Change can be difficult in any organisation and general practices are no different in that respect. But general practices are funded and run in a different way to most of the NHS and need to approach change in a way that that reflects that difference. The growing crisis facing general practice, where demand is outstripping available workforce, means that, as integrated care systems (ICSs) take on responsibility for NHS resources, understanding how to make change happen and happen well in general practice is vital. ICSs will need to make sure any changes are based on what has been shown to work and given the best possible chance of succeeding. In the report Levers for change in primary care, we outlined the findings from the published evidence on how change happen. That report was commissioned by NHS England and published alongside the Fuller stocktake on primary care. In this document we set out four principles drawn from this evidence to highlight how to make change happen. For each principle we describe why it matters, and what it might mean for those working in general practices and in ICSs. However, it is worth noting that these ideas would equally apply at a national or place level. We hope you find these principles helpful--they are not new but leaders in both general practice and ICSs will need to demonstrate they truly understand them and implement them in order to see successful and effective changes in general practice.
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