Published: 03/06/2004, Volume II4, No. 5908 Page 18 19

Tired of 'MBA in a weekend' books? Katy Gordon reviews a more worthy contribution to management theory

Management for Nurses and Health Professionals Theory into practice By Alistair Hewison Published by: Blackwell Science. ISBN: 0632064331.£19.99

This book was written with the specific intention of applying management theory directly to practice.

By developing a greater understanding about how our organisations work and how past problems have arisen, we should be able to become better, more effective managers.Well, That is the theory, anyway.

It is so refreshing to find a book that scratches beneath the surface and really tries to look at the whole perspective.We hear too much about organisational theories, management theories and facilitating change, and read in eminent journals about examples of good practice for us to emulate.

It is too easy to say that if one organisation or area has got it working well it must be translatable. There is so much local variation in how services are delivered, who delivers them and what training they have had, culture and organisational hierarchies, values, beliefs and attitudes.

The first chapter of Management for Nurses and Health Professionals looks at the history of management in the NHS and how in the early days of the service organisational changes led by government policy were incremental until the Griffiths report. This was a catalyst for more profound 'changes in thinking about healthcare generally and its management in particular'.

Following chapters take us through specific elements of management and management theory and the different components that need to be considered, starting with the theory of new public management.

Quality management and clinical governance provide a framework for continually improving service quality and how they need to be applied to deliver high standards of healthcare and service provision.

A central tenet to this is keeping three dimensions of quality at the forefront of how we deliver care: what clients and carers want from the service, led by their experiences of the service; that the service is delivered to meet national standards of the professional providers and that procedures and investigations are carried out correctly to meet the needs of the client; and third, that management makes the most efficient and productive use of resources.

Organisational culture is highly complex and the author looks at the origins and definition of culture.He presents three categories of the concept of culture and discusses these in relation to healthcare, showing the complexity of organisational culture and how beliefs, attitudes and values shape how people feel about the the organisation and their role within it. This can profoundly affect the effectiveness of the organisation.

Remaining chapters look at how middle management is perceived to be the level in an organisation where clinical leadership and hybrid management come together in increasingly significant roles, frequently as the panacea to all ills.Middle managers are often pressurised from above and below.

However, at this level there is often a mismatch of skills and experience as well as conflicting expectations.Hewison identifies the vital need to do further research into the role of middle managers as it is little understood, and yet increasingly significant.

This book provides insight into the various management and organisational theories and influences which impact on healthcare and the implications for healthcare professionals. It will enable managers to gain a broader perspective on delivering efficiency and quality in health services. It provides a toolkit for individuals to pick from to maximise their potential for effective management. It is certainly more worthy than the 'MBA in a weekend' type volumes.

However, if nothing else, Alistair Hewison's work should stimulate the debate around the translation of change, the understanding of culture and the ability for middle managers to actually influence work in an increasingly politicised and ever-changing environment.

Katy Gordon is an independent nurse consultant.