Re‐Organizing Work Roles in Health Care: Evidence from the Implementation of Functional Flexibility
| Date | 01 June 2006 |
| DOI | http://doi.org/10.1111/j.1467-8551.2005.00473.x |
| Published date | 01 June 2006 |
Re-Organizing Work Roles in Health Care:
Evidence from the Implementation of
Functional Flexibility
Terry Desombre
*
, Clare Kelliher
w
, Fraser Macfarlane
*
and
Mustafa Ozbilgin
z
*
School of Management, University of Surrey, Guildford, GU2 7XH, UK,
w
Cranfield School of Management,
Cranfield University, Cranfield, MK43 0AL, UK,
z
School of Business and Management, Queen Mary,
University of London, Mile End Road, London, El 4NS, UK
Corresponding author e-mail: t.desombre@surrey.ac.uk
Functional flexibility has been advocated as a mechanism for improving efficiency and
service quality and is, it is argued, especially appropriate to service environments. In
recent years the UK public health service has been subject to an ongoing programme of
reform, designed to modernize the way in which health services are provided. A central
feature of the reform involves breaking down traditional boundaries and the re-
organization of work roles. This article is concerned with examining the implementation
of functional flexibility in three health-care settings. Case-study data are presented,
focusing on the responses of employees and managers to initiatives to work more
flexibly. For managers the implementation achieved efficiency gains and improvements
to service quality, in spite of some resistance from employees. For employees the
outcomes were more mixed. There was evidence of ‘humanization’ through greater job
variety, challenge and access to training, but there were also costs in terms of
intensification, role confusion and stress. The implications of these findings both for
understanding the issues raised by the use of functional flexibility and for the
implementation of policies in the NHS involving job redesign are discussed.
Introduction
This article is concerned with examining the
implementation of functional flexibility in three
health-care settings. Labour flexibility has been
advocated as a mechanism for improving orga-
nizational performance (Cordery, 1989; Crid-
land, 1997; Pinefield and Atkinson, 1988). The
re-organization of work and the redeployment of
staff associated with the implementation of
functional flexibility are likely to have significant
implications for the employees and managers
involved. To date there has been relatively little
empirical work examining how employees and
managers are affected. In recent years, health care
in the UK has been subject to an ongoing process
of change, designed to modernize the way that
the service is delivered. Many of these changes
have implications for the organization of work
and a number are specifically concerned with staff
working more flexibly. Few studies have exam-
ined the use of functional flexibility in health-care
contexts and as such there is a dearth of evidence
to inform the implementation of these changes.
The aim of this article, therefore, is twofold.
First, by reporting evidence from three case
studies we aim to make a contribution to
furthering understanding of the issues raised by
the implementation of functional flexibility.
Second, by considering the specific context of
the health-care environment we aim to shed some
light on the issues raised by the reforms currently
being undertaken in the UK National Health
Service (NHS) (Department of Health, 2001b).
British Journal of Management, Vol. 17, 139–151 (2006)
DOI: 10.1111/j.1467-8551.2005.00473.x
r2005 British Academy of Management
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