One of the most important tasks requiring management is securing the implementation of change. That is the focus of this chapter and the approach will be to provide some overall concepts which people have found help them to be effective in these turbulent times.

On one level, the management of change needs no introduction, since it is something we cope with throughout our lives. As we go through the different stages and different educational and economic opportunities, we manage each transition. On a micro-level, our bodies and our social relations are always undergoing minor, and sometimes major, changes and we manage the necessary adjustments. However easy or difficult we find these changes, we manage. The issue is whether we manage them well and whether having the right theories to help guide our thoughts, feelings and behaviours might move us from coping with, to thriving in, change.

‘Skills and ability to manage change’ is a phrase appearing in most organisations’ job descriptions and person specifications these days. Psychiatrists as individuals will be skilled in supporting service users through their personal changes – the clinical change task. This chapter offers an approach which should enable psychiatrists to have a way of thinking which will give them confidence in approaching the managerial and organisational change task.

Why is the management of change necessary?

Society in the UK, as elsewhere in the world, is changing rapidly and will continue to do so. The effects of developments in information and communications technology are well known and support the prediction that constantly adjusting services and provider practices will be a feature of the modern world. This has an impact on all parts of the economy, including the delivery of mental healthcare. The context for that delivery is one where the right to choice is an expectation of service users and being subject to contestability is a fact for service providers. As the public becomes more educated about options and more prepared to voice their needs and wants, the requirement is for services and clinicians to offer flexible and responsive services which are experienced as personalised by each service user.