| Plus ça change, plus c'est la même chose: senior NHS managers' narratives of restructuring. | |
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MedLine Citation:
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PMID: 21371053 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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The UK National Health Service (NHS) is regularly restructured. Its smooth operation and organisational memory depends on the insights and capability of managers, especially those with experience of previous transitions. Narrative methods can illuminate complex change from the perspective of key actors. We used an adaptation of Wengraf's biographical narrative life interview method to explore how 20 senior NHS managers (chief executives, directors and assistant directors) had perceived and responded to major transitions since 1974. Data were analysed thematically using insights from phenomenology, neo-institutional theory and critical management studies. Findings were contextualised within a literature review of NHS policy and management 1974-2009. Managers described how experience in different NHS organisations helped build resilience and tacit knowledge, and how a strong commitment to the 'NHS brand' allowed them to weather a succession of policy changes and implement and embed such changes locally. By synthesising these personal and situated micro-narratives, we built a wider picture of macro-level institutional change in the NHS, in which the various visible restructurings in recent years appear to have masked a deeper continuity in terms of enduring values, norms and ways of working. We consider the implications of these findings for the future NHS. |
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Authors:
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Fraser Macfarlane; Mark Exworthy; Micky Wilmott; Trish Greenhalgh |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-4 |
Journal Detail:
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Title: Sociology of health & illness Volume: - ISSN: 1467-9566 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8205036 Medline TA: Sociol Health Illn Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2011 The Authors. Sociology of Health & Illness © 2011 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd. |
Affiliation:
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School of Management, University of Surrey School of Management, Royal Holloway, University of London Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine Centre for Health Sciences, Queen Mary University of London. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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