Organisational Structure Of Nhs

Part One
The chosen organisation for the purpose of this paper is the National Health Service, concentrating predominantly on NHS England. The motivation derived from the recent event encountered in the media; the young boy passing away due to failure in appropriately diagnosing his symptoms as a result of the implemented 111 tick box system (see Appendix 1). Although a complex organisation, it is one which has continually tried to change and is presently in desperate need of undergoing organisational change. NHS England’s structure and culture will be analysed using Weber’s bureaucratic theory (1978) and Harrison’s four cultural dimensions’ theory (1972), as means of understanding the principles of effective change management in organisations.

The organisational structure refers to the relationships among the parts of an organised whole (Hatch, 1997) and it can be influenced by factors such as size and the complexity of tasks. Therefore, due to the size of NHS, the structure is probable to be very hierarchical with numerous layers and an extensive chain of command. The NHS structure is divided into different hierarchies that are for example, the national directors’ hierarchy followed by different departments’ such as commissioning operations directorate, medical directorate et cetera (NHS England, 2016). Using Weber’s bureaucratic theory, employees who work in bureaucratic structured organisations work according to pre-set, standardized rules and procedures. Although the event highlighted a flaw in their helpline system rather than its structure, it does suggest that their instigated structure is indeed bureaucratic as the 111 call handlers follow a pre-set script when handling calls. Consequently, this highlights a crucial problem with this subdivision implementing a bureaucratic structure which, as shown in the case study, has led to delays, absurd decisions and ineffective communication. Such problems associated with bureaucratic organisations are all too familiar and experienced on a

The definition of culture is difficult, largely as a result of the numerous interpretations available. Nevertheless, Schein (1985) suggests that culture is clarified as the shared assumptions that an organisation acquires and this interpretation is supported by Ouchi and Johnson (1978) who have suggested that organisational culture is merely how an organisation does things. In addition, in an examination undertaken by Konteh et al. (2011), 90% of its partakers agreed that culture is indeed used in their organisation to describe the ways things were done. For such an important organisation such as NHS, the culture is significant because it is the culture, as well as the informal psychological and social aspects of an organisation, that influence how patients view NHS (Cameron and Quinn,