The Impact of Organisational change on Health Care Delivery to the Adult Mentally Ill

Abstract

This thesis is about assessing the impact of organisational change on health
care delivery to the adult mentally ill patients by North West London
Mental Health (NHS) Trust which became a Third Wave NHS Trust health
care provider unit on 1 April 1993, following a successful application to the
Secretary of State for Health, Mrs Virginia Bottomley.

The research study examines the processes, contents and contexts of
organisational change of the Trust; the extent to which the Trust has
successfully managed the processes of strategic change and achieved
improvements in the quality standards of service delivery since it became a
self governing NHS health care provider.

Cost improvements, improved performance and service quality were
identified as the key objectives and priorities of the corporate strategy of
North West London Mental Health (NHS) Trust. These objectives are
reflective of the main aims of the NHS reforms - Working for Patients
(1990).

The framework of organisational change of North West London Mental
Health (NHS) Trust involved changes in its management structures,
systems, strategic direction and organisational values. The new governance
of the Management Teams and the introduction of information systems and
technology, development of community based mental health service and
other elements of strategic change.

It was noted that the changes had been evolutional, the efficiency savings
(Cost Improvement Programmes) targets that the Trust achieved over the
period were mostly through the measures of redundancies and deletion of
vacancies. Financial control to reduce cost and expenditure was noted to
have predominantly featured as the main priority of the strategic
programmes of the Trust during the period.

NWL Trust, however, did not achieve its main aim and priority to improve
the quality of service delivery to the adult mentally ill, particularly
inpatients, during the period.

It is worth to note the limitations of a single empirical case study, the size
of the respondents interviewed and time and material resources constraints.
Therefore, the findings of the research study cannot be generalised and do
not represent the general experiences of NHS mental health service provider
units in London or entire England. Nevertheless, the experiences of
organisational change of North West London Mental Health NHS Trust and
the service users are, perhaps, not unique in the National Health Service.

Top and senior managers of other NHS health care provider units who read
this report might learn from the experiences of NWL Trust, reflect upon
their own experiences and take the most appropriate action to improve the
performance and quality of health care delivery by their organisations.

Date of Award	1996
Original language	English
Awarding Institution	Aston University