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Purpose

This paper explores the practicalities of organizational change in complex settings where much change has already occurred. It therefore offers insights into tackling and overcoming change fatigue.

Design/methodology/approach

The paper uses a longitudinal study of change within a healthcare organization. The paper draws on interviews, focus groups and observations during a 2.5‐year long action research project.

Findings

The paper reports findings on the speed at which change takes place, the importance of communication and the burden placed on senior officers during such communication and consultation processes, the use of appropriate external resources and expertise, the benefits of sharing best practice across sectors and the role of academic researchers in change processes.

Originality/value

The paper offers valuable insights to those charged with effecting organizational change in change fatigued settings.

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