Management, People and Organisations - Nhs

3700 Words Nov 10th, 2007 15 Pages
1.1 Introduction to NHS

Statistics from the NHS Confederation (2007) reports a colossal number of employees and patients in the NHS. Managers and senior managers account for 2.8 per cent of the almost 1.3 million staff employed by the NHS. 27 per cent of NHS chief executives come from a clinical background and 50.2 per cent of NHS managers have a clinical background. The NHS deals with over 1 million patients every 36 hours.

There are many hospitals and infirmaries under the NHS management. From the Leighton Hospital and Victoria Infirmary, we can see the typical organisation chart of a hospital in the NHS. Figure 1.1 below is adapted from Mid Cheshire Hospitals NHS Trust (2007).

Figure 1.1 Organisation chart of Leighton
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Mintzberg (1981) discussed that divisional structured organisations ' top management often uses performance control systems over each divisions but leave the details to the division 's management. This system adds extra paper work and slows communications. Tasks are duplicated across divisions, increasing costs and efficiency. These problems also lead to increasing the span of control of the managers. Problems associated with a divisional organisation structure are typically:
- Increased overheads
- Slower and ineffective communications
- Increase the distance between management and their subordinates
- Slow decision making
- Too many people managing a task
- Managers are overloaded because of the above mentioned reasons

Mintzberg (1981) added that centralisation tend to happen within the divisions as they hold the responsibility of their performances. However divisional structure is difficult to be dynamic because of the procedures and red tape they have to go though to make a change.

However, Daft (2006 p. 366) argues that in a divisional structure, the organisation has fast response, is flexible in an unstable environment, fosters concern for customer needs, and has excellent coordination across functional departments. This was supposed to be theoretically correct and NHS must have adopted this structure in the hope of gaining all these advantages. From the previous analysis, all these advantages are wiped out because

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