Using Mintzberg’s Configuration Model To Review

The Development Of Home Treatment Teams In Shropshire.

Gemma Styles and Julia Jones

Critical organisational theory

Critical organisational theory is concerned with how organisations function (Tsoukas, Knudsen 2003).

The analysis of potential problems (Thompson, McHugh 2009).

The concerns

There will be no coherence in the service offered across the four areas covered by the community dementia teams

That a broad strategy passed down from the commissioners may result in the expectations not being met

That increased complexity and hence input/hours with individual clients may adversely affect activity recording, this data is used by the commissioners to allocate funding resources

The professional organisation

The professional organisation:professionalism is key and strategy requires individual or group learning

Professional teams are characterised by being led by highly trained professionals, who provide largely standardised work. These professionals can work independently, show loyalty to their profession and strategy tends to be that of an emergent kind, as group or individual learning is the preferred method of strategy formation.

The diversified organisation

This is a large collection of individual professional teams bound together by shared administration, training and leadership teams.

the majority of the people at the operating core would be described as health professionals

The political organisation

The political organisation. An organisation that has to respond to conflicts, forces (political or business) and forms its strategy based in the power school (Mintzberg 2011a).The commissioning body can be described in this way.

The first concern

That there will be no coherence in the service offered across the four areas covered by the community dementia teams.

The differences are predominately pertaining to geography, commissioning and resources rather than ethos.

What is home treatmentMedication management

Positive risk taking

Support with attending appointments

Promoting social inclusion

Arranging and completing parts of physical health checks

Liaising with family members, other professionals and other agencies

Relieving carer stress

Education

Signposting

Flexible Working

How the team behaved

used words such as ‘evolved’ and ‘intuition’ in order to describe the development of the service. This demonstrates that they have all developed an emergent strategy.

The Teams are learning from themselves and other professionals around them by reading up on current evidence and benchmarking against other teams (Guven-Uslu 2005).

Mintzberg describes professional teams as being more loyal to their profession than to the company

The second concern

That a broad strategy passed down from the commissioners may result in expectations not being met.

“Are we doing it right”

How the commissioners behaved

a political organisation that provides broad overarching deliberate strategy

that the expectation of emergent strategy is not communicated.

However what could be seen as lack of guidance from commissioners could alternatively be described as professional respect.

a Foundation NHS trust has the ability to decide on its own strategy (Davies 2012)

confidence

The Teams display a lack of confidence in their own abilities to make strategic decisions

All showed a sense of relief to learn others had developed similar services

This indicates the issue of leadership

Leadership

Mintzberg states that management and leadership should not be separate (Mintzberg, Ahlstrand et al. 2010

the Francis report recommends that leadership is taught at every level of the Trust from the operating core upwards (Francis 2013).

The third concern

That increased complexity and hence input/hours with individual clients may adversely affect activity recording, this data is used by the commissioners to allocate funding resources

Recording activity in terms of contacts with patients made by staff originates with the Department Of Health. The NHS as a whole records contact with one million patients every 36 hours in England alone (Davies 2012).

Outside the model

Mintzberg collected data on what managers do with their time first in 1973 and later, in ‘managing’ (Mintzberg 2011a).

He recorded that managers worked at an unrelenting pace and that time is spent doing a number of brief, varied activities in an environment where they are constantly interrupted.

This description could also apply to the case load work of home treatment staff (Jarvis 2005).

Further learning

How can The Trust develop a stronger corporate image so that the members of the different professional teams show loyalty to the Trust as well as to their own professional bodies?

How can The Trust and the Commissioners communicate that emergent strategy is what they require and promote this as positive?

How can Team management support staff and allow them to grow in confidence in the area of developing strategy and services?

More Details

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