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The operation of provider units, both NHS Trusts and Directly Managed Units, as competitive organizations in the market place, is as yet rudimentary. Although some have achieved notoriety through radical "business" behaviour, there is little evidence that they have adopted scientific business practices in order to strengthen or re-orientate their position in the market place. Neither is there as yet any hard evidence that such behaviour would be beneficial in the long term. This paper describes an exercise of strategic market analysis used as a device to lead and inform the business planning process for an NHS Trust. The primary objective of the analysis is to identify hitherto unrecognized strategies which would enhance the position of the organization in the market place and also to identify areas where business development is possible and desirable. [ABSTRACT FROM AUTHOR]

The paper takes a processual approach (Mintzberg and Waters, 1985; Pettigrew, Ferlie and McKee, 1992) in conjunction with a typology of middle-management influence upon strategic change (Floyd and Wooldridge, 1992) to investigate the role of middle managers in business planning in the National Health Service (NHS). Over time, as the business planning process becomes increasingly one which adopts a top-down approach, the main influence middle managers have is upon the implementation of deliberate strategic change. Middle managers modify the implementation of deliberate strategy by contesting the performance indicators that form the basis of the business planning framework. In particular they draw upon features of inner and outer context of the organization to question the legitimacy of business planning. However, the findings also show, albeit to a limited extent, that middle managers are purveyors as well as recipients of change. That middle managers can have upward influence has important implications for policy-makers since potentially, middle managers can enjoy an enhanced role and add value to organizations, in this case to patient care. Therefore recent attacks upon their numbers and role may be misplaced. In addition a high degree of central intervention in the NHS generally may be inappropriate, since it militates against an enhanced role for middle managers. [ABSTRACT FROM AUTHOR]

The 1990 NHS and Community Care Act can be seen, as the culmination of the importation into the UK National Health Service of 'business' language, This has entailed struggles between-the values, of new general managers and the traditional professions and unprecedented attention to issues of 'measurement'. A recent study of NHS Trusts involved three yearly rounds of interviews With managers and the administration of questionnaires to the nursing workforce in the same areas. Although the main intentions: of the research lay in gauging the job satisfaction of the workforce and describing the managers', approaches to organisational strategy, the way that each group used language soon emerged as an area of interest and as a pointer to the foundational values and epistemologies of each group: An approach to the texts of, interviews and questionnaire responses was informed partly by an analysis of discourse, elaborated by Foucault and others and partly by deconstruction, an approach usually associated with literary texts. The approach to analysis is based on the realisation that language is structured in away that reflects existing power relations and that attention to metaphor and other rhetorical devices can give insight into these discourses. After briefly: introducing the policy context and a particular approach to literary texts, this paper offers analysis of how managers talked about measurement and financial constraints. [ABSTRACT FROM AUTHOR]

The article explores some of the lessons learned from the longitudinal and in-depth study of complex, rapid and organizational change of the National Health Services Greater Glasgow and Clyde (NHS GG&C) in Great Britain. According to the authors, the institution should need to consolidate its organization immediately while facing real public scrutiny over the changes process and performance outcome. In addition, it is suggested that one should consider speed is a relative and not absolute concept when applied to organizational change.

A key to the success of public organizations is their ability to identify and build capacity, particularly their distinctive competencies, in order to produce the greatest value for key stakeholders. This article grounds this proposition in the resource-based view of organizations and presents a method for identifying and making use of distinctive competencies in the form of a “livelihood scheme”—a business model appropriate for the public sector—that links distinctive competencies to organizational aspirations and goals. The case of a major public sector training and consultancy unit that is part of the United Kingdom’s National Health Service is used as illustration. A number of conclusions are offered in the form of a set of propositions tied to the resource-based view and related research issues. The results contribute to both public strategic management theory and practice. [ABSTRACT FROM AUTHOR]

This article reviews the introduction and development of business planning in Great Britain's National Health Service. It presents a guideline for writing a business case for service development that would form part of a pathology business. Appropriate discussion with managers in either service development or planning may identify a way of targeting a business case to an appropriate source of funding. Business planning and the development of a successful business case in pathology present a challenge to all those working in that service. Time needs to be taken to prepare well, collect accurate information, and gain support from colleagues for any plan to be successful.

This article focuses on a central feature of the former Conservative Government's approach to the National Health Service (NHS), the introduction of General Practitioner Fundholding. It examines the nature of business planning undertaken by fund holding practices in the North West Region by looking at the participation of various stakeholders in the business planning process, the business planning techniques adopted and the extent to which fundholding practices set and monitor their objectives. [ABSTRACT FROM AUTHOR]