, with adjustments made based on feedback.
Impacts of change
The impacts of change generated by new ways of working need to be understood and managed supportively. Understanding the current ways of working is part of all EPR vendors’ playbook. This is necessary to understand pathways, workflows and processes which will need to be supported by the system. This is the route to realising the benefits promised in the original Business Case.
To assess the current state, subject matter experts are needed from across the organisation. These are people who know how things work today and will be involved in designing how things will work in a digitised world. New ways of working may require changes to job descriptions and new organisational structures. Conducting this HR-driven process openly and transparently engenders trust. Encouraging and supporting SMEs to become ambassadors for the programme will foster greater trust by providing a conduit for communication and engagement activities to reach into every corner of the organisation.
Learning and education.
This is a monster of a topic, so will be the focus of a subsequent article. For now, here are a few things to consider when planning and delivering training to X thousand staff in 8-12 weeks…
- How are we going to conduct the Training Needs Analysis? When are going to do it? Who is going to sign it off?
- Will the Training Approach be e-learning/classroom based or a combination of both? Who is going to develop the courses and their content? Who is going to sign off the content? What happens when there are last minute changes to the build? How else are going to give people the opportunity to familiarise themselves with the new system and new ways of working?
- How will we track Training Registration and attendance? Who is going to drive training registration and attendance? How will we make sure people are aligned to the right training courses? What will we do if people are aligned to the wrong course?
- When are we going to recruit Trainers? How many do we need? How can we strike a balance between those who have training skills and experience, and those who know the Trust and could do the job?
- Aside from Trainers, how many people will we need to be in the Training Team to: Create/update the schedule? Support and manage trainers? Update the staff list to understand who needs to be trained? Handle the inevitable questions from staff training will generate?
- Do we have enough Training Rooms of a suitable size? Who will help free up rooms if needed? What equipment is needed to train successfully? What will we do if there is a problem with Estates/IT in designated training rooms?
- Who will offer Senior Leadership support to make sure staff register, attend, and complete training?
Clinical/Operational Ownership
Implementing an EPR is a major undertaking and requires a transfer of the programme to Clinical/Operational Ownership. Adopting new ways of working throws up activities which require clinical and operational teams input and action. During the implementation phase, designing, testing, cutover, training, all need staff to do something.
In the days and weeks after going live, acclimatising to new ways of working means productivity levels will dip. Engaging clinical and operational managers across the organisation is critical if programme activities are to be done, and the performance dip does not become too deep or too long.
Identifying and educating managers about the clinical and operational “Pull” on their teams, at the earliest opportunity, sets clear expectations and helps create the sense of the programme being a shared endeavour. This really matters, because in the long term, clinical and operational managers and leaders will be responsible for living with the system and the new ways of working.
Alongside these activities, clinical and operational managers and leaders have the not so small matter for planning and delivering services for patients, whilst chunks of staff are engaged in EPR activities. In an organisation as complex as an NHS Trust, the completion of activities and a plan for the delivery of services in the run up to and post- go live needs to be assured. Establishing a governance framework to track progress and provide support, de-risks the delivery of patient care and the programme.
