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This essay is going it focus mainly on the change of a wider strategy transformation in the NHS on human resources and the changes in quality and value. However, it will illustrate the understanding of teamwork, theories, power, leadership, culture and change. It will also identify the advantages and disadvantages of the NHS Trust in the UK hospitals and how it is beneficial to the society (Jerald and Robert, 2003,Behaviour in organisation).

Another aspect of this case study is on the basis of motivation and although this is an important aspect for job performance, along with ability. Motivation according to Mitchell in (Mullins 2005:471) defines motivation as “degree to which an individual wants and chooses to engage in certain specified behaviours”. In other words (Mullins 2005:471) people’s behaviour is determined by what motivates them. Their performance is a product of both ability level and motivation.

Looking into the size of the NHS Trust, it’s a medium-sized hospital where the management implements multi-skilled working. The approaches to management such as mechanistic organisation is an internal organisational structure in which people perform specialised jobs and authority vested in a few top-ranking officials (Tim, 2002). This can be seen in the number of employees in NHS Trust and as well as the management team such as the Deputy Director of Site Services and Hotel Services.

They brought about the changes in an organisational structure, which can modify rules, responsibilities, procedures and the effectiveness to manage change in the Trust. In the development of an organisation due to changes made, an organisation development program leads to improved organisation performance through an improved decision-making climate. This enables the employees’ benefit from the result of job enrichment and cooperative teamwork with its patients being kept in a good condition (Porter, et.

al). According to French and Bell (1992:614), organisational development is a long-range effort to improve an organisation’s problem solving and the renewal processes for effectiveness. It is also a planned process of change in an organisation’s culture through the utilization of behavioural science technology, research, and theory (Burke, 1992:614). Therefore teams can provide the way for linking employee performance targets to the factors critically as a success to the organisation.

(Mullins 2005:892) Power culture depends on a central power source with rays of influence from the central figure through out the organization. There is also a power culture present in the NHS between the managers and workers. Power is defined by Weber in (Wilson 1999:91) as the ability to get others to do what you want them to do, even if this is against their will. It is also defined specifically by Morgan in (Mullins 2005:843), who sees power as a medium through which conflicts of interest are ultimately resolved.

This has led to the struggle, which can be characterised, by competition and challenge. Power and control both play a major part in NHS Trust, the organisation has been driven by what Etzioni describes as coercive power which mean (Mullins 2005:844) “power that relies on the use of threats, or physical sanctions or force” from the foundation, when there was an influence over the decision of multi-skilling in the area of domestics that were divided into teams and how the supervisors designated their area of cleaning and other duties.

Luke’s (1974) portrays this as Radical face of power ‘ power reflects a dominant set of interests that is somehow imposed on the majority (Steven Lukes from Fincham ; Rhodes 2005,p. 561). Power has been a force in the NHS practices; this is illustrated through the proposals for change put forward by the management as it follows on to an interesting question, which will gain from theses changes? The staffs involved in this changes will gain from participating in different tasks, which enables them to undertake a full range of domestic and pottering role.

The NHS downside that were met amongst the porters and nursing staffs was based on Changes of task, shift and pay rise if their performance at work for this change is accomplished. This enables each individual to keep a record of job success so that the relationship between the organisational goal and actual performance is apparent (Hammer and Hammer, 1976). . These are the ethical issues raised when managers are provided with tools like authority designed to control subordinate (Gill and Anne-Marie, 2000).

It also presumes that the controller of behaviour which are the managers at work all have unquestioned control and authority (Gill and Anne-Marie, 2000). The disadvantage aspect of this improved programme is that, inconsiderable cost savings will occur since it would be difficult to track down porters and also allowing the porters power over nursing staffs come to an end in the NHS. However, the Finance Director, Steve Fountain (NHS Trust), argued that successful implementation would help to provide good value for money and make cost savings.

This can be brought about the alteration from the process of staffs working in NHS Trust, while their needs are not met equally even when changes have been made for the workers to be multi-skilled There are different views from the managers such as the shift changes in tasks and pay rise but some are supporting or opposing the facts of the multi-skilled workers taking up the various tasks given. Managers will also try to avoid making decisions with very long-term implications. Therefore, decision-making becomes an activity to solve pressure and not to discuss uncertainty avoidance like the long-term strategies (Cyert and March, 1963).

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