Managing change in learning disability services

Learning disability services are peculiarly resistant to change. People who use these services, their families, and the professionals who support them are often readily accepting of the status quo. However, if the local services and support are still characterised by any of the following, change has to happen:

  • Reliance on residential care at the expense of ordinary housing and support.
  • Culture of over-protecting and over-supporting people with learning disabilities.
  • Practice of fitting people into services.
  • Limited ambitions and low expectations of what people can achieve.
  • No real understanding of either costs or personal outcomes.
  • People denied their ordinary rights and entitlements.

Any change initiative of this scale must be underpinned by common adherence to non-negotiable core principles, such as:

  • Unambiguous and constant communication of values of inclusion, opportunity and choice.
  • Unswerving leadership commitment to put these values into action.
  • Clear, simple and achievable strategy which specifies objectives, priorities & outcomes.
  • Recognition by commissioners that real experience & expertise rests with providers.
  • Programme management process which recognises providers as real partners – with commissioners and providers sharing incentives to make change happen.
  • Starting with the best possible information about people, places and costs.
  • Telling the story of inclusion and opportunity over and over again!

Putting these principles into practice is not easy – otherwise the change would have happened already! However, there is plenty of learning to guide us along the way:

  • Provide strong, unwavering leadership focused 100% on putting values into action – believe in it and stick with it!
  • Identify and support the change management capacity that is required to make the desired change happen.
  • Select providers who share the commissioner’s vision and values – and incentivise them to make change happen.
  • Build real trust and mutual respect between commissioner and providers – but don’t be afraid to challenge each other.
  • Collect evidence and information to prove that specified outcomes are being achieved.
  • Do not talk about empowerment unless you really are prepared to give up some of your own power – this proves you are serious about people taking control.
  • Accept that it is normal to encounter obstacles and don’t let them surprise or deter you – traditional services and culture are hard to shift!
  • Identify the people who really care & understand – develop and support them as change agents.

Above all just do something! It is too easy to get mired in consultation and planning at the expense of making real change happen. All the time that is expended on searching for the perfect strategy is time lost to the real business of doing things differently.