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College News
27 August 2004
Medical Management Book of the Year 2004 evaluates the complexities of corporate change in the NHS
The British Association of Medical Managers (BAMM) - the national body
which represents doctors who also work in management - has awarded the
Medical Management Book of the Year 2004 to 'Reengineering Health Care
- The Complexities of Organizational Transformation' by Professor Terry
McNulty, Leeds University Business School, and Professor Ewan Ferlie,
School of Management, Royal Holloway, University of London.
One of the few rigorous empirical studies of the impact of service redesign in health care, the book examines the implementation of a radical service redesign programme, Business Process Reengineering (BPR), in a major NHS teaching hospital. Public organizations are being encouraged to experiment with new structures and processes from the private sector and BPR ideas were brought into the NHS by external management consultants. BPR is associated with a novel patient pathway or lateral approach to organizing, which challenges the vertical and functional mode of structuring, built up around clinical directorates since the 1990s.
The book draws on empirical data gathered from comparative case studies; analysis of the changing context of contemporary public organizations; and assessment of the effects of imported private sector reform models, providing an in-depth study of the dynamics of change. It reveals that the impact of BPR was far more nuanced than the 'Big Bang' transformation promised at the beginning of the change programme. The findings show how powerful professional groups, such as doctors, have actively restrained the innovative impact of the programme to defend their 'professional jurisdictions' - including opposition to neighbouring groups of doctors. Change was found to be more evolutionary and convergent than transformational. With the discovery of unexpected alliances forming between local clinicians and general managers, to defend 'their' settings against externally generated redesign.
The book's interesting revelations make an important contribution to the currently limited resources of empirical studies of public organizational reform. Indicating that attempts at organizational transformation within complex public service settings will continue to run into difficulties, as long as there is resistance from a critical mass of powerful professionals. With the continuing presence of professional 'ownership' in public services reform, the implication for designing a reform strategy is that it is more likely to be successful if it is gradualist rather transformational in nature, particularly in the presence of these powerful groups.
In winning the award, it is clearly demonstrated that this work has strong policy and management implications of interest to BAMM's members, many of who work in senior management positions in the NHS.
For more information see: www.bamm.co.uk/
ENDS
Notes
'Re engineering Health Care - The Complexities of Organizational Transformation'
(Oxford University Press, 2004)
Contacts:
Prof Ewan Ferlie (Head of School of Management, Royal Holloway, University
of London)
Tel: 01784 414366; e-mail: ewan.ferlie@rhul.ac.uk
Royal Holloway, University
of London, Press Office:
Christine Long
Press & PR Officer
01784 443967, christine.long@rhul.ac.uk
Vicky Cousins
Assistant Press & Comms Officer
01784 414480, victoria.cousins@rhul.ac.uk
