Working with organizational issues in the NHS

An Occupational Health Service is described in this contribution, which offers support in working with complex organizational situations. A multi-disciplinary team engages with groups and individuals who need help with difficult organizational situations. A participatory approach is adopted in which the team endeavours to experience first-hand and make sense of the presenting problems. An example is given of working with a particular department in a busy District General Hospital and the type of intervention adopted. Central to the approach is a view of communication as a co-created process formed within relations of power. This is different from the traditional sender-receiver model of communication and the differences are emphasized. The dynamics and pressures of working within a Health economy predicated upon targets and performance are also explored.