Managing within the challenges and tensions facing the twenty‐first century UK National Health Service (NHS): the dilemma of a managerial identity within the context of a socially responsible organization

Exploring senior nurses' experiences of leading organizational change

Purpose - The aim of this paper is to explore Senior nurses' experiences of leading organizational change. There is a substantial literature reporting middle-level nurse managers' experiences of change; however, there is less evidence concerning senior nurses' perspectives. In view of this, interview data collected from senior nurses, as part of a study of major organizational change, were analysed to redress this imbalance. Design/methodology/approach - In-depth semi-structured interviews (n = 14) were conducted with senior nurses (between 2009 and 2012). Findings - Senior nurses' activity centred on leadership and workforce issues, internal influences and external pressures. In periods of change, appropriate leadership was vital, and "weak" leaders were considered to have an adverse effect on teams. Concerns were expressed about financial strictures and their impact on patient care and service provision. The senior nurses were striving to provide the best quality of service delivery with the limited resources available. Concentration on operational matters was necessary to maintain stability in periods of change. However, this prevented senior nurses from influencing strategic decision-making in their organizations. Practical implications - If senior nurses are to realise their potential to operate at a strategic level, they need to be given time and support to lead, rather than just react to change. This research emphasises the importance of a "nursing voice" to inform board-level decisions and maintain a focus on patient care. Originality/value - This research sheds light on the work of a key group of staff in health-care organizations. Understanding senior nurses' experience of and contribution to change is a useful contribution to health services research.

Does the explicit recognition of the commitment and contribution of staff within an organisation's CSR strategy matter?

Purpose

The purpose of this paper is to identify and explore the possible underlying reasons for the differences in approaches adopted by organisations regarding the inclusion or exclusion of explicit statements in relation to the personal commitment and contribution of their employees within their publicized CSR strategies.

Design/methodology/approach

The approach is based on a longitudinal study involving interviews with 47 UK National Health Service (NHS) managers between 2000 and 2009. Theoretical frameworks and literature related to CSR, organisation culture and institutional theory are drawn upon in an integrated manner to analyse and discuss the findings.

Findings

Although the majority of NHS managers report holding core altruistic values they believe the general public does not recognize this and views them negatively. It is suggested that a combination of direct and indirect strategies aimed at highlighting the socially responsible role of NHS managers and their overall commitment and contribution to the NHS would help challenge the existing negative public image of NHS managers.

Research limitations/implications

The study is based on a relatively small number of London based NHS managers consisting mainly of managers occupying senior and middle management positions and who may not necessarily represent the views of all managers nationally.

Originality/value

Whilst issues related to CSR are of concern to a wide range of organisational stakeholders, there appears to be relatively limited research undertaken in the context of directly exploring issues of concern from the employee stakeholder perspective. Within the context of the aims of this paper, this paper addresses this relative gap. The paper is of interest to a wide range of readers including NHS and non‐governmental organisation (NGO) policy formulators and practitioners; academics and students.