Change management as important as change itself

Change is an inevitable part of any nation’s development.

Fifty years ago the Commonwealth moved our nation’s currency from English pounds, shillings and pence, to a decimal system with the Australian dollar.

This important reform was a substantial undertaking with years spent on planning and developing designs, as well as a comprehensive education campaign to bring the public on board.

Change management was a critical part of these monetary reforms, helping to make sure that government, businesses and everyday Australians were able to move to the new system effectively.

A more modern example of a reform with far reaching implications was the switchover to digital television, completed in December 2013. Again, extensive planning was required, with research, a clear timetable, public information campaigns and government subsidies needed to help individuals and organisations make the switch.

Broadcasting companies received financial assistance to help them upgrade their transmitting equipment, while citizens receiving government assistance payments were eligible to have digital set-top-box receivers provided free of charge.

It wasn’t as simple as just turning on the new signal and expecting everyone to be able to watch television – this modern reform also required a dedicated process of change management by government, business and the community.

Reform to Australia’s mental health system is more complex than either of these initiatives. For it to be successful, it will require a similar level of investment in change.

As indicated in November, we welcome the proposed reforms to mental health outlined by the Prime Minister The Hon Malcolm Turnbull MP and the Health Minister The Hon Sussan Ley MP.

However, as I said at the time, now the real work must begin. Much like the change to digital TV, this isn’t a case of simply ‘switching on’ a new system. The implementation of reform, and how the sector adapts to it, is now more important than the fact that there is change itself. The million dollar question now is how all the stakeholders involved - including consumers and carers, governments, service providers, and NGOs – will work together to implement change as the reforms are rolled out.

The proposed changes are extensive. One of the most significant is the move to have mental health services regionally managed by Primary Health Networks (PHNs) in partnership with Local Hospital Networks, NGOs, Aboriginal and Torres Strait Islander organisations, National Disability Insurance Scheme (NDIS) providers, and drug and alcohol services.

While many of the benefits of this move are apparent - such as removing duplication and inefficiencies of local services, and ensuring the administration of programs is based on local needs - the transition is complex. The implementation of the transfer to PHNs must include stakeholders at the local level - including consumers and carers - to ensure new programs are effective and current programs aren’t abandoned completely. But to have real influence, those local consumer and carer representatives will also need to be linked in to state and national networks.

Co-design requires that at all times, consumers and carers must be involved in the development and design of new models and PHN-commissioned services, rather than the old approach of a top down structure imposed from above. People must be brought along for the journey throughout the transition. This is one of the fundamental planks that underpins a successful change process.

It’s encouraging to see that some of this collaborative approach appears to already be taking place. In early March, Mental Health Australia members along with consumer and carers will sit down with PHNs to discuss their ideas and concerns. To be truly effective, these kinds of discussions will need to continue, and be carefully managed, as the process rolls out, with clear dates and milestones outlined for everyone involved.

In addition, coupled with the actual design of the programs, is the requirement for accurate data to inform those designs. With new reporting guidelines, what is measured and how it is measured is set to change. In some places the data itself isn’t actually even measured at present. The correct management and use of accurate data is crucial in the design of new programs. We should also take this change as an opportunity to properly utilize data to help create the best possible systems.  That means local initiatives must be benchmarked against national performance.

One example of this is the move to digital health records. Digital health records could have a major positive impact on individuals navigating the system. However, many organisations will need to update their existing data systems in order to communicate and utilize an electronic record, and in some cases will need entirely new IT systems. We know that when electronic records were introduced to General practice some 20 years ago, the Australian Government invested heavily in the equipment and skills required in a General Practice setting through the then Practice Incentives Program. How will this investment occur in mental health?  This is another area governments should consider providing assistance so service providers can achieve an adequate level of compliance in a timely manner.

Just another step on the change management ladder.

The current reforms represent an exciting time to be in the mental health sector, but if the transition is to be smooth governments must invest in change management. If this was a corporate initiative, a very significant proportion of the overall budget would be spent on this vital cog in reform.

We know from history that complex programs with a diverse range of stakeholders can be implemented with confidence if the change is managed carefully. With some foresight, and an investment in the change process, the same can happen for mental health reform.

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mental health reform, Newsletter, perspectives