16.6 Changes in structures, rules, procedures and ways of working will also contribute to the process of cultural change, but there needs to be an element of flexibility in this, allowing both for local adaptation to prevailing circumstances and for opportunities to learn from practice and make consequent adjustments. Care also needs to be taken not to assume that shifts in culture can be achieved by structural change alone or that people's practice will alter without support, development and investment. Organisational inertia and the lure of the familiar will also threaten to obstruct the start of cultural change or slow its progress, so champions and advocates of the change will be essential to the success of the strategy at all levels.

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