Perceptions of success within the NHS: “We’ve got a public who are convinced the NHS is absolutely bloody marvellous”

Hotchkiss, Keith (2022) Perceptions of success within the NHS: “We’ve got a public who are convinced the NHS is absolutely bloody marvellous”. Doctoral thesis, University of East Anglia.

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The concept, understanding, and determinants of success have not been explored in relation to the British National Health Service (NHS). This historical focus has instead been on effectiveness. While NHS effectiveness is routinely configured in respect of certain performance metrics, success is not something that is easily measured. Nonetheless, and as this research goes on to demonstrate, it is vitally important. Notably, and as one of the chief executives interviewed in this research quipped, the British public “are convinced that the NHS is absolutely bloody marvellous”. But does this necessarily translate to a broad and sustained perception that it is successful? In order to explore the elusive concept of success, in this research I adopted a social constructionist epistemology and qualitative methodology. I undertook comprehensive semi-structured interviews with NHS chief executives and chief executives of healthcare monitoring services. Notably, my findings reveal that the British government has no definition for, or formal means of evaluating, success in the NHS. The same is true of NHS England, NHS Improvement and the NHS leadership academy. When challenged, NHS Chief executives regard performance measurement targets as proxies for NHS success. Notably, the failure to meet these targets results in NHS chief executive dismissal. However, this staff turnover, rarely – if ever – transforms poorly performing hospitals. The purported institutional solution, then, to poor performance in the NHS is fundamentally ineffective. This thesis concludes that a broader understanding of and deliberate focus on success and how it is perceived (in place of a dogged preoccupation with performance metrics) may go some way to addressing this disconnect.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Social Sciences > Norwich Business School
Depositing User: Chris White
Date Deposited: 22 Feb 2023 09:42
Last Modified: 22 Feb 2023 09:42

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