Please use this identifier to cite or link to this item: http://hdl.handle.net/1893/21353
Appears in Collections:Management, Work and Organisation Journal Articles
Peer Review Status: Refereed
Title: A model of organisational dysfunction in the NHS
Authors: Pope, Rachael
Burnes, Bernard
Contact Email: bernard.burnes@stir.ac.uk
Keywords: National Health Service
Corruption
Denial
Ego-defences
Image
Negative behaviour
Organizational silence
Issue Date: 2013
Publisher: Emerald
Citation: Pope R & Burnes B (2013) A model of organisational dysfunction in the NHS, Journal of Health Organisation and Management, 27 (6), pp. 676-697.
Abstract: Purpose - This paper explores the reasons for the sometimes seemingly irrational and dysfunctional organisational behaviour within the NHS. It seeks to provide possible answers to the persistent historical problem of intimidating and negative behaviour between staff, and the sometimes inadequate organisational responses. The aim is to develop a model to explain and increase understanding of such behaviour in the NHS. Design/methodology/approach - This paper is conceptual in nature based upon a systematic literature review. The concepts of organisational silence, normalised organisational corruption, and protection of image, provide some possible answers for these dysfunctional responses, as does the theory of selective moral disengagement. Findings - The NHS exhibits too high a level of collective ego defences and protection of its image and self-esteem, which distorts its ability to address problems and to learn. Organisations and the individuals within them can hide and retreat from reality and exhibit denial; there is a resistance to voice and to "knowing". The persistence and tolerance of negative behaviour is a corruption and is not healthy or desirable. Organisations need to embrace the identity of a listening and learning organisation; a "wise" organisation. The "Elephant in the room" of persistent negative behaviour has to be acknowledged; the silence must be broken. There is a need for cultures of "respect", exhibiting "intelligent kindness". Originality/value - A model has been developed to increase understanding of dysfunctional organisational behaviour in the NHS primarily for leaders/managers of health services, health service regulators and health researchers/academics. Research, with ethical approval, is currently being undertaken to test and develop the conceptual model to further reflect the complexities of the NHS culture.
Type: Journal Article
URI: http://hdl.handle.net/1893/21353
DOI Link: http://dx.doi.org/10.1108/JHOM-10-2012-0207
Rights: The publisher does not allow this work to be made publicly available in this Repository. Please use the Request a Copy feature at the foot of the Repository record to request a copy directly from the author. You can only request a copy if you wish to use this work for your own research or private study.
Affiliation: University of Manchester
Management Work and Organisation

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