What Difference Can it Make?
Running even the most complicated corporation must sometimes seem like child’s play compared to trying to manage almost any hospital.
— Henry Mintzberg
If anything the management challenges in healthcare have become even more acute in recent years, with the rising complexity arising from population ageing, a deepening workforce crisis and austerity measures that imperil existing service models. Demand for new technology and innovations to raise the quality (and productivity) of health services has grown exponentially. So too have calls to integrate health and social care services and, where possible, locate them in community settings.
While these challenges require world class management and leadership capabilities, healthcare organisations frequently struggle. All too often, busy clinical professionals regard management as an unnecessary hindrance on their autonomy or at worse, a move to the dark side. Some politicians and the media often denigrate managers as a costly administrative overhead: part of the problem rather than the solution. At operational levels, heavy workloads and frequent interpersonal conflicts often overwhelm junior and mid-level managers.
However, although management and leadership has often been described as an ‘extreme’ job in healthcare settings, it is also an important job. Following a review of Leadership in the UK National Health Service (NHS), General Sir Gordon Messenger highlighted the ‘very real difference that first-rate leadership can make in health and social care, with many outstanding examples contributing directly to better service’.
At the School for Business and Society, University of York, we are adopting an innovative, interdisciplinary approach to understanding healthcare management. By integrating insights from management and organisational theory, employment relations, health policy, and economics, we offer a comprehensive perspective on management roles and relationships in healthcare settings. Our research addresses critical questions surrounding healthcare governance, explores the nature and development of management capacity, and investigates how leadership capabilities can be enhanced to drive sustainable performance improvement. This multifaceted lens allows us to tackle complex healthcare challenges, bridging the gap between academic theory and practical application to foster more effective, efficient, and patient-centred healthcare systems.
Current research projects at the School for Business and Society:
Management Capacity and Capability in the NHS
While NHS managers have often been denigrated as a costly bureaucratic overhead, the need to invest in management capacity is now recognised. Professor Ian Kirkpatrick and his team explore what management capacity is required and how NHS organisations can support managers to enhance innovation and improvement. Read More
New Organisational Forms and their Impact
As in other healthcare systems, the NHS has created collaborative structures, bringing together organisations and hospital sites. Professor Nicola Burgess investigates the governance and leadership of these new organisations and assess their impact on workforce transition and improvement at scale. Read More
System Integration and Network Governance in the NHS
The NHS is undergoing a major process of reform to create Integrated Care Systems that combine primary, community and secondary health services to ensure a stronger focus on prevention and public health. Professor Federica Angeli‘s research focuses on the leadership dynamics of this reform. looking specifically at the experience of Place-based Partnerships. Read More
The Use of External Management Consultancy in the NHS
The NHS has relied increasingly on the advice of external management consultants from the private sector to improve efficiency and generate innovation. Professor Ian Kirkpatrick, with colleagues at the University of Bristol, considers the impact of external consultants and alternative (blended) solutions which helps develop internal consulting capabilities. Read More
Ambulance Services, Paramedics and Pre-hospital Medicine
Emergency services in the NHS are in crisis, facing austerity, rising demand and major transformations in professional roles. Focusing on paramedics, Professor Leo McCann explores how these transitions are being managed and what strategy is needed for pre-hospital medicine. Read More
