Anne McBride and Paula Hyde
Healthcare delivery relies upon the ability of healthcare organisations to train and develop, then deploy, manage and engage their workforce. Challenges to healthcare managers are demonstrated through difficulties involved in getting good staff to provide high quality services as efficiently as possible. These challenges remain critical to healthcare management as significant staff shortages are predicted, exacerbated by increasing demand for services. Managers around the world, therefore, share a common desire to manage people in ways that enable the workforce to perform at their best.
There is a range of approaches to managing the healthcare workforce for high(er) performance. In the UK, two streams of activity are evident: the first focuses on making the NHS a 'good employer' thereby recruiting and retaining 'good staff, which could be called human resource (HR) management; the second approach concerns rethinking how to provide 'high quality services' as 'efficiently' as possible, which could be called 'different ways of working'. Such approaches are often referred to as 'modernisation (see Bach 2002). However, Seifert and Sibley s argument that '[modernisation] is not a neutral step forward but a highly coloured version of progress rooted in market-style efficiency' (2005: 226) indicates the contentious nature of such terminology. 'Different ways of working is an attempt to avoid value judgements on the process and outcome of the different ways of working for employees, employers and service users. Given that the UK NHS is the third largest employer in the world, employing 1.3 million staff in 2004, it provides a useful case study to illustrate the processes, outcomes and questions raised by both streams of work.
The chapter begins by outlining characteristics of the healthcare workforce in the UK and the challenges raised for managers. Against this background, the chapter reviews the rationales put forward for HR management and different ways of working, providing recent UK examples of both types of initiatives. The authors then use the Changing Workforce