COURSE/UNIT INFORMATION

Course MBA – UCAM

Course Level Postgraduate

Module Name Strategic Change Management

Awarding Body CIQ/UCAM

Module Code STCMONL2207D

Faculty Michael Raymond

ASSIGNMENT INFORMATION
Full/ Part Assignment Full
Assignment brief IV by Dr. Vivek Mohan
Assessor
Assignment due date 03-Aug-2022
Turnitin Class ID 31587022
Turnitin Enrolment Key CIQGM701

TO BE FILLED BY THE STUDENT

Student Name
Student ID
Email ID
Date Submitted

1|Page
 ASSESSMENT FEEDBACK

TO BE FILLED BY THE ASSESSOR

Assessment type Marks Marks Awarded
Task 1: Report 80
Task 2: Reflective Report 20
Overall Marks achieved
GRADE ACHIEVED

Summative Feedback by Assessor for further improvement

Comments for REDO submission (If applicable)

2|Page
 GRADE DESCRIPTORS

70% and above The assignment evaluated is of a high to exemplary standard. The work
(Distinction) addresses clearly and articulately the assignment requirements and thus meets
and satisfies all the learning outcomes (either well or in an exemplary way).
The work demonstrates: clear knowledge; references to appropriate academic
literature; analysis; critical evaluation; and originality of argument. It is
structured and presented to a high (or exemplary) standard. Referencing
conventions are fully observed.
60 to 69% The assignment evaluated is of a good to a high standard. Substantial
(Merit) knowledge, comprehension and analysis is evident throughout. Arguments
presented are clear and focussed with a logical structure in place. There is clear
evidence of critical evaluation of a wide range of theories/perspectives from
academic literature and some independent thought. The work is well-written
and addresses well all of the learning outcomes. Referencing conventions are
fully observed.
50 to 59% The assignment evaluated is of a fair to good standard. Adequate knowledge,
(Pass) comprehension and analysis is evident throughout. The arguments presented
have a logical structure and show some critical evaluation in places, although
there may be limited evidence of an independent perspective. There is
evidence of some good engagement with some of the appropriate literature.
Learning outcomes have been largely met and to an appropriate degree.
Referencing conventions are observed.
40 to 49% The assignment evaluated is of a basic standard. The arguments presented
(Fail/Redo) have some logical structure and are supported by academic literature in most
cases. The academic literature used is outside of the suggestions made in the
module guide but remains limited. Little critical evaluation is evident, and the
work tends more widely towards a descriptive style. Learning outcomes have
been addressed in a basic but satisfactory way. Referencing conventions are
mostly observed.
Fail Grades
30 to 39% The assignment evaluated is of a limited standard. Limited use of academic
(Module retake) literature and as such knowledge and argument is very weak. A simple
descriptive style with no evidence of critical evaluation throughout. Over-
reliance on simplistic, limited sources. Referencing conventions may not be
observed. Some learning outcomes met but in a weak and simplistic way. The
work is needs to be developed in greater depth and detail to move to a passable
standard at this level of study
29% and Below The assignment evaluated is of an unacceptable standard. There is little or no
(Module retake) evidence of knowledge and understanding that is required at this level.
Referencing is inadequate or non-existent. The learning outcomes have not
been addressed fully and the work requires significant modification to bring it
to a passable standard.

3|Page
 STRATEGIC CHANGE MANAGEMENT

Module description

This course defines sequential process, role and dynamics to organisational change, which imparts
the skills and knowledge to support active engagement in the process of strategic change
management and further highlights ways of dealing with it. It focuses on need, phases and
conditions for successful organisational change. The knowledge developed as part of the module
assists in real-world decision making. Different organisational interventions are also incorporated.
The SCM module is designed to help students understand the dynamics of Strategic Change
Management.

Learning Outcomes

LO1. Identify and analyze the implications for managing strategic change in supporting
organizational transformation.
LO2. Analyze the organizational management challenges faced during the transformation and
changes experienced by the organization.
LO3. Analyze and evaluate the significance of strategy employed in trying to bring about an
effective change management in an organization. How does this impact leadership and human
behavior in the organization.
LO4. Evaluate different change management theories propounded on management and leadership
attributes which leads to enhanced contribution by managers and the employees.

4|Page
 Expectations

1. Materials Access

All learning materials are provided in the form of a module kit and can be accessed from
the Learning Management system (LMS)

2. Learning Hours

Students need to be aware of their commitment requirements in regard to study time. In

order to give you an indication of that, we have based the following information on the
United Kingdom (UK) Higher Education Quality Assurance Agency guidelines. "The
notional learning hours associated with qualifications, programmes and individual units of
study are based on a broad agreement across institutions that students can expect to spend
10 hours learning on average in order to gain one academic credit unit" (QAA 2006).

3. Re-sit

If you do not secure a pass, please read closely the feedback and speak with your Course
leader(s) or faculty. After consulting the feedback, close attention is essential to rework on
the areas of weakness, and then resubmit the work at the next opportunity. As per the QAA
requirements, only one REDO is allowed where the marks will be capped at a Pass.

4. Plagiarism

All forms of plagiarism are taken seriously, and any suspected cases will be investigated
thoroughly. If a case is found proven, then the work will be graded as a fail and the case
will be reviewed by the academic committee.

5|Page
 5. Student appeals

There are no re-evaluations as the marks are graded and internally verified before release.
However, as per our appeals policy, a student can make an appeal to the course leader
which will be then reviewed by the academic committee (please check our academic
policies and procedures manual for more information)

6. Assignment submission extensions

Students can apply for extensions via the LMS based on extenuating circumstances (if any)
with evidence (proof) as per our extensions policy.

General Guidelines

1. Complete the 'To be filled by the student section' in the cover page.
2. All assignments must be submitted as an electronic document in MS word via the LMS (Use
12 Times New Roman script with 1.5 spacing between lines)
3. The results are declared only if the student has met the mandatory attendance requirement of
75% and/or minimum 50 % under extenuating circumstances approved and ratified by the
academic committee and the examination board.
4. The assignment should not contain any contents with references cited from websites such as
ukessays.com, styudymode.com, slideshare.net, scribd.com, Wikipedia but should contain
references/citations from credible academic journal and articles.
5. Submit the assignment in MS word document with the file name being:
First Name Last Name _ Module Code
Example: John Smith_GM701

6|Page
 Checklist

 I have filled the student Information columns below.

The contents of my assignment have been submitted to Turnitin and I have attached
 the Turnitin report
 I have strictly followed Harvard Referencing Style and Citations.

7|Page
 ASSIGNMENT TASKS

This assignment consists of two tasks. Task 1 is a report writing task, while Task 2 is a reflective
report.

Task 1 (Report, 80 marks)- Maximum word count: 3500 words

Word count note: Maximum word limit: The maximum expected word count for both the
tasks is 4500 words, excluding references (any additional text will be discarded for
evaluation).

Scenario: Managing change is tough, but part of the problem is that there is little agreement on
what factors most influence transformation initiatives. Ask five executives to name the one factor
critical for the success of these programs, and you'll probably get five different answers. That's
because each manager looks at an initiative from his or her viewpoint and, based on personal
experience, focuses on different success factors. The experts, too, offer different perspectives. A
recent search on Amazon.com for books on "change and management" turned up 6,153 titles, each
with a distinct take on the topic. Those ideas have a lot to offer, but taken together, they force
companies to tackle many priorities simultaneously, which spreads resources and skills thin.
Moreover, executives use different approaches in different parts of the organization, which
compounds the turmoil that usually accompanies change.

In recent years, many change management gurus have focused on soft issues, such as culture,
leadership, and motivation. Such elements are important for success, but managing these aspects
alone isn't sufficient to implement transformation projects. Soft factors don't directly influence the
outcomes of many change programs. For instance, visionary leadership is often vital for
transformation projects, but not always. The same can be said about communication with
employees. Moreover, changing attitudes or relationships is difficult; they're deeply ingrained in
organizations and people. And although changes in, say, culture or motivation levels can be
indirectly gauged through surveys and interviews, it's tough to get reliable data on soft factors.

Read the full article here:

8|Page
https://hbr.org/2005/10/the-hard-side-of-change-management

Report Information:

Your task is to find a client organisation that has to change and help them manage this change.
The organisation you need to analyse could be the organisation you work for, or one in which you
are involved in in your private capacity or any other organisation you know that might need
assistance (perhaps even an organisation in which a friend or family member works) or even a
Multinational company. Analyse the key decision makers in the organisation and determine the
challenges, what needs to change and the consequences of not changing. Apply change tools and
models and develop a change strategy and plan. Also show how the organisation can lead its
stakeholders in developing and adopting the strategy for change, how they should plan to
implement the chosen change strategy and how they should deal with resistance. Reflect what you
have learnt from this process and what you could have been done better.

Write up the total process in a written assignment format by answering the questions below.
Although this academic report could be of value to the client who could use it to implement the
recommendation, strict academic guidelines such as referring to credible academic journals and
articles and following the Harvard referencing format must be adhered to.

Note: - Primary data collection is not required for the assignment; only information gathering
is expected from client organisations.

1. Executive Summary [5 Marks]

2. Introduction of the Chosen Organization and background to change [10 Marks]

3. Examine the need for change in the organisation. Assess the factors that drive the need
for strategic change and critically evaluate the resource implications for not responding
to these changes. [15 Marks]

4. Explain any two change management models and evaluate the relevance of these models
in the chosen organisation. [10 Marks]

5. Describe any three significant types of changes in the chosen organisation and evaluate

9|Page
 their implications on the organisational performance. [15 Marks]
6. Investigate the barriers to change during the changes in question 5, and explain how the
chosen organisation overcame those barriers? [15 Marks]

7. Conclusions and recommendations. [10 Marks]

Task 2 (Reflective Report, 20 marks)- Maximum word count: 1000 words

This is a reflective report; a Reflective Report is a piece of writing that summarises a student's
critical reflection on a subject. Report guidelines are as follows:

a. Curiosity: What made you curious in this module? How does learning feel different when
you're curious? [5 Marks]
b. Description: What's the most important concept you learned in this module? Why do you
think so? [5 Marks]
c. Self Realisation: Which topic brought out the best in yourself as a student, and why do you
think that is?
[5 Marks]
d. Extension: What do you want to learn more about, and why? [5 Marks]

References (Adhering to Harvard Referencing Format)

(START WRITING YOUR ANSWER HERE…..)

10 | P a g e
Contents
1.0 EXECUTIVE SUMMARY..................................................................................................... 12
2.0 INTRODUCTION .................................................................................................................. 12
3.0 CHANGE AT LIFE HEALTHCARE .................................................................................... 13
3.1 Need for Change ................................................................................................................. 13
3.2 Drivers for Change .............................................................................................................. 14
3.3 Implications of Non-Responsiveness .................................................................................. 15
4.0 CHANGE MANAGEMENT MODELS ................................................................................ 16
4.1 The Kotter Change Management Model............................................................................. 16
4.2 The McKinsey 7-S Change Model ..................................................................................... 18
5.0 SIGNIFICANT TYPES OF CHANGE .................................................................................. 19
5.1 Transformational Change.................................................................................................... 19
5.2 Employee-Centric Change .................................................................................................. 20
5.3 Structural Change................................................................................................................ 21
6.0 BARRIERS OF CHANGE ..................................................................................................... 22
7.0 CONCLUSIONS AND RECOMMENDATIONS ................................................................. 23
8.0 REFLECTIVE REPORT ........................................................................................................ 24
9.0 REFERENCES ....................................................................................................................... 25

11 | P a g e
 1.0 EXECUTIVE SUMMARY
South Africa has a healthcare dichotomy, and the divide between public and private
healthcare highlighted the need for Government to expedite the implementation of National
Health Insurance (NHI). With private healthcare unaffordable to most, NHI will establish a
central funder model that allows access to improved healthcare for all. Government lacks
capacity and critical skills (Kerry Cullinan, 2006) for effective administration and has ailing
infrastructure. Doctor, staff and supplier challenges further negatively impacts their ability to
effectively manage this initiative, which secured a lifeline for the private healthcare industry.
Life Healthcare (LHC) have set their sights of a collaborative agreement with
Government to assist with the implementation. This will entail a complete business
remodelling phase including their most valued asset, their employees. Kotter's 8-Step- and
the McKinsey’s 7-S Change Management Models, are both invaluable tools for LHC to
navigate these treacherous waters. Both focus on a phased approach considering hard, soft,
micro and macro impacts on organisations and the process needed to affect successful
change.
LHC must enhance their employee engagement and retention mechanisms. This will
create a culture conducive for smooth transitioning and assist with effectively managing the
integration period. LHC’s executive will face unseen challenges pushing their leadership
abilities beyond the norm as they become part of the biggest transformation effort ever faced.
2.0 INTRODUCTION
Life Healthcare Group (LHC), formerly Afrox Healthcare, is the second largest private
hospital operator with 6 500 registered beds in South Africa. With humble beginnings and a
total of 5 acute care hospitals, they grew from strength to strength, amassing the powerhouse
they are today. LHC has an extensive footprint in Southern Africa and abroad. South Africa
boasts 66 healthcare facilities across 7 provinces, whilst there is 1 hospital in Gaborone
Botswana (Wharton-Hood, 2022). LHC ventured into international expansion and acquired
Alliance Medical Group in November 2016 (Life Healthcare, 2022). Alliance Medical is the
leading diagnostic imaging services provider to the United Kingdom Government National

12 | P a g e
 Health Service (NHS) and has a footprint in 10 countries including Italy and Ireland. LHC
has a full-time staff component of more than 5500 employees.
Like all businesses, LHC was not immune to the impact of the Covid 19 pandemic. The
uncertainty, underestimation and severity of Covid 19 resulted in delayed action against the
pandemic. Corporate, behavioural and policy change was needed to navigate the storm as
employees faced Covid 19 regulations, curfews and national lockdowns, affecting their
families and resulting in prolonged effects of uncertainties, acute panic, fear, depression,
obsessive behaviour, stigmatisation and anxiety within a female dominant working
environment.
Private healthcare in South Africa is facing a new dawn. The South African Government
embarked on the establishment of a National Health Insurance (NHI) following the
publication of its green paper on the National Policy dated 11 August 2011 (The South
African Government, 2011). The National Policy document describes the history of the South
African Healthcare system as one that is fragmented, unbalanced and divided into two tiers,
namely public and private healthcare, resulting in treatment inequalities. This is further
compounded by a shortage of key human resources (Lauren Campbell, 2012) in the health
sector and in particular the public sector. Plans are in motion to implement the next phase of
NHI towards the end of 2022, ensuring access to appropriate, efficient and quality health
services for all.
3.0 CHANGE AT LIFE HEALTHCARE
3.1 Need for Change
Currently operating as one of the top healthcare service providers dealing with an ensured
patient base, profitability was guaranteed and most funder related challenges easily
negotiated. NHI will be a regulated environment with a single funder model and whilst there
is a lack of clarity around the scheme, it will have an enormous impact on LHC’s current
operations and the status quo. LHC responded by issuing a position statement outlining their
willingness and the importaints of partnering with Government on NHI. The statement
outlined LHC’s experience working with Governments in the United Kingdom and European
Union, where private healthcare service providers remain a significant part of the healthcare

13 | P a g e
 system (Life Healthcare, 2022). They further expressed their support to provide quality
healthcare to all and assist with narrowing the gap between current healthcare service
offerings.
3.2 Drivers for Change
NHI will avail access to private healthcare using a Private Public Partnership (PPP)
model currently in discussion with the South African Government. Serving a much larger
population will demand specialist employees, greater innovation, technological and clinical
investment, most likely contributing to further growth within their South African business
operation. Whilst the main drivers are external in terms of Government and healthcare
treatment policy reform, the following internal factors will need strategic consideration
(Wharton-Hood, 2022).

Figure 1 Life Healthcare Group NHI Oral Submission (Wharton-Hood, 2022, p. 9)

14 | P a g e
 Being an organizations most valued asset, HR departments need to keep a keen eye on
staff shortages and consistently monitor their satisfaction levels. This will assist LHC to
identify possible challenges and providing solutions through clear direction and improved
communication. Staff development and training are further tools to manage change which
will be critical to LHC if they want to succeed. Cost management and re-negotiation with
suppliers of pharmaceuticals and medical equipment will reduce their operating cost making
them more competitive. At this stage they should leverage both supplier and bulk
procurement influence. In the short term there will be a reduction in capital expenditure
(CAPEX), therefore operational expenditure (OPEX) on equipment and maintenance must be
optimized to maintain their facility standards and aesthetic.
A NHI partnership approach and funder engagement regarding fee for service negotiation
will be key to create investor confidence. The focus on quality care, efficiency and positive
post treatment outcomes should remain. Their ethos, “Making Life Better” must remain
paramount. Shareholder and investor confidence might be affected in the short term, however
continued profitability and transparent auditability will ensure they retain their market edge.
The executive leadership must be committed to the PPP approach and align the organizations
governance model to NHI policy and regulatory changes. Public and private sector
collaboration along with community involvement will bring forth a new model of community
and home-based care models. This is not an unknown field for LHC and can be aligned to
their occupational health model. Investment in innovative Specific, Measurable, Achievable,
Relevant, Time-bound (SMART) technologies and the integration of paperless systems will
streamline the operation and medical treatment claim process. Providing appropriate training
in the transitional phase will promote employee buy-in and assist them to adapt to change.
3.3 Implications of Non-Responsiveness
All healthcare companies undergo change (Steven H Appelbaum, 2000), however this
reform is the single most difficult undertaking by LHC and will require innovative strategic
change to ensure a successful outcome. Sound change management also requires a
collaborative and partnership approach. This is the reality of the healthcare industry adapting
to a changing landscape and newly introduced regulatory, funder and legislative challenges.

15 | P a g e
 Non responsiveness will not only impact their employees, but also the company’s
sustainability and profitability. Doctors practicing in their facilities will need clear guidance
and transparency regarding the negotiated terms and payment guarantees for treatment or
they will seek opportunities outside the country borders (Writer, 2021). LHC should have a
collaborative approach, partnering with employees and key stakeholders. Building on their
collective input to positively influence and reinforce the “jenesaisquoi” that defines the
organisation. Non responsiveness to these milestones will lead to a loss of their competitive
edge and could lead to downsizing and possible organisational failure.
4.0 CHANGE MANAGEMENT MODELS
Change management is the oversight of people, processes, and structures (Shirey, 2013)
to ensure meaningful and sustainable change. Change management in healthcare
organizations are complex (James W Begun, 2015) and LHC will need effective
communication across large groups of employees, which is challenging, especially when it
comes from senior management and lower management is expected to be the implementers.
Change management in healthcare can be challenging when the vision is clouded, thankfully
there are many models available benefiting change which include staff engagement,
awareness to improve communication, training and productivity.
4.1 The Kotter Change Management Model
Kotter's 8-Step Change Management Model (Prathibha Varkey, 2010) focuses on change
as a process and has 8 steps.

Figure 2 Kotter’s 8 Step Management Model (Source: https://www.bing.com/images/)

16 | P a g e
 Creating a sense of urgency is the first step in Kotter's model. It involves identification
of the support needed for effective change. LHC can do statistical analysis, highlighting
current operational challenges in their South African business and draw comparisons to their
European model where NHS is implemented. Rather than focusing on the negatives, the
executive and senior management should present this as an improved service offering
opportunity. Forming a coalition with employees in favour of change is critical. The coalition
should include key stakeholders (Goodman, 1996), influencers and union / employee
representatives with a personal interest to succeed. To effectively resist opposition to change,
right sized and influential coalitions should be formed. Information should be shared
frequently focussing on milestone progress and the long-term benefits for change.
NHI will necessitate the need for LHC to pivot, therefore the executive vision for change
must include employee and stakeholder input. Once the vision is defined, existing goals,
performance standards and objectives must be redefined and aligned with an aim to strengthen
internal and external support. Employees embrace change when the benefit is clarified and
aligned to their personal interest. Effective communication, outlining the immediate, medium-
and long-term (Adrian Done, 2011) operational impact will spur employee awareness. LHC
should not underestimate the impact of effective communication. Primary and contingency
planning effectively communicated will encourage participation and change employee
perception.
It is important to remove current obstacles and barriers that will prevent an organization
to progress. Obstacles come in various forms and might be related to human, process or
transformational change. LHC need to identify and prioritize these and formulate a strategy
to overcome immediate barriers influencing change. Celebrating small wins early on
showcases their value. This will establish a sense of accomplishment and must be shared
throughout the entire organization. Using their existing communication platforms namely,
TEXT-IT, e-mail and internal communiques, LHC can reach all levels of staff highlighting
success.
After the implementation phase, it will be beneficial to identify the remaining gaps. A
Gap analysis will assist the change leaders to identify barriers and obstacles faced during the
implementation phase. The formulation of a plan to address these gaps is critical and will
17 | P a g e
 allow LHC to build on the foundation laid. Continuous improvement and staff awareness must
be ingrained in their new culture. Policy and organizational change cannot be ingrained until
it becomes part of the company and employee culture (Amos Lakos, 2004). Anchoring change
will not be easy, therefore allocating adequate time and effort at every stage of the process is
needed for this to be effective. No matter the difficulty, it is key for all the stakeholders to
grasp the importaints of this step. The Kotter 8-Step change management model will be
invaluable to cement permanent change to LHC’s vision, mission and policy framework.
4.2 The McKinsey 7-S Change Model
The McKinsey 7-S model is a collection of 7 independent dimensions for modelling
organisations (Chmielewska, 2022), which include organisational structures aligned to
achieving common goals.

Figure 3 McKinsey 7-S Change Model (Source: https://www.bing.com/images/)

After strategic assesment of their new goal (partnering on NHI), LHC will be required to
evaluate current best practice within the organization. Allocating specialist resources (Khiew,
2020) during this phase and using their influence to identify and overcome inhibitors, will
assist LHC to reach their goal. Finding a strategic advantage over their competitors will
improve the likelihood of success. LHC needs to review their organisational structure,
identifying strengths-, qualities- and employee resources that can be leveraged or improved
to affect successful change. LHC must evaluate their current needs and the way they are
18 | P a g e
 organised. Understanding their current framework is essential and will allow employees to
aligning themselves with process change and reinforce the desired to understand it. They need
to identify potential obstacles and formulate plans (Chmielewska, 2022) to address them
effectively prior to implementation.
Understanding their core values before defining long-term goals is critical. This step
includes the consideration of hard and soft elements of influence. Team engagement by means
of an employee survey can assist LHC to identify their employee needs and make change
more palatable. Understanding their roles and identifying gaps will be paramount. Corporate
culture will further influence change and adopting a likeminded culture will be more effective.
LHC should consider a blending the traditional top-down and bottom-up approach (Shawyun,
2005) as some people may require more finesse. Identifying the type of organisational change
is tricky and will be specific to the requirement. As stated before, focus on organizational
strengths and employee skills will be advantages. Employee skills and qualifications will need
aligning to the NHI requirement. Some staff might lack people management skills and have a
language barrier to communicate effectively, whilst others will be best suited to patient centric
roles.
5.0 SIGNIFICANT TYPES OF CHANGE
Organizational change is unavoidable and NHI will certainly impact the existing
healthcare landscape from a regulatory and functional perspective. Some employees will
leave and others will join as the company transitions to stay relevant and ahead of the curve.
Ambiguity will be experienced by most of their staff members, without employee awareness
campaigns and the implementation of and effective change management strategy.
5.1 Transformational Change
NHI will affect most aspects of LHC, but not all of them will be transformational.
Adjustments in their daily operations will influence but not necessarily change their focus.
They need to define new goals and work towards turning them into a reality. LHC’s, vision is
to be a market-leading healthcare provider (Life Healthcare, 2022). While the vision remains
relevant, their focus must align and incorporate NHI objectives and the Governments vision
of Ubuntu (quality that includes the essential human virtues; compassion and humanity) and

19 | P a g e
 providing access to high quality healthcare for everyone. Whilst technology is aimed at
smoothing workflows and refining process effieciencies, learning and implimenting new
systems can be tricky. People gravitate towards the known and have oftern state “but we have
always done it this way” (Debra J Hain, 2015). LHC needs a plan to migrate from the
existing and impliment technologies aligned to NHI with employee acceptance. Granulating
the transition will make it understandable and build confidence for staff to embrace
technological change. To succeed, regular check and live support by the IT department is
required. Developing training aids either cellphone application based or online, to track these
changes would be invaluable. If managed effectively, additional training will be viewed as a
benefit. Employees will also see the value and LHC’s commitment to invest in their personal
growth.
5.2 Employee-Centric Change
While change affect all people, employee-centric organizations like LHC will demand an
empathetic approach. In fact, many change management models, such as the Kübler-Ross
Change Curve Model (Esther Cameron, 2019), focus emotional reactions during change.

Figure 4 Kübler-Ross Change Curve (Source: https://www.bing.com/images/)

20 | P a g e
 The onboarding and training of new staff will be time consuming and will affect
employees throughout their organization. Similarly, staff resignations due to new
opportunities or higher salary offerings by Government will adversely affect morale. LHC
will need to communicate effectively and explain the recruitment need and justify their salary
offering with a focus on basic wage and company benefits. Similarly, they should
communicate effectively when restructuring due to financial and economic pressures. The
latter might not be required due to the scarcity of skilled staff in the healthcare industry. Job
descriptions might change, however changes to an employee’s role will require the HR
department to have a hands-on approach. When changing policies, employees might feel
short-changed and become despondent. Some might leave and seek alternate employment,
whilst others will become unproductive. Thankfully LHC has an HR department in each
Hospital ready to deal with the challenge mentioned.
5.3 Structural Change
Big reform, or restructuring in LHC might not happen, however the way they are
organized and the responsibilities of various departments will be impacted. Mergers and
partnerships contribute to structural change. Lewin’s Change Management Model can be
applied during this phase because it focuses on creating a new status quo (Carter, 2008). It
consists of three steps, namely: unfreeze, change and refreeze.

Figure 5 Lewin’s Change Management Model (Source: https://www.bing.com/images/)

LHC should identify their employees’ individual strengths and specific interests. The
remoulding and necessary shifting of duties and responsibilities will create tension. They
should justify the change with clear responses, highlighting its benefits. Highlighting the
21 | P a g e
 positive aspects will allow further team engagement and lead to accelerated acceptance. LHC
should communicate change progress, focussing on positive elements worthy of celebration.
Transition will not be easy and solidifying change (Avinash Pawar, 2017) early on will avoid
major issues down the line.
6.0 BARRIERS OF CHANGE
Barriers influencing change are different in every organization. Overcoming these
barriers will assist LHC to successfully transform and align the company and their employees
with NHI. Effective change will turn to reality if an organisation has unclouded vision. If the
vision is undefined, the implementers will not have a clear perspective and could derail the
entire initiative. Change management communication is typically top down. Not all
managers know the reason for organizational change. Gartner suggests that due to poor
change communication, 73% of employees experience moderate to elevated levels of stress
(Gartner, 2022) and affected employees under perform. Information shared on time with
employees will remove anxiety and stress of the unknown.
Communicating realistic timelines and providing adequate staff training and support is
key to implement successful and effective change. Setting measurable KPIs and providing
timeous feedback on progress (Esther Cameron, 2019) will further assist to cement the
change. Over time, employees become familiar with engrained organizational processes. The
comfortability and familiarity factor can however cause employees to stagnate and slow
organizational progress. To overcome this barrier, LHC should clearly identify all
stakeholders impacted by the change. They should focus on employee transition as well as
creating an environment favourable for the promotion of sustainable change.
Mentioned before, change starts at the top and happens at the bottom (Kenzar, 2013). For
effective change, LHC need internal and external support from all stakeholders including
their most valued asset, their employees. Legitimacy to change will be promoted by top
management being the change sponsors. Their roles however need to entail more than just
sponsorship. They need to lead by example and prove legitimacy in their effort. Mid-level
management (change influencers) and entry level employees (change enablers) need to be
on boarded early on to implement change. Organizations often have more than one initiative
or project that requires some form of change. Prioritization of critical workflows is key to
22 | P a g e
 deal with this barrier. Change fatigue (Kim McMillan, 2013) is a reality leading to burnout,
mental breakdown and frustration. This will affect employee productivity and their
willingness to change. During NHI implementation, LHC will need to focus on the key
factors needed to make it a success and shelf the remainder of the non-critical projects.
Focussing their efforts on the biggest change in the South African healthcare landscape will
be paramount!
7.0 CONCLUSIONS AND RECOMMENDATIONS
Without effective change management, transformation efforts will result in poor
performance, poor morale having a negative impact on staff and consumer confidence. The
effective implementation of the models mentioned, and stakeholder involvement will have
the opposite effect, leading to further growth, boosting consumer confidence and lead to
improved opportunities for their staff. Identifying the correct change sponsor (CEO or
executive), change leader (senior manager) and change enabler (middle manager or senior
staff) is equally as important as the accuracy of information shared. Coalition involvement is
also critical to an organizations transition, during change. The McKinsey 7-S change model
has been implemented by many healthcare organisations with remarkable results due to its
productivity enhancement- and behavioural approach. It can be used within organisations that
are experiencing obstacles related to employee knowledge, experience and culture.
NHI represents fundamental reform of the private healthcare sector from a cost,
occupancy and funder model perspective. LHC could face a sudden change to their revenue
stream and become confined to charging fixed NHI treatment rates. Similarly, many of their
doctors might need to reduce treatment cost, especially if it falls outside the reduced scope of
private medical aid schemes offerings, for example cosmetic and elective surgery. The key to
successful change is defined by planning and an effective management approach. Keeping
employees and stakeholders informed and ensuring they grasp the need to embrace change,
will reduce the impact in the short and long term. Transformation will not happen overnight
and monitoring the incremental effect of change in the organization will assist management
to make the necessary corrections as they progress. LHC will need to work closely with their
entire team as NHI unfolds. People-centric changes are prone to emotional responses and
LHC must be prepared for the journey ahead. Instead of announcing the changes and
23 | P a g e
 expecting staff to simply follow and adjust, they must work on an effective communication
and implementation strategy.
Government cannot rely on the private healthcare sector to save it. What they can and
must do, is to use their influence to negotiate pricing and treatment offerings in their favour.
They must also negotiate and encourage the participation of the private sector, including their
most valued recourse, their staff. The construction of a symbiotic system in the spirit of
Ubuntu will ensure that adequate access to improved healthcare becomes a reality for all.
8.0 REFLECTIVE REPORT
My curiosity was spurred by the need to accumulate knowledge and learnings from real
life experiences shared by my fellow students. Whilst the subject matter was educational, I
tend to pay more attention when comparing theoretical learnings to practical experience.
During the online sessions, I would almost envision myself in the same scenario and think
how my management approach or problem-solving experience could be paralleled using the
strategic change management principles presented. I found it comforting to know that
although we had varying industry experience, the models presented a gameplan and if
applied in the correct manner would assist our teams to navigate change. On a personal level,
I pay more attention when I am curious and enjoy interactive participation. I also tend to
memorize principles and concepts better when they are illustrated, therefore the illustrations
were invaluable.
Although not applied in my assignment, the ADKAR model (Hiatt, 2006) would be my
first choice to apply in operations. The model clearly differentiates two zones, namely
enablement and engagement. The model is like a playing field, divided into zones and as we
know during a football match, the aim remains to have forward momentum and reach the
goal post. On a personal level, what differentiates this model form the others is the team
engagement and the scrum approach. It focused on forward momentum and allows a team to
learn from mistakes ultimately improving the overall outcome. Scoring a goal can be seen as
celebrating small wins, while winning the match can be seen as navigating and implementing
successful change.
The different and varying models prove that there is not a “Golden”, best or single
solution during change. It is more beneficial to have a collective approach using various
24 | P a g e
 model or methods appropriate to your organization or the change required. Executives often
rely on the collective input and experience of the entire EXCO team to be more effective.
They base their change decisions on fact after collective input, considering internal as well as
external factors, combined with the hard and soft elements of change. Most organizations
change over time to grow and adapt to a changing world. Being rigid, thinking you the best
and all-knowing will lead to self-destruction, becoming obsolete or irrelevant. Organizations
should have clear lines of communication and regularly engage their staff. Feedback should
be analyzed to seek further refinement or organizational improvement. They should share
relevant information, not only focusing on the positive and small wins, but also communicate
the negatives and constantly look for ways to improve. Having this approach will leave
employees feeling engaged, valued and informed.
There are many cultural impacts that influence the change management process. This
module could be extended to cover more aspects of change management, focusing on the
cultural, socio economic and religious barriers of change. Born and raised in South Africa
and now working in the Middle East, it would be invaluable. Most organisations have their
own distinct culture influenced by legislative and internal policy, however employees
influence the culture by adding emotion. In my current organization there are more than 25
nationalities, each with their own culture and beliefs. Whilst we all adhere to the corporate
culture and apply policy to affect transformation, it would be advantages to acquire
additional knowledge on processes dealing with cultural change.

9.0 REFERENCES

Adrian Done, C. V. a. N. G. R., 2011. Best practice interventions: Short-term impact and long -
term outcomes. Journal of Operations Management, 29(9), pp. 500-513.
Amos Lakos, S. E. P., 2004. Creating a culture of assessment: A catalyst for organizational
change, s.l.: Libraries ant the Academy.

25 | P a g e
Avinash Pawar, K. C., 2017. Study on adaptability of change management: review of Kurt
Lewins and Kotter model of change. Research Revolution International Journal of Social
Science and Management, 5(4), pp. 79-83.
Bara-Slupski, T. K., 2016. Holidtic Approach: paradigm shift in the research agenda for
digitalisation of healthcare in Sub- Saharan Africa. The African Journal of Information systems,
8(4), p. 3.
Carter, E., 2008. Successful change requires more than change management. The Journal for
Quality and participation, 31(1), p. 20.
Chmielewska, M., 2022. Evaluating Organizational Performance of Public Hospitals using the
McKinsey 7-S framework. BMC health services research, 22(1), pp. 1-12.
Debra J Hain, T. M. K., 2015. Using evidence-based practice to move beyond doing things the
way we have always done them. Nephrology Nursing Journal, 42(1), p. 11.
Esther Cameron, M. G., 2019. Making sense of change management: A complete guide to the
models, tools and techniques of organizational change. s.l.:Kogan Page Publishers.
Gartner, 2022. Gartner. [Online]
Available at: https://www.gartner.com/en
[Accessed 14 July 2022].
Goodman, R. M., 1996. An ecological assesment of community-based interventions for
prevention and health promotion. American Journal of Community Psychology, 24(1), pp. 33-61.
Harrison, R., 2021. Where do models for change management, improvement and implimentation
meet?. Journal of healthcare leadership , Volume 13, p. 85.
Hiatt, J., 2006. ADKAR: a model for change in business, government, and our community.
s.l.:Prosci.
James W Begun, M. T., 2015. Managing complex healthcare organizations. s.l.:Edward Elgar
Publishing.
Kenzar, A., 2013. Understanding sensemaking/sensegiving in transformational change processes
from the bottom up, s.l.: Higher education.
Kerry Cullinan, 2006. Health services in South Africa: Abasic introduction, Johannesburg:
Health-e News Service.

26 | P a g e
Khiew, K.-F., 2020. The Implimentation of Adopted Balanced Scorecard with New Insight
Strategy Framework for the Healthcare Industry. Open Journal of Business and Management, 9
January, 8(2), pp. 600-627.
Kim McMillan, A. P., 2013. Nurses amidst change: the concept of change fatigue offers and
alternative perspective on organizational change. Policy, Politics & Nursing Practice, 14(1), pp.
26-32.
Lauren Campbell, J. C.-M., 2012. Comparitive analysis of nursing shortages. International
Journal of Nursing, 1(1), pp. 21-26.
Life Healthcare, 2022. Life Healthcare. [Online]
Available at: https://www.lifehealthcare.co.za/news-and-info-hub/latest-news/life-healthcare-
acquires-uk-based-alliance-medical-group-nov-2016/
[Accessed 24 July 2022].
Life Healthcare, 2022. Life Healthcare. [Online]
Available at: https://www.lifehealthcare.co.za/media/3612/position-statement-on-national-
health-insurance-nhi-
bill_approved.pdf#:~:text=Life%20Healthcare%20Position%20Statement%20on%20National%
20Health%20Insurance,and%20we%E2%80%99re%20excited%20about%20the%20opportuni
[Accessed 14 July 2022].
Life Healthcare, 2022. Life Healthcare. [Online]
Available at: https://www.lifehealthcare.co.za/about-us/a-closer-look/
[Accessed 10 July 2022].
Prathibha Varkey, K. A., 2010. Change management for effective quality improvement: a
primer. American Journal of Medical Quality, 25(4), pp. 268-273.
Shawyun, T., 2005. Higher education reform. A strategic multi-pronged framework for the
academic institution, 1 April.
Shirey, M. R., 2013. Lewin's theory of planned change as a strategic resource. Jona : The
Journal of Nursing Administration, 43(2), pp. 69-72.
Steven H Appelbaum, L. W., 2000. Transformation or change. An Internattional Journal.

27 | P a g e
The South African Government, 2011. Parliamentary Monitoring Group. [Online]
Available at: https://static.pmg.org.za/docs/110812nhi_0.pdf
[Accessed 13 July 2022].
Wharton-Hood, P., 2022. Presentation to the Portfolio. Johannesburg, Life Healthcare.
Writer, S., 2021. Businesstech. [Online]
Available at: ttps://businesstech.co.za/news/government/516254/doctors-plan-to-leave-south-
africa-because-of-the-nhi/
[Accessed 24 July 2021].

28 | P a g e