L. McCann
"You can't do both- something will give" : limitations of the targets culture in managing UK healthcare workforces
McCann, L.; Granter, E.; Hassard, J.; Hyde, P.
Authors
E. Granter
J. Hassard
P. Hyde
Abstract
Based on a three-year ethnographic study of four UK National Health Service (NHS) organizations, we explore the everyday cultural experience of managing clinical and administrative workforces. Although NHS organizations claim to function as enlightened HRM employers, we argue that the inflexible application of metrics-based target systems to clinical and administrative tasks, including HRM operations, can result in dysfunctional outcomes for patient care and workforce morale. Reminiscent of the recent Mid Staffordshire health care scandal, the priorities attached to NHS personnel meeting the demands of performance management systems can prove incompatible with them also meeting the fundamental “human” needs of patients. The everyday experience of health care organization becomes one of employees reconciling competing logics of business efficiency and integrity of care. Trapped metaphorically between shrinking resources and expanding targets, the inclination—on the frontline and at mid-management level—is to extend the integrity of care, although this is sometimes impossible and can prove problematic in terms of system accountability. In response to such organizational tensions the behavior of many frontline and mid-management staffs ultimately reflects a form of “street-level bureaucracy”—a situation in which traditional professional norms are reasserted informally in ways that often transgress prescribed performance systems.
Citation
McCann, L., Granter, E., Hassard, J., & Hyde, P. (2015). "You can't do both- something will give" : limitations of the targets culture in managing UK healthcare workforces. Human Resource Management, 54(5), 773-791. https://doi.org/10.1002/hrm.21701
Journal Article Type | Article |
---|---|
Online Publication Date | Apr 27, 2015 |
Publication Date | Sep 18, 2015 |
Deposit Date | Feb 4, 2014 |
Publicly Available Date | Apr 27, 2017 |
Journal | Human Resource Management |
Print ISSN | 0090-4848 |
Electronic ISSN | 1099-050X |
Publisher | Wiley |
Peer Reviewed | Peer Reviewed |
Volume | 54 |
Issue | 5 |
Pages | 773-791 |
DOI | https://doi.org/10.1002/hrm.21701 |
Keywords | Healthcare management, National Health Service, Performance targets, Professionalism, Street-level bureaucracy. |
Public URL | https://durham-repository.worktribe.com/output/1443920 |
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Copyright Statement
This is the accepted version of the following article: McCann, L., Granter, E., Hassard, J. and Hyde, P. (2015), “You Can't Do Both—Something Will Give”: Limitations of the Targets Culture in Managing UK Health Care Workforces. Human Resource Management, 54(5): 773-791, which has been published in final form at http://dx.doi.org/10.1002/hrm.21701. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
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