Changing Management Cultures in the English National Health Service

Abstract

This chapter focuses on changes in senior management team culture in English NHS acute care hospitals, illustrated by data from surveys in 2001 and 2006 that used the Competing Values Framework. This period spans the implementation of pro-market system reforms, which potentially influence changes in values and beliefs underpinning management behaviour. It explains how changes in senior management culture can affect the behaviour and performance of health care organisations in driving for economic efficiency, affecting equity, influencing overall economic and social objectives, and encouraging co-operation and maintenance of reputation. Analysis of the two data sets suggests significant change in the nature of managerial cultures. A decline in 'clan-type cultures' and a rise in 'hierarchical and rational cultures' was accompanied by a general shift away from organic towards 'mechanistic organisational processes' within hospital trusts. Theses changes link with values and behaviours expected in more market-orientated health care economies. Cites 39 references.