If we look around in the environment we are in, change is happening everywhere. The NHS has changed massively in past years. Our patients and customers have changed attitudes and their expectations of us.

Medicines supply has changed, with the introduction of many direct to pharmacy schemes by manufacturers. The expectations of the NHS contract have changed. If we fail to recognise and respond to these changes, at best we put ourselves at a disadvantage.

At worst, if we dig our heels in and refuse to respond, we could find that we don't have a business. In a storm, the flexible trees bend and flex with the wind, but trees that can't bend get up-rooted. We might choose to change when faced with it.

For example, to change the offer we provide from our pharmacy: reducing retail space; increasing services and changing the categories we offer. Change is easier to implement when we are motivated to do so. When we have chosen to change, we can put more energy into the change since we feel we have had a choice.

There are other occasions when the change is forced upon us. These are more difficult. However, if the change is happening whether we like it or not, there is little point in acting like King Canute trying to hold back the tide.

We spend time and energy resisting. We increase our stress and decrease our effectiveness. The first thing to consider when change occurs is our attitude towards it and how we can exercise as much choice as possible.

We can choose our reactions. We can also choose, to some degree, how we implement the change. If we exercise this choice, however limited, we will find an imposed change more positive.