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SeCtion one Four key approaches to change
Starting the change
The first stage of Action Research is ‘problem identification’. The recovery hub was itself a response to a perceived weakness in services for people with long term mental health problems, but Manager C wanted to understand how different stakeholders viewed the current services and what problems they would identify. As he previously managed the social work team Manager C already knew both the health and social care staff and the third sector organisations, and had a good relationship with most of the people with these different teams and services. He recognised though that they would have seen him in the context of a different role and this could be a barrier to others accepting that he had greater responsibility and a wider remit. For the health staff this would involve them seeing him as a manager rather than as a colleague, and for the third sector organisations as a contract manager. He also recognised that whilst he had some knowledge of the roles and professional backgrounds of his health colleagues this was limited.
Manager C therefore decided to meet individually with the team leaders or senior clinicians from all the health disciplines and the leads within the third sector organisations. This enabled him to re-introduce himself in his new role, find out more about their work, and understand their hopes and concerns for the new hub. Manager C also arranged to speak to the director within the Foundation Trust who would be his new line-manager. Manager C and the Psychology Team Leader contacted the health and social care management faculties within the local universities to enquire if any of them would be interested in working with the recovery hub. One responded with experience of organisational development and integrated working and seemed to be a good fit for the project. Together they drew up a proposal for a one year action research project and submitted this for funding by the Foundation Trust. It was approved, although at slightly less than was initially applied for. A senior researcher agreed to act as the main point of contact with the university with a more junior researcher providing fieldwork support. The university also suggested that they could engage co-researchers who had experience of mental health services.
Manager C’s director had advised that the hub was seen as a ‘flagship’ by the Foundation Trust, the Local Authority and the Clinical Commissioning Group. There would therefore be merit in arranging a periodic meeting of the relevant representatives from these organisations. Manager C also wanted to create a local change infrastructure that was separate (but linked) to his management team and which emphasised that people with mental health problems needed to be at the centre of the developments (Diagram C2).
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