Resistance to Change in Primary Care: An Exploration of the Role of Professional Identity

Abstract

This thesis contributes to the academic knowledge in the field of professional identity and organisational change. This thesis also has a practical implication as the findings helped to shape an organisational change within the co-funders organisation. The research was guided by the wish to explore the extent to which professional identity affects the willingness of those within Primary healthcare Units to accept fundamental changes in their working practices. Specifically, the aim was to establish the relationship of professional identity to processes of change. As the owners of small businesses who contract their services to the Health Board, the opinions of General Practitioners (GPs) were deemed to be of particular interest. The study was undertaken using a mixed method design, based upon a Constructivist grounded theory methodology. This was chosen as the ideal vehicle to examine the complex nature of identity within healthcare professionals and how they viewed organisational changes. Research started with unstructured interviews (n-14) and the analysis of the data obtained was fed into a questionnaire (n-97). The questionnaire offered validation of the initial findings. The findings of the research showed that professional identity has a bearing on the willingness of professionals to accept changes to their working environment. The resistance demonstrated by Healthcare staff, and specifically, GPs, to organisational change could be linked to feeling a perceived threat to their professional identity. Therefore, to undertake a successful organisational change, change managers must recognise that identity is vitally important and can affect the success or failure of an organisational change. Consideration of how any change may be perceived by professionals, within an identity context, must be built into the organisational change programme and revisited regularly during the change programme.