Change is now considered to be the biggest challenge for virtually all organisations public and private, large and small - but especially for large, well established 'complex adaptive' organisations. Change is everywhere and the rate and pace of it is almost universally reckoned to be increasing.
Several 'gurus' (including Tom Peters and Charles Handy) and academics (notably Colin Carnall author of several books on Managing Change) have drawn attention to the 'challenges of change'.
At the time that this article was written, the NHS was the the third largest employer in the world after the Chinese Army and The Indian Railways and had over many years and despite many efforts found it difficult to change. Whilst the article considers change and efforts to manage it generally in organisations it looks specifically at key issues around change in the NHS.