What New Year’s resolutions teach us about NHS strategy

How many of us have made a New Year’s resolution? And how many quietly abandoned it by the third week of January?

We know the basics. Eat the superfoods, drink the water, do the steps, spend less time doomscrolling. Knowledge is not the problem. The hard bit is turning good intentions into day-to-day practice.

I am coming up to my third round of strategy at Oxleas. The challenge is exactly the same. Strategies rarely fail because people misunderstand them. They fail because changing behaviour is hard, and organisations are just big groups of people, with their own habits, pressures, loyalties, doubts, exploding inboxes and never-ending to-do lists.

Make it part of your identity

I was talking about this with my husband, as he bemoaned the weight gained over a World Cup weekend. A gym joined in a burst of January enthusiasm fades by February. Start to see yourself as someone who looks after their health, build your routines around that, and the change is far more likely to last. So I asked him: do you see yourself as someone who parties hard and then has to impose controls on himself, or as someone who lives a healthy life?

Organisations are no different. We can write in a strategy that we want to work more collaboratively with partners. Very lovely, very worthy, very 10-year plan. Little will change until we start seeing ourselves as partners: noticing and celebrating the partnership working already happening, making it part of the organisation’s lifeblood.

Remove the friction

On a personal level: pack the gym bag the night before, put the trainers by the door, hide the biscuits (a step too far for me). In strategy: remove whatever makes delivery harder than it needs to be. At Oxleas we did this through our ‘squad goals’ (a Taylor Swift reference, I believe). It stands for strategy, quality and directorate goals. Directorates each held separate action plans for strategy, quality, finance and delivery; we combined them into one clear set. Teams see the whole picture, and strategy sits in the middle of day-to-day work, the structure everything else fits around.

Take resistance seriously

People rarely resist change because they are difficult (well, not usually). They resist because change is emotional. It touches identity, relationships and our sense of security. When launching a strategy, ask: can our people see themselves in the future we are describing? Do they trust the direction? Does it reflect the real life of the organisation, rather than a beautifully written boardroom ambition? If we are unsure of the answers, we have not done enough engagement. Engagement is never a tick box: people only deliver a strategy they actually want to deliver.

At Oxleas we run three-year strategies (I cannot cope with five-year ones; the NHS changes too much) and we spend a whole year of each three engaging on the next. The conversation is as important as the conclusion.

Let it live without you

We launched our current strategy in September 2024. Since then we have had the 10 Year Health Plan, a new oversight framework, neighbourhood health and dramatic changes to the finances. I have learned to make that endless change work for us. Every time something new lands, we use it to explain how it fits our direction. It helps people make sense of the change and reinforces where we are going.

I have also learned to resist bringing all the energy myself; it leaves less space for everyone else, especially my executive team. The test I set myself: if I won the lottery tomorrow, would the strategy keep taking hold without me and my team pushing it?

Celebrate the wins

Just as we mark 30 days without smoking or a first 10k, shine a light on small wins. Our spotlight sessions focus on what is moving, especially the creative work that gives people energy.

Strategies succeed for the same reasons people do: not because the goal is beautiful or clever, but because we create the conditions that make change feel personal, possible and worth it. That is when a strategy stops being a document and becomes the way we do things. With the NHS changing at such pace, strategy has never mattered more: our job is to give people something to hold on to. If you are doing this work, stay strong. You are on the side of the angels.

Kaleidoscope supported Oxleas to develop its strategy. For a conversation about your own, email the Kaleidoscope team, or download our Little guide to strategy.