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Helen Durdy and Tim Bradshaw examine the literature on the impact of organisational change in the NHS and mental health, in the context of the coalition's austerity measures
Abstract
As a result of austerity measures imposed by the coalition government the NHS is currently undergoing unprecedented change. We undertook a literature review to establish the impact of organisational change in the NHS, particularly in mental health care, on staff and patients. A total of 49 papers were identified and thematic analysis was used to identify five key themes: leadership, impact on staff, organisational culture, resistance and impact on patients. The most significant finding was that the impact of organisational change on patients is barely taken into account. Further research, both quantitative and qualitative, is needed to evaluate the impact of change in the NHS on patients.
Key words
Organisational change, NHS, austerity, cuts, mental health
Introduction
The NHS has been in a state of almost constant change since its inception in 1948 (Rampling, 1998).
Cortvriend writes: "The NHS seems continuously to experience some form of change process whether that be at an incremental, local level and/or a discontinuous national level' and quotes a member of NHS statt who sums up their experience with the phrase: 'You're more shocked if it stays the same for more than two years' (Cortvriend, 2004: 177).
Mental health in particular is seen as a 'constantly changing working environment' and thus a stressful field of work (Gulliver et al, 2003: 101).
Austerity measures introduced by the Conservative-Liberal coalition government in 2010. with the aim of reducing the national deficit, placed limits on public spending until 2014/15. This resulted in substantial cuts to public service budgets.
The impact of the cuts has varied within the NHS across the four UK countries, and this paper largely focuses on the NHS in England.
In order to assess what the effects of such organisational change in the NHS might be on staff and patients we undertook a comprehensive review of the literature regarding previous evaluations of change.
In this article we describe the methods used to undertake this review and its key findings. The implications of these findings in relation to good practice in managing change and the need for future research...