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A model of organisational dysfunction in the NHS

A model of organisational dysfunction in the NHS 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. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Health Organisation and Management Emerald Publishing

A model of organisational dysfunction in the NHS

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References (64)

Publisher
Emerald Publishing
Copyright
Copyright © 2013 Emerald Group Publishing Limited. All rights reserved.
ISSN
1477-7266
DOI
10.1108/JHOM-10-2012-0207
pmid
24422253
Publisher site
See Article on Publisher Site

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.

Journal

Journal of Health Organisation and ManagementEmerald Publishing

Published: Oct 25, 2013

Keywords: National Health Service; Corruption; Denial; Ego‐defences; Image; Negative behaviour; Organizational silence

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