Managing in Uncertainty: Complexity and the paradoxes of everyday organizational life by Chris Mowles

Author:Chris Mowles
Language: eng
Format: mobi, azw3, epub, pdf
Publisher: Taylor and Francis
Published: 2015-03-11T22:00:00+00:00

Cultural change within the NHS in the UK

The Department of Health (DH) and the NHS Commissioning Board have issued a new strategy and vision for nurses, midwives and care staff in the NHS. This is in response to a perceived crisis in the values of caring following a number of scandals about the standard of care in hospitals and care homes. The intention is to reinforce the existing values which underpin caring for vulnerable and sick people, but the strategy also intends to change culture: ‘There is also growing recognition in all levels of the health, care and support system, that we have to change our culture if we are to change our care’ (2012: 12).

At the heart of this strategy are what the document refers to as ‘the 6 Cs’: care, competence, compassion, communication, courage and commitment. Compassion is understood to be ‘how care is given through relationships based on empathy, respect and dignity. It can also be described as intelligent kindness and is central to how people perceive their care’. I will return to the idea of intelligent kindness later on to look at the provenance of the idea because I think it opens up areas of discussion not covered by either Schein or the Department of Health. Meanwhile, these 6 Cs will inform everything that caring staff do, will be communicated vigorously in collaborative working relationships with others, will form the basis of training, promotion and performance management and will be instrumental in whole organizational culture change. Each of these areas of organizational activity is intended to fit neatly over the others to form a coherent whole of overlapping and reinforcing organizational change, and is amplified through reward and recognition.

This strategy is currently being implemented across the health service. All front-line workers are considered to be ‘change champions’, and leadership is expected to occur at ‘every level’ of the organization, although staff designated as leaders and managers are thought to have a particular role in the process:

Leadership is key. Leaders and managers need to create supporting, caring cultures, within teams, within organizations, and in the system as a whole in the way that organizations relate to each other. Leaders at every level have a responsibility to shape and lead a caring culture.

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