dissertation proposal draft 5

Title - To be or not to be

An investigation/evaluation of change management

implications in developing into social enterprise from a

public sector organisation

Name - Damian Aston

Assignment - Dissertation Proposal

Course - MBA Business Administration

Date June 16 th 2010

Damian Aston 4/10/20231

Contents

1 Aims and Objectives

2 Background

3 Literature Review

4 Methodology

5 Ethnical issues

6 Data Handling

7 Timescale


1, Aim

To evaluate the implications of changing a public sector organisation (NHS)

into a third sector organisation (social enterprise) through the Right to request

process.

Objectives

To research the potential change management issues within NHS Oldham

Community Health Development Team into becoming a Social Enterprise.

Analyse and conclude the findings of the investigation.

Analyse and evaluate the various change management models, which may

facilitate change from a public sector organisation (NHS) into a third sector

organisation (social enterprise)

Questions

1. What are the issues public sectors NHS staff have in transforming into a social

enterprise?

2. Which relevant Change Management models will facilitate change within public

sector NHS staff into a social enterprise?

3. How would appropriate ‘Change Management’ models be implemented within the

NHS Staff

2, Background

2.1, National

In January 2006 the Government’s white paper ‘Our health, Our care, Our say’ ‘a

new direction for community services’ set out plans for a major shift in the way in

which care is delivered in England. It argued for services to be more personalised to

the needs of the individual, increased choices and more integrated services,

provided by a range of different organisations, including social enterprises.

Most recently the ‘High Quality Care For All: NHS Next Stage Review Final Report

2008’ and the Primary and Community Care Strategy set out a vision for this change,

stating the need to empower staff and give patients greater choice.

The NHS Next Stage Review includes a number of recommendations that present

huge opportunities for new and existing social enterprises.


The most significant of these is the recommendations to create new Social

Enterprises to deliver primary and community services, and the commitment that

staff are given the ‘right to request’ from their PCT to enable them to set up a social

enterprise. This allows NHS staff to explore setting up a social enterprise if they

believe that this could provide them with the independence, flexibility and

responsiveness to innovate and improve services and outcomes for patients.

Establishing the ‘right to request’ is a good example of the principle of subsidiary –

the idea that decisions about services should be taken at a local level – which is

central to the Next Stage Review. It is clear that NHS staff have a good

understanding of patient needs and how to meet them. Through the creation of

social enterprises, staff will be enabled to set up and lead new organisations that can

both empower staff and improve services to patients and users. This is intended to

create the conditions where NHS staff can innovate and lead rather than being told

what to do.

This commitment is underpinned by:

The ability for NHS staff that is transferred to social enterprises, with

the appropriate legal form, to retain their membership of the NHS Pension

Scheme while they work on NHS funded services.

The commitment to receive professional advice and guidance.

The offer of an uncontested contract.

Under these proposals PCTs contracting with new social enterprises will aim to

secure service quality and value for money, while also aiming to build their

sustainability and ensuring their long-term certainty.

2.2, Community Health Development Team

The research will analyse the organisational and cultural change the staff within NHS

Oldham’s Community Health Development Team and related staff will need to

change to successfully move into a third sector environment using the Right to

Request process.

The Community Health Team is an innovative, enthusiastic team of professionals

that include one lead, 3 supervisors, 6.5 wte Community workers and 5.8 wte

Community Food Workers and administration support with running costs of approx


600K a year. As a Community Health Team they have developed an innovative

approach in the delivery against these themes, this is evidenced by the team

successfully meeting and overachieving our NHS commissioned output/come targets

and the extensive external funding portfolio the team has developed.

3.Literature review

A list of key theories and concepts will be defined through research and referencing

from general management texts and a review of articles, books and journals that

address cultural and change management.

3.1 Literature review – change management

‘There is little question that the intellectual father of contemporary theories of applied

behavioural science, action research and planned change is Kurt Lewin. His seminal

work on leadership style and the experiments on planned change that took place in

World War II in an effort to change consumer behaviour launched a whole

generation of research in-group dynamics and the implementation of change

programmes’

Edgar Schien (1988)

Action Research was a term coined by Kurt Lewin in (1946) in an article entitled’

Action Research and Minority Problems’. The article was originally conceived as a

collective approach to solving important social problems such as racial and religious

prejudice; it rapidly began to be applied mainly to organisational problems.

Therefore in organisational terms a Action Research project would usually comprise

of three distinct groups: the organisation (one of the senior managers from the

organisation), the subject (people from the area where the change is taking place)

and the change agent( a consultant who may or may not be a member of the

organisation). These three entities form the learning group in which the

organisation’s change can take place.


One of the barriers in successful organisational change through Action Research is

that you need buy in from both those who manage the organisation and those who

are subject to change. This becomes especially difficult with large organisations such

as the NHS, therefore a key strategy would be to have a top down approach. This

does not always work, as compliance at the top does not always mean cooperation

at other levels within the organisation. (Clarke 1972)

Cooperation is not enough, there needs to a felt-need as Lewin term it. Felt-need is

when an individual’s inner realisation accepts that change is needed and necessary.

If Felt-Need is low within the organisation then change becomes problematic. Even

if change is accepted it doesn’t mean that anxieties about change have altered. This

can be particularly so when there is a close relationship between personal identity,

position at work and social standing, which may threatened by the proposed change

(Bennis 1966)

Kurt improved upon the Action Research model by developing the Three Step

Change model (1947a 228-9). Lewin believed for successful change to place

involves three steps which involves Unfreezing the present level, Moving to the new

level and Refreezing the new level

This three step change model recognises that before new behaviour can be adopted,

the old has to be discarded. With the old behaviour being discarded the new

behaviour can be accepted. Yet again this model stresses the need to understand

the importance of Felt-Need, with the old way discarded ‘unfreezing’ and the

‘moving’ to the new, can result in personal anxieties. Rubin (1967) suggested that a

re-education process or some confrontation meeting for those involved would ease

the change from Unfreezing to moving.

The research will also look into the expansion of Lewins three step change model

into Lippitt et (1958) seven phase model of planned change and Cummings and

Huse eight phase model. Finally Bullock and Batten four phase model of planned

change, which is based on a review, and synthesis of over thirty models of planned

change.


3.2 Literature review – Organisational Change

Brown (1995: 6-7) estimated that there are literally hundreds of definitions of culture.

Such as

‘Culture…is a pattern of beliefs and expectations shared by the organisations

members. These beliefs and expectations produce norms powerfully shape the

behaviour of individuals and groups in the organisation.’

(Schwartz and Davies 1981)

Elbridge and Crombie definition is the one must widely accepted as defining

organisational culture which ‘to the unique configuration of norms, values, beliefs

ways of having and so on, that characterise the manner in which groups and

individuals combine to get things done’ (Elbridge and Crombie 1974)

The literature review will examine organisational cultural change management

concepts and theories. The literature review will take into account writers such as

Allen and Kraft (1982), Deal and Kennedy (1982) and above all Peters and

Waterman (1982)

The literature will examine models of cultural change, including a survey carried out

by Dobson (1988) on the thousand largest private and public sector organisations in

the UK, revealed that 250 of them had been involved in a culture change programme

within the previous 5 years. Based on this survey, Dobson states that the

organisations sought to change the culture within their organisations through shaping

beliefs, values and attitudes of employees. Based off this survey on these

companies Dobson identified a four step approach to culture change.

Cummings and Hues (1989) identified an approach, which takes, into consideration

change in a strategic context, also Peters and Waterman (1982) eight steps to

excellence that takes a very prescriptive line. Finally, Egan’s (1994) article on how to

identify and change organisational culture.

There will also be a literature review on research and studies which the NHS has

undertaken on Service Delivery, Organisation Research and development

programmes. This review will include ‘Organisational Change’ which is a review for


health care managers, professionals and researchers, on making Informed decisions

on change management.

4. Methodology

4.1 Introduction

The specific empirical research will relate to the research objectives on change and

cultural management within NHS Oldham Community Health Development Team

into becoming a Social Enterprise. The literature review has revealed the current

amount of studies and work carried on both cultural and organisational change. This

research offers an opportunity to examine the impact of cultural and organisational

change directly a specific team place, which is placed within a large public sector.

4.2 Research Strategy

Through the research of the appropriate literature on cultural and organisational

change there was not any empirical research from the employee prospective,

therefore this research will carry out qualitative interpretative (phenomenological)

methods of research. Interpretative research will give the sample group (Community

Health Development Team) the opportunity to present a variety of different views on

the change in organisation structure and the change it the work environments

culture.

4.3 Sampling

The sample was purposefully selected (Patton 1990) from within Community Health

development Team. The staff who will be selected will represent the team has a

whole age, gender ethnicity and service. Table 1 below identifies a typology of

other sampling strategies, appropriate for qualitative enquiry, which were considered.

Table 1 Typology of sampling strategies

Type of Sampling Purpose

Maximum variation Documents diverse variations and identifies important common

patterns

Homogenous Focuses, reduces, simplifies, facilitates group interviewing

Critical case Permits logical generalisation and maximum application of


information to other cases

Theory-based Finding examples of a theoretical construct and thereby elaborate

and examine it

Confirming and

disconfirming cases

Elaborating initial analysis, seeking exceptions, looking for

variation

Snowball or chain Identifies cases of interest from people who know people who

know what cases are information rich.

Extreme or deviant

case

Learning from highly unusual manifestations of the phenomenon

of interest

Typical case Highlights what is normal or average

Intensity Information rich cases that manifest the phenomenon intensely,

but not extremely

Politically important

cases

Attracts desired attention or avoids attracting undesired attention

Random purposeful Adds credibility to sample when potential purposeful sample is

too large.

Stratified purposeful Illustrates sub groups; facilitates comparisons

Criterion All cases that are meet some criterion; useful for quality

assurance

Opportunistic Following new leads; taking advantage of the unexpected.

Combination or

mixed

Triangulation, flexibility, meets multiple interests and needs

Convenience Saves time, money and effort, but at expense of information and

credibility

(Source: Kuxel, 1992)


The sampling strategy will be aimed to achieve a range of perspectives in relation to

gender and race. This favoured a ‘maximum variation strategy’, which includes the

views of the ‘powerful as well the disenfranchised’. However, compromise is

inevitable due to limitations of time and resource thus the resulting strategy

combined the idealism of the ‘maximum variation’ strategy and the pragmatism of a

‘convenience’ strategy (Kuzel, 1992). The staff to be interviewed will be one male,

one female and a staff member from a minority ethnic origin to ensure the broadest

range of perspectives.

4.4 Data collection

To triangulate results the data collection will include more than one technique to

collate results. Triangulation is particularly useful in qualitative research, as it

achieves a more rounded picture of ‘thick description’ of what you are looking at

(Geertz 1973). The triangulation of data collation will include, Strategic Health

Authority (SHA) Social Enterprise support adviser, staff within the Community Health

Development Team and the literature review.

The other reasons for using qualitative methods are described in Table 2 below:

Table 2 Reasons for deploying qualitative methods in this study

1 Qualitative research methods lend itself to questions which start with

how or what

2 Enables exploration of behaviour or of theory development

3 Enables a detailed view

4 The interaction of the researcher is easily identifiable and the personal

pronoun “I” is used

5 Sufficient time and resources for data collection and detailed analysis of

text information

6 Audiences are receptive to qualitative research

7 The researcher is an active learner in the process and seeks to tell the

story from the participants view rather than imposing their own view as


an expert.

(Source: Creswell, 1998)

The table below shows a range of qualitative methods that could have been

deployed instead of the semi structured interviews.

Table 3 Methods of Qualitative Research

Method Features Claim

Observation Extended periods of contact Understanding of ‘sub cultures’

Texts and

documents

Attention to organization

and use of such material

Understanding of language and

other sign systems

Interviews Relatively unstructured and

‘open ended’

Understanding ‘experience’

Audio and video

recording

Precise transcripts of

naturally occurring

interactions

Understanding how interaction

is organised.

(Source Silverman D, 2000)

Interviewing respondents seem to be the most appropriate method to explore

perceptions. The epistemological approach tends towards non-directive methods

e.g. semi-structured interviews, which are commonly used to explore understandings

(Willms et al, 1992).

Observation was ruled out as it is not possible to have extended periods of contact

and texts and documents would not have provided access to staff own experiences.

Semi structure interviews will be employed to collect the data; this will introduce a

degree of flexibility to the interview process. Semi structured interviews have a

limited number of pre arranged questions which will allow the interview to ebb and

flow. “Due emphasis [is given] to the meanings, experiences and views of all the

participants” (Pope & Mays, 1995 )


Qualitative interviewing using semi-structured questions, makes use of opened

questions to encourage meaningful responses (Patton 1990). The interviews will be

using open questions but with a recognition that open questions can prove difficult

for respondents to answer. Respondents might be tempted to give an answer that

either shows them in good light or which they think would please the interviewer.

There are a number of common problems with semi-structured interviews including

for example leading questions (Bynner & Stribley, 1988), which impact on the

trustworthiness and credibility of the data (Patton, 1990). This will be minimise by

providing a full transcripts and exploring researcher bias (Mays & Pope, 1995).

These and other issues are explored in full in the Critical Appraisal.

As the manager of the Community Health Development Team it would be good

practice for me to employ gate keepers to act as the interviewer, this we will ensure

impartiality, and allow the respondents to answer freely without the added pressure

of their manager being present.

4.5 Significance and Limitations

The limitations of the research will be that the staff will be from NHS organisations

and include a representative from the Strategic Health Authority (SHA), the two

members from the Senior Management Team and a sample of nine members from

the Community Health Development Team. Group sessions will also be employed to

allow respondents to discuss issues in different environments. The significance will

be that the results of the research will presented to the NHS National Social

Enterprise Dept, Oldham NHS Board and NHS colleges.

4.6 Framework for data analysis

The framework to analyse the research will be to produce a ‘Synthesis of the

research’ this will be achieved through producing the empirical research findings and

combining these findings with the literature review.

The empirical research findings will be analysed by ensuring that all audio taped

interviews are transcribe and verbatim. The analysis of interviews will be a

cumulative process and will tend to be dependant on the results from a number of

question responses. These responses can be combined with cross-referencing the


related literature review. To help focus the interviews in terms of reflecting the main

objectives of this research and ease the analysis of the interviews will be structured

according to the themes. These themes will reflect the overall aim and objectives in

this research and also echo main areas arising from the literature review.

The study will be analysed using Framework Analysis, which has been developed in

Britain specifically for applied, or policy relevant qualitative research where the

objectives have been set in advance (Ritchie and Spencer, 1994).

Table 4 Stages in Framework Analysis

Stages Actions

Familiarisation Immersion in data to list key ideas and

recurrent themes

Identifying the thematic framework Identifying key issues, concepts and themes to

produce a detailed index of the data

Indexing Applying the index systematically to the data

Charting Forming charts from the data which contain

distilled summaries of views and experiences

Mapping and interpretation The charts are used to define concepts and

map the range of phenomena to find

associations between themes with a view to

providing an explanation for the findings

(Adapted from Pope et al, 2000)

Stage 1 Familiarisation

The interviews will be taped and verbatim transcripts produced. This process will

involve listening to the tapes, reading the transcripts and listing the key ideas and

recurrent themes (Ritchie and Spencer, 1994). This process will enable the research

to gain an overview of the richness, depth and diversity of the data.


Stage 2 Identifying the Thematic Framework

Through the interview transcripts all the themes, issues and concepts will be

identified and the first index will be produced. This will be largely descriptive and

heavily rooted in a priori issues.

Stage 3 Indexing

A final index will be developed with multiple codes (Ritchie and Spencer 1994).

Which will systematically evidence each transcript.

Stage 4 Charting

The second stage will involve synthesising the coded data into charts, which will

develop the themes identified during the coding process.

Stage 5 Mapping and Interpretation

The charts will be analysed to identify concepts, map the range of phenomena and

to identify if there were associations between themes.

Two other strategies were also considered: analytic induction and grounded theory.

The first involved iterative interplay between data collection, analysis of cases to

compare against preset hypothesis. The second involves the discovery of theory

from data by generating categories from the data. Both methods involved multiple

trips back into the field until the hypothesis is proven or to retest emerging theory

(Bryman and Burgess, 1994). Because of time restraints there will be insufficient

time to undertake either of these approaches.

5. Ethnical Issues

The ethical issues in relation to this project are limited compared to covert research

where informed consent is not sought (Hornsbey-Smith, 1993). Participation in the

study will be voluntary and verbal consent will be obtained. The respondents

anomity will be protected by giving the respondents numbers (Crewell, 1998).

6. Data Handling

Interview tapes will be kept under lock and key until the end of the evaluation, at

which point they will be wiped clean. Paper transcripts will also be kept under lock

and key until the end of the evaluation, at which point they will be destroyed.


Individually identifiable data stored electronically will be password protected and

deleted at the end of the evaluation process.

7. Timescale

The table below outlines the timescale that the dissertation will take to complete

Table 5 timescale

Literature search June

Development of semi-structured questionnaire

July

Obtain ethical approval July

Submit Draft Literature to Supervisor July

Devise focus group questions and process July

Submit methods chapter to Supervisor August

Semi-structured interviews and focus groups to take place

August

Analyse transcript data September

Write up interview data as results chapter October

Submit draft results Chapter to Supervisor October

Submit draft Discussion Chapter to Supervisor

November

Final write up including proof reading bibliography and binding

November

References

Barbour, R. 2001, ‘Checklists for improving rigour in qualitative research: a case of

the tail wagging the dog?’ BMJ, vol. 322, pp. 1115-1117

Bell, H. 1987, Doing Your Research Project: A guide to first-time researchers in

Education and Social Science, Milton Keynes: Open University Press.


Bryman, A. & Burgess, B. 1984 (eds) Analyzing Qualitative Data, Routledge,

London,

Burnes, B. Managing Change. Pearson Educational Ltd 2004.

Creswell, J, 1998, ‘Designing a qualitative study’, in Qualitative Inquiry and

Research Design: choosing among five traditions, Sage, London, pp 13-26.

Creswell, J. 1998, ‘Five different qualitative studies, in Qualitative Inquiry and


Creswell, J. 1998, ‘Turning the story and conclusion’, in Qualitative Inquiry and


Dale & Shipman 1976

Denzin, N. K. 1994, ‘The art and politics of interpretation’, in Handbook of Qualitative

Research, eds N.K. Denzin & Y.S. Lincoln, Thousand Oaks: Sage, pp. 500-515.

Edenborough, R.1999, Effective Interviewing: a handbook of skills, techniques and

applications. Kogan Page Limited, London.

Eagly, A. H. & Carli, L.L. 1981, ‘Sex of researchers and sex-types communications

as determinants of sex differences in influenceability: a meta-analysis of social

influence studies’, Psychological Bulletin, vol. 90.

Koning K. De, & Martin, M. 1996, ‘Participatory research in health: setting the

context’, in Participatory Research in Health: issues and experiences, ZED Books,

London, pp 1-18

Dockery, G. 2000, ‘Participatory research: whose roles, whose responsibilities,’ in Research

and Inequality, (eds) C. Truman, D. Mertens & B. Humphries, UCL Press, London, pp.67-79.

Gergen, K.J. 1985, Social Psychology and the phoenix of unreality. In S. Koch & D.E. Leary

(Eds.), A Century of Psychology as Science, NY: McGraw-Hill, pp. 528-557.

Hornsby-Smith, M. 1993, ‘ Gaining access,’ in Researching Social Life, ed. N.

Gilbert, 1993 Sage Publications, London, pp. 52-66.

Long, A. 1996, ‘Health services research: a radical approach to cross the research and

development divide’, in Research and Development for the NHS: Evidence, evaluation and

effectiveness, eds M. Baker & S. Kirk, Radcliffe Medical Press Ltd, New York, pp 51-64.


Kuzel, A. 1992, ‘Sampling in qualitative inquiry’ in Doing Qualitative Research, eds B.F.

Crabtree, W.L.Miller, Sage Publications Ltd, Uk, pp. 31-44.

Loftland, J. 1971, Analysing Social Settings, Belmont, CA: Wadsworth.

Martin, M. 1966, Issues of power in the participatory research process, in Participatory

Research in Health: Issues and experiences, ZED Books, London, pp 82-86

Mason, J. 1996, ‘Sorting, organising and indexing qualitative data’, in Qualitative

Researching, Sage, London, pp 107-134

Marshal, C. & Rossman, G. 1989, Designing Qualitative Research, London, Sage

Moser 1993

Miles M & Huberman A (1984) Qualitiative Data Analysis: An expanded sourcebook, Sage,

London

Moser, C. A. & Kalton, G. 1988, ‘Question wording’, in Social Research: principles and

procedures, eds J. Bynner and K. M. Stribley, the Open University Press, Longman Group,

England.

Newell, R. 1993, ‘Questionnaires,’ in Researching Social Life, ed. N. Gilbert, Sage

Publications, London, pp. 94 –115.

Oakley, A. 1981, ‘Interviewing women: a contradiction in terms’, in Doing Feminist Research,

H. Roberts, (ed) London: Routledge and Kegan Paul.

Patton, M.Q. 1990, Qualitative Evaluation and Research Methods, 2nd edn, Sage

Publications, USA.

Pope C, Zieblan S and Mays N (2000) Analysing Qualitative data BMJ, 320 114-1

Ritchie, J. & Spencer, L. 1994, ‘Qualitative data analysis for applied policy research’, in

Analyzing Qualitative Data, eds A. Bryman & R.G. Burgess, Routledge, London and New

York, pp. 173 – 194.

Senior, B. Organisational Change. Pearson Educational Ltd. 2002

Silverman, D. 2000, ‘What is Qualitative Research?’ In, Doing Qualitative Research: A

Practical Handbook, D. Silverman, Sage, London, pp. 1-13.

Thornhill, A. Lewis, P. Millmore. Saunders, M. Managing Change. Pearson Educational Ltd.

2000.


Witkin, S.L. 1995, ‘Family Social Work: A critical constructionist perspective, Journal of

Family Social Work’, vol. 1 no. 1, pp 33-45.

Wenger, C. (ed) 1986, the Research Relationship: practice and policy in social policy

research, London: Allen and Unwin.

Wiseman, W. P. 1979, The research web, in Social Research: principles and procedures,

(eds) J. Bynner & K.M. Stribley, Longmon Group, Essex, England richness
