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leadership of a culture change process

leadership of a culture change process

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[31 ]
Leadership & Organizat ion
Development Journal
17/ 5 [1996] 31\u201337
MCB Universit y Press
[ISSN 0143-7739]
Leadership of a cultural change process
Ian Brooks
Principal Lect urer, Facult y of Management and Business,
Nene College, Nor t hampt on, UK
Explores the successful role of
leadership in initiating and

sustaining a major process of
change. The \ufb01 ndings build on
the work of others who have
so ably demonstrated the

in\ufb02uence of powerful leaders. Research is based on qualita- tive data from an

ethnographic study which
immersed itself in the minu-
tiae of organizational life.
Outlines the processes that
have unfolded in the wider
context of NHS change. Dis-
cusses the \ufb01 ndings and
debates supporting evidence.
The resultant model of change
indicates that successful
leadership of cultural change
requires leaders to think
culturally, to be guided by a
cognitive model of change and
to employ the cultural tools of
symbolism while actively
focusing on the politics of
acceptance. Hard systems and

structural changes can be
implemented in parallel with
soft symbolic and political

activity. A highly receptive
context, either real or created,
assists by providing a trigger
for change.
Introduction
This paper explores the successful role of
leadership in initiating and sustaining a
m ajor process of change. More em otively, it
illustrates how a chief executive, Frank
Collins, and a cadre of skilled managers, man-
aged to win both hear ts and minds. In the
space of three years\u2019consultants in a National
Health Service (NHS) general hospital

changed from outright objection to over t sup- port of their unit gaining self-managing Trust status. These consultants had begun to own

the change involved, a fact so graphically and
symbolically illustrated by their unanimous
signing of the Trust status proposal document.
This paper builds on the work of others who

have so ably demonstrated the in\ufb02uence of powerful leaders (Tushman and Romanelli, 1985) or new chief executives (Grinyer and Spen der, 1979; Slatter, 1984). Alth ou gh th is

may appear to contradict of the work of cul-
tural purists, who argue that things are
largely unaffected by the intervention of
leaders, and by more recent research which
suggests that leadership is a pluralistic phe-
nom enon (Bate, 1994), there is, never theless, a
compelling story to tell. The paper does not

claim that one man, or even the management team, transfor med the organization, but that a new CEO and senior team actively, persis- tently and consistently sought to bring about

organizational change and achieved consider-
able success in that endeavour.
In 1990, three years before the hospital
(refer red to throughout as GH) applied for
Trust status and shortly before the CEO
ar rived, there was a front-page article in the
local newspaper, signed by over 20 senior
consultants at the hospital, strongly opposing

any moves towards Trust status. Change to Trust status represented a counter-cultural invasive force that was alien to the \u201clocal

cultural infrastructure\u201d (Brooks and Bate,
1994).
In 1993 the Trust status application docu-
ment was signed by the 15 original consul-
tants who were still working at GH and who
earlier had publicly denounced change. The
CEO characterized this voluntary signing-up
as, \u201csymbolic of a changing of hear ts and
minds\u201d. This is seen as a considerable
achievement by all who were interviewed

during this research exercise, including the consultants themselves. For the CEO it was merely the tangible manifestation of a more

signi\ufb01cant cultural change to an organization
\u201cthat now wants and expects to succeed\u201d.
There has been considerable research in
the \ufb01eld of leadership. Initially, it was thought
that good leaders possessed a series of traits
that accounted for their success. These are
well sum m arized by Stogdell (1974). The Ohio
State University studies argued, more con-
vincingly, that leadership is better explained
by behaviours. Unfortunately both schools
are acontextual, that is, they ignore the set-
ting or contingent factors. Contingency theo-
rists, such as Fiedler (1967), recognize that
inter personal relationships in a context are
critical to leadership endeavours.

This paper further explores the importance of context and builds on more recent research on th e sym bolic (Bate, 1994; J oh n son , 1990)

and political roles of leadership. Hence this
paper suggests that the softer, more symbolic
and less tangible, aspects of leadership are
every bit as impor tant in securing speedy

transfor mation as the more tangible hard
structures and systems changes.
Research design
This paper is based on qualitative data from
an ethnographic study which was immersed
in the minutiae of organizational life. Central

to the data collecting process was a series of 20 semi-structured interviews with an array of personnel from the Trust hospital.

Research concentrated on pur posive sam-
pling. Initially, senior personnel were inter-
viewed, including two lengthy interviews
with the chief executive himself. This was
widened to include junior, non-medical and
non-managerial employees. Eventually,

domestic staff, por ters, executive and non- executive board members, the deputy chief executive and other senior and middle

\u00a9 Ian Brooks, 1996.
[32 ]
Ian Brooks
Leadership of a cult ural
change process
Leadership & Organizat ion
Development Journal
17/ 5 [1996] 31\u201337
managers, including business managers and
a number of clinical professionals, were
interviewed. All interviews were taped and
comprehensive transcripts made. Over 30
hour s of \u201cr ich descr iption\u201d (Geer tz, 1973)
resulted. Analysis was based on predesigned
categories, compiled by reference to litera-
ture in the \ufb01elds of leadership, culture and

organizational power. Some of the data, in the for m of respondents\u2019 discourse, is reproduced in this paper to help tell the story.

Context

The processes outlined in this paper unfolded in the wider context of NHS change. The NHS refor ms have stimulated considerable

research, largely \ufb02amed by political and
social ideologies and focused on marketiza-
tion, managerialism and con\ufb02icting value
system s. It is extensive, covering widely dif-
ferent issues and topics like \ufb01nancial man-

agement and infor mation systems, the politi- cal-managerial and professional-managerial interfaces, and NHS structures, systems,

policies and control mechanisms. There has
been far less research at the micro process
level of organizational leadership.
In the public services generally, and the
NHS speci\ufb01cally, a top-down invasive model
of change has predominated, inspired by
political agendas and prevailing socio-eco-
nomic and technological conditions. Man-

agers in the NHS generally have been positive about the changes. Manifestations of manage- rialism abound: strategic planning systems,

business plans, mission statements, business
managers, and new initiatives like lear ning
organization theory, TQM and Investors in
People prolifer ate (Lawton and Rose, 1991;

Pollitt and Har r ison, 1992; Talbot, 1994). NHS managers, as opposed to clinicians and trade unionists, are seen as the bene\ufb01ciaries of

change (Ferlie, 1994).
This research was undertaken in a
medium-sized general hospital (four th wave)
NHS Trust which gained its new status in
April 1994. The hospital has made consider-
able progress in many respects in recent
years and is generally considered to be a fast
improving and sound Trust. The critical
managerial-clinical interface appears to be a
more constructive relationship than others
repor ted elsewhere. Considerable progress
has been made on exter nal measurements of
quality and operating success. The chief exec-
utive has recently moved to a larger hospital
Trust.
The leadership of change
Tur naround involved an all-embracing
attempt at organizational change and not a
merely persuasive campaign aimed at 15 con-
sultants. This section will demonstrate the
multiple, largely parallel, approaches adopted
by the CEO and his new management team.
Management of hard infrast ruct ure
The management team oversaw the restruc-
turing of the organization, including the devel-
opment of separate clinical directorates, each
headed by a lead consultant who sits on the

senior management executive. Business man- agers were introduced to each directorate and a small senior management team appointed

and developed. Systems were introduced to

facilitate the achievement of operational and
strategic objectives. Financial systems, annual
planning cycles, inter nal tracking systems,

administrative systems and \ufb01nancial methods were upgraded to cope with the inter nal mar- ket and subsequent Trust status. They enabled the organization to cope with and prosper in

the newly introduced \u201cinter nal market\u201d in the
NHS and, eventually, to gain Trust status.
They also facilitated the shor tening of waiting
lists and the achievement of many exter nally
and self-imposed targets.
Politics of acceptance
There is ample evidence that the CEO and
management team paid particular attention
to the politics of acceptance. They adopted a

more collaborative and less coercive (Dunphy and Stace, 1988) style than is often the case in many organizations. The CEO engaged in a great deal of discussion at an early stage and particularly involved individuals and groups who held both for mal and infor mal power.

These included a group comprising the lead
consultants and the senior management
executive, exter nal bodies like purchasing
authorities and, later, general practitioner
(GP) fundholders. Initially, these were largely
exploratory meetings in which ideas about
the future of the hospital were discussed
openly. The CEO developed a highly visible,
energetic and dynamic approach, assisted by

an effusive and out-going personality, which
was, initially at least, aimed at gaining accep-
tance of the need for change.

The CEO saw his \ufb01rst task as \u201cgaining their
[senior consultants\u2019and managers\u2019] under-
standing of the environment\u201d. At the early

stage a consultant commented that \u201cthis was the \ufb01rst time we had been engaged in discus- sion of this nature\u201d. Collective action was

emphasized and views sought. Instilling in
[33 ]
Ian Brooks
Leadership of a cult ural
change process
Leadership & Organizat ion
Development Journal
17/ 5 [1996] 31\u201337
othersa sense of ownership of both the prob-
lem and the solution was seen as crucial by
the senior managers.
Rapidly impending, centrally imposed
change in 1991 created a trigger for action.
This was the adoption, throughout the NHS,
of an inter nal market for the purchase and
supply of health care and related activities.
The CEO\u2019s awareness of this was evident: \u201cwe
were on an 11-month, exter nally imposed
process of change, and the clock was ticking.
It was no good saying, \u201cwe\u2019re a little bit
sleepy can we make it 18 months?: [it was]

not-negotiable. On 1 Apr il 1991 you would be delivering!\u201d. He consciously heightened this sense of impending crisis while instilling

con\ufb01dence that \u201cwe\u201d were competent to man-
age the required changes. Use was made of
such phrases as \u201cgo under\u201d, \u201cwe will not

survive\u201d and \u201cfalling-over\u201d. These, the CEO
later agreed, were quite star tling messages.
On regular walkabouts he would ask people
how they were prepared for the forthcoming

refor ms. He argues: \u201cI used that ever-decreas- ing time frame as an opportunity to legitimize my discussions\u201d, and he admits to \u201ccon-

sciously using some for m of crisis language\u201d.
This initial approach was largely, but not

exclusively, focused on senior consultants and other senior and middle managers in the orga- nization. His aim was clear to ensure that \u201cthe road was clear for us to introduce the

refor ms\u201d. The imposed change and the
urgency it created were, the CEO argued,
\u201cvery useful\u201d. They helped legitimize the

change process and the discussions with con- sultants and managers and establish the man- agement team, not as the source of the demand for change, but as the body of exper ts who

could provide the solutions. The CEO was
aware of this role, suggesting that: \u201cit wasn\u2019t
me as the new manager who wanted the
change because I had perceived a weakness in
the organization, but I was here and so were
the refor ms and \u2018we\u2019had to do something\u201d.

The organization coped well with the intro- duction of the inter nal market, so that after 1 April 1991 \u201cwe were able to congratulate our- selves\u201d. This \u201csm all win\u201d (Weick, 1979) served to reinforce the change process. There then

followed, quickly on the heels of this success,
a series of senior management and consul-
tant away-days and other discussions \u201cto
start thinking strategically and introduce an
annual planning cycle\u201d. The away-days were
used to design the mission of the organization.
Although as one senior manager noted, some-
what inevitably, \u201csome consultants were
embracing it better than others\u201d, one consul-
tant, whoenjoyed the experience, suggested
that \u201cfor the \ufb01rst time we realized that there
were as many views as [there were] people
present\u201d. This divergence of opinion between
consultants from different directorates
helped legitimize management intervention
still fur ther. Leadershipwas viewed as essen-
tial to ensure fair-play.

This teasing out of ideas and the process of
gaining ownership of strategy were opera-
tionalized alongside the hard structural and

systems changes discussed above. Winning
over consultants was facilitated by the
appointment of business managers who

\u201cwould act as their assistants\u201d and help them with day-to-day administrative responsibili- ties. Couching this in ter ms of \u201cassistance\u201d and relieving them of tiresome administra-

tion seemed to reduce the sense of prevailing managerialism which many medical person- nel resent. Another structural change which addressed the political issues that sur round change was the decision to make the medical directors (the lead consultant in each of 12

directorates) the majority group on the
senior management executive. This was a
vital symbolic gesture in managing the politi-
cal acceptance of strategic change. It helped
reassure the consultants and indicated to
other clinical personnel that their voice
would be heard. It also symbolized the intent
to encourage consultants to own both the
management and the change processes.
Although the CEO continued to \u201clead the

agenda\u201d, a consensual approach was usually adopted. Nevertheless, as one consultant put it, \u201cthe management team was a forum in

which [the CEO] comes with ideas and we
leave with them\u201d. There were a couple of

occasions when the CEO gave way to collec- tive consultant opinion, although he argued that these were of symbolic value in

signalling his desire to gain collective owner- ship of the strategic organizational processes. One senior manager argued that the

approach taken and the range of tactics out- lined above \u201clocked people in to the strategic management and change processes\u201d.

Management of symbols
Many organizational leaders virtually ignore
both the concept and the reality of culture,
\u2018\u2026T he im posed change and the urgency it created were, the CEO

argued, \u201cvery useful\u201d. T hey helped legitim ize the change process and the discussions with consultants and m anagers and establish the m anagem ent team , not as the source of the dem and for change, but as the body of experts who could provide the solutions\u2026\u2019

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