Health Services Change Guide

Change Guide logo

The Health Services Change Guide is a step-by-step guide that will help you to lead and bring about change. It features helpful and practical advice from practitioners, leaders, service users and staff. You will also find evidence to back-up the approach.

Our focus is on people and culture. This Change Guide works as part of our Human Resource and other service, quality improvement and culture change programmes. In line with our Health Services People Strategy 2019-2024 all of these programmes are bringing us closer to our goal of delivering person-centred care and public value.

People are at the centre of all of our initiatives. The Health Service Change Guide focuses in particular on People’s Need Defining Change. It provides guidance on working with Service Users, Families, Citizens, Communities and Staff to understand their needs better when undertaking change. It can be used at all levels to support managers and staff. It should help us all improve how we bring about change. The guide also provides useful information on the context to organisational change.

A summary booklet of the Change Guide is also available for download:
Change Guide Summary Booklet (PDF, size 1.4 MB, 16 pages)

All of the support resources are available in hard copy on request by emailing

Implementation of the Health Services Change Guide

The Health Services Change Guide is a resource for all staff across the health and social care system and is a core reference for the work of the HSE Organisation Development and Change team. It provides an evidence informed and coherent approach to guide change, innovation and integration. Organisation Development and Change is a team focused on building skills, confidence and knowledge for good change and innovative practices. Our work is based on an organisation development approach to change, where people’s needs inform service design and improvements.

We recognise the importance of understanding local contexts and the need to support multi-disciplinary teams respond to rapid and emergent change in a complex system such as healthcare. We work with those leading change and integration, frontline teams and business support services to focus on people and culture and create the conditions for change. To support capacity building for change across teams and services we have a range of services and bespoke resources for you to access and begin to put the Change Guide into action.

Access Digital and Self-Directed Learning building your capacity to deliver change (PDF, 373 KB, 1 page)  

Access Organisation Development & Change Practitioners providing individual and team supports (PDF, 320 KB, 1 page)

Creating the Conditions for Change & Integration

HSE Organisation Development & Design - Improving Change Capacity have launched Creating Conditions for Change & IntegrationThis resource has been designed to provide practical help and guidance to individuals and teams to increase readiness for change and support integrated working enabling the implementation of Health Regions across the country. It is aligned to the Health Services Change Guide programme of work which is focused on building change capacity and capability across the system.

Creating Conditions for Change & Integration - A New Resource has Launched (YouTube)

Creating Conditions for Change & Integration recognises the importance of:

  • Focusing on people and culture as a key platform for change
  • Understanding the complex nature of health and social care services
  • Assessing readiness so that ‘changemakers’ know when and how to intervene appropriately

Creating Conditions for Change with the Health Services Change Framework - Explained (YouTube)

The evidence on change is clear – we need to engage with the people who will be impacted by the change early and often. Their experience and insight will be key to informing what needs to be attended to and how best to progress change at local level.  There are helpful prompts included in this resource that will assist teams to consider all of the different elements:

  • Why is this change so important?
  • How will it impact on me and the team I work with?
  • What do we need to do to improve readiness and support the transition?

It is also important to recognise that change within health and social care systems is complex, unpredictable and often quite messy. It rarely follows a step by step process. To bring about meaningful change it is important that we take the time to understand our own local context and all of the factors that make it unique – the people, relationships and the ways we do things.  This resource outlines three simple rules:

  1. Agree a shared purpose – this will help to unite people on what is really important
  2. Focus on relationships – connecting with people and working together to find solutions
  3. Use appropriate interventions – thinking about what will work best in your team or service based on your needs.

Speaking at the launch, Caitríona Heslin, HSE Organisation Development, acknowledged the importance of having change, project management and quality improvement supports in place for teams and services across the country to enable the implementation of Health Regions and to build on the work that is already taking place on delivering integrated pathways of care. “We have a responsibility to support change leaders at all levels to find solutions to the many challenges they face on a daily basis in delivering services to local communities. We cannot be change leaders on our own and we need to develop networks of support locally. This resource is intended to help in a practical way and builds on the work we have been doing in recent years to join up our efforts to support service improvements.”

Helen Bevan who is very well known internationally as a strategic leader and advisor on change and transformation shared very interesting insights at the launch –  “the most important factor when it comes to the ability to make change happen across big complex systems is cultural readiness for change. Organisations that have invested in building cultural readiness and that have developed and amplified the values of their organisation, strengthening relationships and building connections are the most successful.” Helen referenced evidence from evaluations citing organisations that have created really strong foundations, so that when an improvement approach is introduced they could plug it into what was already happening.

Creating Conditions for Change and Integration is available in hard copy on request by emailing or you can download a digital copy and supporting template below:

Creating Conditions for Change & Integration - Health and Social Care Services (PDF, size 4.9 MB, 32 pages)

Template 6.5.3: Creating the Conditions for Change & Integration (Word, size 556.6 KB, 7 pages)

Contact us:

Organisation Development & Design
HSE Offices,
Co Meath.
A82 H3C7

Phone: 046 9251466

Connect with us on LinkedIn at Health Services Change Matters for updates or follow us on Twitter @HSEchange_guide