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Sense-making by clinical and non-clinical executive directors with new governance arrangements

Holti, Richard and Storey, John (2008). Sense-making by clinical and non-clinical executive directors with new governance arrangements. In: Academy of Management Annual Meeting: the questions we ask, 8-13 Aug 2008, Anaheim, CA, USA, Open University Business School.

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This paper explores the various ways in which clinical executive directors and non-clinical executive directors are interpreting and responding to the extensive reforms and restructuring in the UK health service. The key changes include devolved accountability, the introduction of some market mechanisms and incentives, some element of competition between healthcare provider organisations, more patient choice, a clearer provider-purchaser split, and increased competition from private sector and third sector providers. Changes to healthcare environments of this kind are occurring in many countries but such is the extent and intensity of these changes that the UK government sees this set of reforms leading to a peerless world class health service. The paper draws upon detailed research in two very large teaching hospital organizations in order to understand how actors crucial to the delivery of this vision are responding. We found the clinical and non-clinical directors of these organizations engaged in a process of active sense making which was leading to significant changes to the service and also changes to identity.

Item Type: Conference or Workshop Item
Copyright Holders: 2008 The Authors
Project Funding Details:
Funded Project NameProject IDFunding Body
Not SetNot SetNHS
Extra Information: Winner of the Best International Healthcare Paper prize.

An earlier version of this paper was produced as a working paper: Holti, RW, and Storey, J (2008) Clinical and non-clinical executive directors' sense-making of the new governance arrangements in the NHS, NHS/SDO Project Working Paper, no. 2008/4.
Keywords: sensemaking; healthcare governance; devolved accountability; profit centres
Academic Unit/School: Faculty of Business and Law (FBL) > Business > Department for People and Organisations
Faculty of Business and Law (FBL) > Business
Faculty of Business and Law (FBL)
Research Group: Innovation, Knowledge & Development research centre (IKD)
Related URLs:
Item ID: 27777
Depositing User: Richard Holti
Date Deposited: 03 Feb 2011 16:37
Last Modified: 07 Dec 2018 09:51
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