Lauermann E
King's Fund College, London.
BMJ. 1993 Jan 9;306(6870):130-2. doi: 10.1136/bmj.306.6870.130.
Whatever ministers actually decide about London following the Tomlinson report, the changes are likely to be large-scale and affect many staff and patients. Therefore how well those changes are handled becomes crucial to their success. The NHS has much to learn from other industries and organisations that have been through similar changes. Firstly, there needs to be an overall strategy for the change, rather than individual units trying to manage their own parts of it in an ad hoc way. Secondly, how well those made redundant are treated is an important factor in maintaining the morale of those who stay behind. For those affected by changes the NHS needs to provide full information, imagination, time, emotional and practical support, and money. Though decisions need to be made quickly, their implementation should take as much time as is necessary.
无论部长们依据汤姆林森报告对伦敦地区实际做出何种决定，这些变革都可能规模巨大，并影响众多工作人员和患者。因此，这些变革的处理效果对于其成功与否至关重要。国民保健制度（NHS）有很多需要向经历过类似变革的其他行业和组织学习的地方。首先，变革需要有一个总体战略，而不是各个部门各自为政、临时应对。其次，如何妥善对待那些被裁员工是维持留任员工士气的一个重要因素。对于受变革影响的人，国民保健制度需要提供全面信息、充分设想、时间、情感和实际支持以及资金。虽然决策需要迅速做出，但实施过程应花费必要的时间。
