Académique Documents
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Culture Documents
1, Aim
Objectives
• Analyse and evaluate the various change management models, which may
facilitate change from a public sector organisation (NHS) into a third sector
organisation (social enterprise)
Questions
1. What are the issues public sectors NHS staff have in transforming into a social
enterprise?
2. Which relevant Change Management models will facilitate change within public
sector NHS staff into a social enterprise?
2, Background
2.1, National
In January 2006 the Government’s white paper ‘Our health, Our care, Our say’ ‘a
new direction for community services’ set out plans for a major shift in the way in
which care is delivered in England. It argued for services to be more personalised to
the needs of the individual, increased choices and more integrated services,
provided by a range of different organisations, including social enterprises.
Most recently the ‘High Quality Care For All: NHS Next Stage Review Final Report
2008’ and the Primary and Community Care Strategy set out a vision for this change,
stating the need to empower staff and give patients greater choice.
Under these proposals PCTs contracting with new social enterprises will aim to
secure service quality and value for money, while also aiming to build their
sustainability and ensuring their long-term certainty.
The research will analyse the organisational and cultural change the staff within NHS
Oldham’s Community Health Development Team and related staff will need to
change to successfully move into a third sector environment using the Right to
Request process.
3.Literature review
A list of key theories and concepts will be defined through research and referencing
from general management texts and a review of articles, books and journals that
address cultural and change management.
‘There is little question that the intellectual father of contemporary theories of applied
behavioural science, action research and planned change is Kurt Lewin. His seminal
work on leadership style and the experiments on planned change that took place in
programmes’
Action Research was a term coined by Kurt Lewin in (1946) in an article entitled’
Action Research and Minority Problems’. The article was originally conceived as a
collective approach to solving important social problems such as racial and religious
prejudice; it rapidly began to be applied mainly to organisational problems.
Cooperation is not enough, there needs to a felt-need as Lewin term it. Felt-need is
when an individual’s inner realisation accepts that change is needed and necessary.
If Felt-Need is low within the organisation then change becomes problematic. Even
if change is accepted it doesn’t mean that anxieties about change have altered. This
can be particularly so when there is a close relationship between personal identity,
position at work and social standing, which may threatened by the proposed change
(Bennis 1966)
Kurt improved upon the Action Research model by developing the Three Step
Change model (1947a 228-9). Lewin believed for successful change to place
involves three steps which involves Unfreezing the present level, Moving to the new
level and Refreezing the new level
This three step change model recognises that before new behaviour can be adopted,
the old has to be discarded. With the old behaviour being discarded the new
behaviour can be accepted. Yet again this model stresses the need to understand
the importance of Felt-Need, with the old way discarded ‘unfreezing’ and the
‘moving’ to the new, can result in personal anxieties. Rubin (1967) suggested that a
re-education process or some confrontation meeting for those involved would ease
the change from Unfreezing to moving.
The research will also look into the expansion of Lewins three step change model
into Lippitt et (1958) seven phase model of planned change and Cummings and
Huse eight phase model. Finally Bullock and Batten four phase model of planned
change, which is based on a review, and synthesis of over thirty models of planned
change.
Brown (1995: 6-7) estimated that there are literally hundreds of definitions of culture.
Such as
members. These beliefs and expectations produce norms powerfully shape the
Elbridge and Crombie definition is the one must widely accepted as defining
organisational culture which ‘to the unique configuration of norms, values, beliefs
ways of having and so on, that characterise the manner in which groups and
individuals combine to get things done’ (Elbridge and Crombie 1974)
The literature will examine models of cultural change, including a survey carried out
by Dobson (1988) on the thousand largest private and public sector organisations in
the UK, revealed that 250 of them had been involved in a culture change programme
within the previous 5 years. Based on this survey, Dobson states that the
organisations sought to change the culture within their organisations through shaping
beliefs, values and attitudes of employees. Based off this survey on these
companies Dobson identified a four step approach to culture change.
Cummings and Hues (1989) identified an approach, which takes, into consideration
change in a strategic context, also Peters and Waterman (1982) eight steps to
excellence that takes a very prescriptive line. Finally, Egan’s (1994) article on how to
identify and change organisational culture.
4. Methodology
4.1 Introduction
The specific empirical research will relate to the research objectives on change and
cultural management within NHS Oldham Community Health Development Team
into becoming a Social Enterprise. The literature review has revealed the current
amount of studies and work carried on both cultural and organisational change. This
research offers an opportunity to examine the impact of cultural and organisational
change directly a specific team place, which is placed within a large public sector.
4.3 Sampling
The sample was purposefully selected (Patton 1990) from within Community Health
development Team. The staff who will be selected will represent the team has a
whole age, gender ethnicity and service. Table 1 below identifies a typology of
other sampling strategies, appropriate for qualitative enquiry, which were considered.
Snowball or chain Identifies cases of interest from people who know people who
know what cases are information rich.
Criterion All cases that are meet some criterion; useful for quality
assurance
Convenience Saves time, money and effort, but at expense of information and
credibility
To triangulate results the data collection will include more than one technique to
collate results. Triangulation is particularly useful in qualitative research, as it
achieves a more rounded picture of ‘thick description’ of what you are looking at
(Geertz 1973). The triangulation of data collation will include, Strategic Health
Authority (SHA) Social Enterprise support adviser, staff within the Community Health
Development Team and the literature review.
The other reasons for using qualitative methods are described in Table 2 below:
5 Sufficient time and resources for data collection and detailed analysis of
text information
7 The researcher is an active learner in the process and seeks to tell the
story from the participants view rather than imposing their own view as
an expert.
The table below shows a range of qualitative methods that could have been
deployed instead of the semi structured interviews.
Observation was ruled out as it is not possible to have extended periods of contact
and texts and documents would not have provided access to staff own experiences.
Semi structure interviews will be employed to collect the data; this will introduce a
degree of flexibility to the interview process. Semi structured interviews have a
limited number of pre arranged questions which will allow the interview to ebb and
flow. “Due emphasis [is given] to the meanings, experiences and views of all the
participants” (Pope & Mays, 1995 )
The limitations of the research will be that the staff will be from NHS organisations
and include a representative from the Strategic Health Authority (SHA), the two
members from the Senior Management Team and a sample of nine members from
the Community Health Development Team. Group sessions will also be employed to
allow respondents to discuss issues in different environments. The significance will
be that the results of the research will presented to the NHS National Social
Enterprise Dept, Oldham NHS Board and NHS colleges.
The empirical research findings will be analysed by ensuring that all audio taped
interviews are transcribe and verbatim. The analysis of interviews will be a
cumulative process and will tend to be dependant on the results from a number of
question responses. These responses can be combined with cross-referencing the
related literature review. To help focus the interviews in terms of reflecting the main
objectives of this research and ease the analysis of the interviews will be structured
according to the themes. These themes will reflect the overall aim and objectives in
this research and also echo main areas arising from the literature review.
The study will be analysed using Framework Analysis, which has been developed in
Britain specifically for applied, or policy relevant qualitative research where the
objectives have been set in advance (Ritchie and Spencer, 1994).
Identifying the thematic framework Identifying key issues, concepts and themes to
produce a detailed index of the data
Mapping and interpretation The charts are used to define concepts and
map the range of phenomena to find
associations between themes with a view to
providing an explanation for the findings
Stage 1 Familiarisation
The interviews will be taped and verbatim transcripts produced. This process will
involve listening to the tapes, reading the transcripts and listing the key ideas
and recurrent themes (Ritchie and Spencer, 1994). This process will enable
the research to gain an overview of the richness, depth and diversity of the
data.
Stage 3 Indexing
A final index will be developed with multiple codes (Ritchie and Spencer 1994).
Which will systematically evidence each transcript.
Stage 4 Charting
The second stage will involve synthesising the coded data into charts, which will
develop the themes identified during the coding process.
Two other strategies were also considered: analytic induction and grounded theory.
The first involved iterative interplay between data collection, analysis of cases to
compare against preset hypothesis. The second involves the discovery of theory
from data by generating categories from the data. Both methods involved multiple
trips back into the field until the hypothesis is proven or to retest emerging theory
(Bryman and Burgess, 1994). Because of time restraints there will be insufficient
time to undertake either of these approaches.
5. Ethnical Issues
The ethical issues in relation to this project are limited compared to covert research
where informed consent is not sought (Hornsbey-Smith, 1993). Participation in the
study will be voluntary and verbal consent will be obtained. The respondents
anomity will be protected by giving the respondents numbers (Crewell, 1998).
6. Data Handling
Interview tapes will be kept under lock and key until the end of the evaluation, at
which point they will be wiped clean. Paper transcripts will also be kept under lock
and key until the end of the evaluation, at which point they will be destroyed.
Individually identifiable data stored electronically will be password protected and
deleted at the end of the evaluation process.
7. Timescale
The table below outlines the timescale that the dissertation will take to complete
Table 5 timescale
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