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.

Abstract

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.

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