Management development in the NHS: nurses and managers, discourses and identities

Abstract

Purpose

Aims to provide a brief discussion of discourses of HRD, then a brief review of HRD within the NHS, including stakeholders in HRD, and particularly management development. To explore some of the different discourses used by different managers, particularly those with a nursing background and those without, and the possible reasons for the use of these different discourses.

Design/methodology/approach

A qualitative case study approach was adopted, including semi‐structured interviews. Primary research data were collected from tape‐recorded interviews with seven Directorate General Managers from two Welsh NHS Trusts. Discourse analysis was used to explore connections between the participants, the discursive resources they employed and their professional identities.

Findings

Provides evidence of some of the tensions associated with management development in the NHS, between professional and managerial development, between central and local HR activities, and between competition and cooperation. A particularly interesting dimension is the transition from being a nurse to becoming a manager and the ways in which different individuals cope, as articulated in their language use. Highlights some of the discursive struggles to maintain one's professional (nursing) identify when promoted to managerial positions. It provides examples of some nurses who have adopted the new managerial discourse without such apparent difficulty of changed identity. It also presents material from NHS managers who have no nursing background to enable further comparative analysis of the relationships between identity and discourse.

Research limitations/implications

The findings are limited by small sample size, although feedback suggests the findings can be generalised to other NHS Trusts across the United Kingdom, and possibly globally. Not one senior manager used the term HRD – it was always “training and development” or “professional development” or “managerial and organisational development” and sometimes “learning”. Nor was there much use of the government's preferred term “workforce development”. This has implications for HRD research within this context, suggesting the need for shared understanding amongst researchers and participants.

Practical implications

Various and varying discourses and associated discursive resources are identified, illustrating the diversity of talk about HRD within the NHS. As one DGM commented, “I think we're using the same words but it means something completely different”. This has practical implications, suggesting the need for shared understanding amongst HRD stakeholders to ensure a coherent and integrated approach to HRD within this complex multi‐disciplinary context.

Originality/value

How HRD is talked about and accomplished through talk has been relatively neglected in the health care context. This paper contributes to our understanding of how the complex range of learning and development activities are perceived and articulated, from the perspective of senior managers responsible for HRD.

Citation

Sambrook, S. (2006), "Management development in the NHS: nurses and managers, discourses and identities", Journal of European Industrial Training, Vol. 30 No. 1, pp. 48-64. https://doi.org/10.1108/03090590610643879