If change is to be effective and sustained it must be co-created and co-owned by the team, instead of ‘raining down’ from the top.

Organisational change can be viewed in terms of building a boat and then paddling it together. The co-creation, or building of the boat, ensures that everyone has the same vision and everyone has input. This means that all members of the team emotionally and intellectually own the change that they are going to implement.

Co-ownership is where the paddling starts. This stage is about actions and people taking responsibility for implementing the change. If people do not paddle in time, or do not put the same amount of effort in, then the boat will not move forward. Everyone, at every level, needs to do their bit when change is being driven forward. Only by co-creation and co-ownership will fundamental change be achievable.

Within health and care, it is necessary that change is not prescribed from the top and implemented on the ground. Everyone should be able to get involved in decision making because this is how everyone will believe in the changes to be made.