Development and organizational change in primary care : a study of local health groups in Wales 1999-2001.

Williams, Stephanie Ann Ross. 2008. Development and organizational change in primary care : a study of local health groups in Wales 1999-2001. PhD Thesis, Cardiff University.

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Abstract

This study was designed to explore organizational change in primary health care, specifically the introduction of Local Health Groups which were meant to create radical change at local level across Wales. The aim was to gain a better understanding of the factors that influence the formation and development of organizations receptive to change. The specific questions included: firstly, what structural and organizational changes were made for the promotion and development of Local Health Groups? Secondly, what leadership behaviours did the selected health professionals apply to their roles as Chairmen, in terms of building organizations capable of change and development? And thirdly, what lessons can be learned for leadership and organisational reform, and policy implementation at local level for the future? The policy decision to devolve decision-making in health care to primary care professionals at local level provided the opportunity to conduct a prospective study. A case study approach was selected to explore the experiences of all 22 Local Health Groups, through the reported experiences of the Chairmen as the lead figures responsible for forming and developing the new organizations. Data were collected using three waves of face-to-face interviews, supplemented with Minutes of Board Meetings tracing the study period: April 1999 to October 2001. Some limited observation of key events was also carried out. The study was conducted at a time of considerable turbulence in the health system in Wales. Firstly, it appears from this study that the structural changes made to implement the new policy were inadequate to that task. But some Chairmen appeared to exercise specific skills that enabled them to manage the consequent uncertainty in the system more comfortably than others. In addition, key leadership behaviours appeared to influence the development of change promoting organizations. These included strategic vision: the ability of the lead figures to articulate an attractive vision of the future, and persuade others to pursue it. Secondly, the ability to forge constructive working relationships with a wide variety of stakeholder organizations proved to be pivotal. Thirdly, the ability to identify key features of the organization and build on them to create unique organizational identities and services emerged as a key leadership behaviour in this context.

Item Type:	Thesis (PhD)
Status:	Unpublished
Schools:	Social Sciences (Includes Criminology and Education)
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
ISBN:	9781303197123
Date of First Compliant Deposit:	30 March 2016
Last Modified:	05 Feb 2020 03:31
URI:	https://orca.cardiff.ac.uk/id/eprint/54523

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