Lessons from the planning and implementation of further reconfiguration in Greater Manchester

BackgroundFurther reconfiguration of the GM acute stroke pathway (GMB) was implemented from March 2015 (see Chapter 11). This chapter analysed the process of agreeing, planning and implementing this reconfiguration. The Best et al. 5 framework of rules for MSC (see Chapter 6 110) has been used to explain the previous centralisation of acute stroke services in GM, showing that feedback may need to be combined with other tools, such as financial incentives and engaging a range of stakeholders, not only physicians. Fraser et al. 203 explored change management roles in the London reconfiguration, suggesting that evidence from clinical research can be used to frame change in a ‘depoliticised’way. They identified discursive power, emphasising evidence, better patient outcomes and professional support as helpful in generating receptiveness to change. Many authors have emphasised the importance of …