The organizational implications of the role NHS Service Managers played in the quality process in the mid-1990s

AIM: It is the intention of this paper to highlight the problems associated with the organizational implications of the role NHS Service Managers (SMs) played in the quality process of the mid-1990s. BACKGROUND: To provide quality care all staff must be committed and involved, in this study it appeared that few SMs played a part in the process. METHODS: Semistructured taped interviews were conducted with 33 SMs and three Chief Executives in seven Trusts. As part of a study they were asked the role SMs played in quality in their clinical directorate. The data was transcribed and analysed in a content-analysis approach. FINDINGS: Quality of care was not the SMs' primary objective. The role played by SMs was dependent on their background, experience and the organization in which they worked. Most Trusts' quality-control strategy was not standardized, co-ordinated or integrated, nor was the audit process regulated. For most, quality was seen as synonymous with professions, managers from a non-professional background found the monitoring of the quality of performance inherently difficult. Only one Trust (the most successful) appeared to undertake organizational learning, influenced by the philosophy of the Chief Executive.