Navigating Responsibilities and Principles in the NHS Era


The Role of a Healthcare Manager in the NHS Setting

The role of healthcare manager is profound and magnificent as they oversee the health services offered by a particular department or a specific medical facility. Basically, they plan and coordinate the actions of medical staff inclusive of doctors, nurses and other healthcare providers. Since the establishment of the National Health Service (NHS), 1948, the roles of health managers have seen a dramatic upsurge. Primarily, the NHS was initiated to bring people together, such as the public and the staff, while working on a set of principles and values the NHS holds (Galloway, 2017). The set of principles and values is used to provide services to all people despite their gender, disability, age, sex, religion, and belief. Also, it allows access to patients for their clinical needs free of charge so everybody could have equal opportunities.


As part of the NHS organizational structure, healthcare managers must ensure the organization is running in the best way possible. This includes ensuring tasks carried out, including financial & human resources, to ensure it is adequate to support the organization's objective. A duty care manager has a lot of responsibilities when working in a provision of care. They carry out duties such as ensuring the patient's health and safety, employees, and other people accessing the services. Every healthcare professional worker is responsible for their own quality of professional practice, including the characteristics they hold should be in the highest care aspects. Working in good practice encourages individuals who work in a team to spread positive healthcare delivery outcomes (Galloway, 2017).

According to Thompson (2017), managers organize various tasks, and they also must make important decisions in working around the provision, both internal and external. These refer to boundaries outside the organization dealing with resources and activities that can considerably affect the organization.

Moreover, internal service management requires several activities such as staffing, budgeting, monitoring the quality of services, patient satisfaction, and financial performances. On the other hand, external service management includes new service development, community demographics/needs, accreditation, regulations, demands, managed care organizations. These must be in order sufficiently to keep the organization maintained.

Health care managers are specified in being in positions of power. They are the ones who shape an organization's development. Organizations have been developed to achieve goals. Managers are required to ensure the organization is running the best way possible by maintaining tasks that are being carried out to sew up financial & human resources since its adequate to support the organizations objective (Galloway, 2017)

Managers effectuate 6 management functions as they do their activities.

These include Planning:





Decision making

Conceptual skills

Technical skills

Interpersonal skills

The function of an organization is complex and dynamic thus requires the intervention of managers to provide leadership for change. Hence, the organization accomplishes its goals; therefore, when tasks are carried out, such as meeting the financial & human resources, leadership would give adequate support (Galloway, 2017).

The NHS leadership Academy came into action to encourage managers to take the lead in changes as it makes a huge difference in care delivery. It allows employees to act & work differently, sharing the vision, and engaging with the team, for example, by having a positive attitude. Leadership should be demonstrated by every healthcare worker focusing on the needs and preferences of patients. It should be their utmost priority to achieve quality care (Galloway, 2017). However, Leadership is usually the indication that a manager has to recognize effective leaders' personal characteristics from their inspiring behaviors to meet patients' positive patient outcomes.

Leadership and management are required for qualified healthcare professionals regardless of what positions they hold. It is an essential skill for everyday practice in delivering care and bringing in new development to lead change and management. According to Galloway (2017), the Health and Social Care Act 2012 is legislation that came into effect in 2013; it aims to improve and deliver healthcare whilst constructing refinement made from the past years. The duty care manager must have to progress knowledge of relevant information and current national priorities for health and social care (Galloway, 2017).


Mental health act

Data protection

Training to staff


All staff should be supervised

Managing change and innovation

Talk about poor leadership

Scenario 2: Explains How Organizational Structure Impacts Organizational Culture

The interrelation between organizational structure and organizational culture has been studied and detailed by several scholars. For instance, studies have found that the size of the organization matters (Felipe et al., 2017). Notably, an organizational culture develops around the organizational structure. Consequently, a culture change can cause a change in the structure of the organization. According to Felipe et al. (2017), various aspects of an organizational culture are impacted on by the organizational structure.

Studies have found out that a change in structure can either improve or deteriorate the performance of an organization (Eniola et al., 2019). The organizational structure shows the leader and the different individual interactions and their consequent impact on the performance of an organization. Also, organizational structure has been linked to impact on the effectiveness of communication within an organization. For instance, the organizational structure determines how information flows between levels within the company (Eniola et al., 2019).

According to Felipe et al. (2017), in a centralized structure, decisions flow from the top down, while in a decentralized structure, decision-making power is distributed among various levels of the organization. The organizational structure of a business can change, though this becomes harder as a business expands. Besides, organizational structure equally influences the perceptions of individuals within an organization (Felipe et al., 2017).

Social enterprises emphasize the social effect that defines and manages the services they offer. In contrast, they are such organizations that operate for social benefits and are responsible for their staff and local communities (Felipe et al., 2017). To do this, the social enterprise provides more public services, which can be established as an efficient guardian of the UK's health services. In the new health and social care, the social enterprise sector may take on a substantial role in delivering services, such as the social workers who run the social enterprise.

Just as the previous definition, organizational structure is a system that outlines how certain activities such as rules, roles, and responsibilities are directed to achieve the goals of an organization (Felipe et al., 2017). Relative to the decentralized organizational structure, the hierarchical structure is the most popular organization model in business. In this structure, employees are ranked either vertically or horizontally within the organization. There are a few factors related to this model, for example, a functional, employees are ranged by the function they provide. Flat structures only have a few management layers and a significantly wider control management span than any other organization to improve coordination and improvement (Felipe et al., 2017)

According to Felipe et al. the NHS is for everyone and works together to bring clear improvements to communities with health and social care needs (2017). Integrated care services have been officially developed since 2018; the NHS enabled local councils, NHS organizations, and other forces to plan and provide residents with health care needs (Felipe et al., 2017). Integrated care partnerships are in association with NHS providers working together by acknowledging corporate rather than competing; these service providers include hospitals, community services, mental health services, and GP'S.

According to Christensen (2019), organizational culture is shaped by certain characteristics that are crucial to formulating successful Interproffesional teamwork that demonstrates the different work quality when working amongst other multi-disciplinary teams. The shared values, beliefs, or perceptions that interact within an organizational culture forms the basis of teamwork that is essential to the success of an organization. . Bringing people together allows underlying assumptions and beliefs to mix in the social and psychological aspect (Christensen, 2019).

Organizational culture is based on the structure because in a hierarchical structure, communication is limited, and credibility is based on employment status, not life experience (Morgeson et al., 2017). In contrast, employees have more freedom in a flat structure. It encourages an easier decision-making process among employees. Both structure and the culture in an organization are very much different. If the small hierarchical GP surgery joins a flat structure social enterprise, there will be many clashes (Morgeson et al., 2017). The culture of both organizations will be affected drastically. One structure has a systematic flow and hierarchy of command, whereas another has freedom of work and more equality. The debate will begin whether to continue a hierarchical structure or a flat one. The most difficult part will be the adaptation of the structure (Morgeson et al., 2017). Small hierarchical surgery and flat structure social enterprise won't be able to adapt to each other's culture as both are completely different, and this will cause a lot of conflict in management.

Scenario 3 Present Different Organizational Structures in Business, Health, and Social Care Organization

The organizational structure is the system that defines the hierarchy within an organization. Ultimately, the organization structure determines the success of the organization (de Kinderen & Kaczmarek, 2020). Basically, the organizational structure determines each duty, its role and where it reports to within the organization. The rationale for developing a structure is thus to establish how the organization operates to execute its goals. There are many types of organizational structures that are distinct for different fields like business, health, and social care organizations (de Kinderen & Kaczmarek, 2020). Amongst these organizational structures are inclusive of the functional structure which is little bit traditional, the divisional structure, the matrix structure and the flatarchy structure. All of these structures possess distinct strengths and limitations.

For the functional structure, it categorizes the organization into departments based on their function (de Kinderen & Kaczmarek, 2020). A functional manager directs each employee, and employees are grouped as per their role. Besides, the managers have experience in the roles they supervise. This ensures that employees are using their skills effectively (de Kinderen & Kaczmarek, 2020). Employees are positioned according to their function in this structure. Some of the advantages of the functional organizational structure are as follows:

  • The team is managed by an experienced person with a high ability and skills to understand and review the entire work adequately.
  • The team members work with other people in the field, and it allows the sharing of thoughts and knowledge to make the people learn new skills.
  • Workers with specialized skills can perform tasks quickly, efficiently, and more confidently while reducing work-related mistakes.
  • This can be an ideal structure for small businesses that focus on one product or service because you can maximize performance by encouraging peer cooperation among different units at various management levels through supervision and coordination.
  • The functional organization may have unhealthy competition working with the other areas. There may be a lack of understanding as to how significant that specific are to the company.
  • The people in the functional organization are grouped according to their special set of skills, roles, or task so that the entire team will operate well. However, the business strategies and the level of bureaucracy make it difficult to respond to changes immediately.
  • When a company uses this type of structure, it groups its people according to their knowledge and skills, which help them, become specialists in that field.
  • There could be a lack of unit coordination. This means that though the functional units can perform with a higher level of efficiency; however, there could be difficulty working well with each other; thus, cooperation is compromised (Christensen, 2019).
Matrix or Team-based Structure
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A matrix organizational structure is a workplace format in which employees report to two or more managers rather than one manager overseeing every project aspect (de Kinderen & Kaczmarek, 2020). For example, an employee may have a primary manager they report to and one or more project managers they work under. This type of structure is often useful when skills need to be shared across departments to complete a task and allow companies to utilize a wide range of talents and strengths. According to Christensen, (2019), some of the advantages of this organizational structure are as follows:

  • A matrix organizational structure allows multiple departments to communicate and collaborate on a project easily. Because employees answer to multiple managers instead of just the functional manager, issues are resolved more quickly, and company-wide interaction is increased.
  • In a matrix organizational structure, employees have much more autonomy and input in projects. This type of structure encourages employee contribution and places a higher value on workers' point of view. Increased teamwork: In a matrix organization, employees work across multiple projects and various departments. This increases employee interaction and promotes a better sense of teamwork.
  • This type of structure allows resources to be maximized because of how equipment and employees are shared across projects. A matrix structure also allows project managers to work in their expertise rather than being pulled across multiple projects, boosting the overall contribution of their talents.
  • Some of the disadvantages of this organizational structure are as follows:

  • It could cause workers to become conflicted between managers and projects. Also, because there are multiple managers in charge, there is the potential for inconsistent managing directives among teams.
  • Matrix organizational structures employ two or more managers that employees answer to. This can cause several potential challenges, including confusion about which the supervisor is, undefined responsibilities among managers, and managers' possibility of opposing each other's decisions.
  • Oftentimes in a matrix organizational structure, employees are assigned to multiple tasks across a few projects (Christensen, 2019).
Service Line Management Structure

Service line management structure can simply be defined as a modern organizational structure strategy for resource planning and allocation for any business size (de Kinderen & Kaczmarek, 2020). Typically, traditional organizational structure models are more vertically aligned -- think of an employee who has several bosses in the hierarchical ladder before being directly under the company's owner or president (de Kinderen & Kaczmarek, 2020). Conversely, service lines follow a more horizontal continuum approach, where the company is strategically segmented into more manageable departments. The service line approach tends to focus more on customers' requirements, which often results in noticeable increases in the customer satisfaction rate. Some of the advantages of this model are as follows:

  • Service line management provides a vehicle to focus the attention of multiple discrete departments into a singular clinical program that can achieve a higher level of performance in three distinct areas:
  • Improving the patient's experience of care
  • Improving the health of patients
  • Reducing the cost of providing excellent
  • The service line model for clinical specialties can provide many benefits through its integrated design and focus.
  • To receive the full benefits of this model, however, hospitals need to create a management structure that fosters independent innovation and alignment with the hospital's strategic plan.
  • Some of the disadvantages of service line management structure are as follows:

  • Hospitals and clinical organizations should consider service line management only if a strategic commitment exists to coordinate patient populations' service delivery; otherwise, this model won't benefit the organization.
  • The commitment to develop a service line is economically and operationally realistic only when the target patient population is large enough to sustain the investment.
  • In some hospitals, service lines are organized around clinical inventions such as radiology or surgery. However, service line should be built around patient populations with similar needs, rather than services offered. These areas may be better thought of as patient care processes that need to be organized, rather than service lines.

In this organizational structure, a manager is appointed to head a specific clinical service line and has responsibility and accountability for staffing, resource acquisition, budget, and financial control associated with the array of services provided under the service line. This model's benefits are lower costs, higher quality of care, and greater patient satisfaction compared to other management models.


Health care managers have a great role in National Health Service. Form the paper,

All three scenarios were found to be linked to healthcare or the medical industry. Some of the common roles of healthcare managers have been discussed. Besides, the paper has detailed the impacts of organizational structure on organizational culture. Some of the organizational structures used in health and social care organizations, and the relation between organizational structure and culture. The various categories of organizational structures have been discussed in the paper. Also, their advantages and disadvantages have also been alighted. The paper is thus a sure step in the quest to understand the roles of health care managers and the interrelation between the organizational structure and culture. Further research on the field is necessary to magnify the understanding of the same.


Christensen, T. (2019). Organization theory and public administration. In Oxford Research Encyclopedia of Politics.

de Kinderen, S., & Kaczmarek-Heß, M. (2020). On model-based analysis of organizational structures: an assessment of current modeling approaches and application of multi-level modeling in support of design and analysis of organizational structures. Software and Systems Modeling, 19(2), 313-343.

Eniola, A. A., Olorunleke, G. K., Akintimehin, O. O., Ojeka, J. D., & Oyetunji, B. (2019). The impact of organizational culture on total quality management in SMEs in Nigeria. Heliyon, 5(8), e02293.

Felipe, C. M., Roldán, J. L., & Leal-Rodríguez, A. L. (2017). Impact of organizational culture values on organizational agility. Sustainability, 9(12), 2354.

Galloway, N. (2017). How effective is English as a medium of instruction (EMI).

Kassem, R., Ajmal, M., Gunasekaran, A., & Helo, P. (2019). Assessing the impact of organizational culture on achieving business excellence with a moderating role of ICT. Benchmarking: An International Journal.

Morgeson, F. P., Aguinis, H., & Ashford, S. J. (Eds.). (2017). Annual Review of Organizational Psychology and Organizational Behavior. Annual Reviews.

Salmond, S. W., & Echevarria, M. (2017). Healthcare transformation and changing roles for nursing. Orthopedic nursing, 36(1), 12.

Zeyada, M. (2018). Organizational culture and its impact on organizational citizenship behavior. International Journal of Academic Research in Business and Social Sciences, 8(3), 418-429.

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