A Longitudinal Case Study of Managing Change in Eye Care in Scotland

Abstract

Eye conditions are remarkably common (WHO, 2022), and incidence levels continue to rise. Eye care services in Scotland must respond and adapt to these challenges; however, the literature on managing change within eye care needs to be expanded because it largely ignores how change initiatives are implemented or how new processes have been introduced. This thesis aims to understand the process involved in implementing two notable change events in the eye care services of a Scottish Health Board, NHS Fife: the Eye Care Integration programme (2011) and COVID-19 (2020). A single, embedded, longitudinal case study approach is adopted to understand the process and management of change within NHS Fife Health Board eye care services. The same case is studied over two different time points, and data collection occurs through in-depth interviews, documents and informal observation. Reinforcing the existing literature on managing change, this study demonstrates that leading with purpose, communication and engagement, understanding the context and culture of an organisation and the pace of change need to be considered when managing change. It also demonstrates additional enablers for consideration. Firstly, applying a structured methodology or model of change is not always necessary to successfully implement change; however, it can provide a helpful framework. Secondly, stating a clear purpose for the change, rather than creating a vision statement for the organisation, resonates well with those managing and implementing change and feels more tangible. Thirdly, reviewing the governance and accountability processes may allow for a more responsive organisation that can react quickly to change, make swift decisions and create opportunities for more self-governance. Finally, enabling autonomy and influence in decision-making through a bottom-up approach to managing change empowers those throughout an organisation.

Date of Award	2023
Original language	English
Awarding Institution	Glasgow Caledonian University
Supervisor	Niall Strang (Supervisor) & Keith Halcro (Supervisor)