NHS Management: Living on the boundary between the self as unitary manager and the self as intersectional ‘me’.  Professor Nancy Harding (University of Bradford)

According to Prof Harding the notion of management was formally introduced into the NHS in the 1980s, following publication of the Griffiths Report.  The instigation of New Public Management, as this came to be known, was interpreted variously. A more confusing term also appeared in the discourse around management practices, namely “talent management”.  The succeeding quarter of a century has seen a legitimisation of the role of management in the NHS, an increase in the numbers of managers employed, and numerous attempts to improve the quality of managerial work. In all of this, the manager has been imagined to be a rational, logical, non-emotional, powerful and one-dimensional person.  Intersectionality theory would warn against such a presumption.

However, two interview-based studies of NHS managers suggest they move fluidly and unquestioningly between an identity or sense of self of a rational manager working within an organizational structure, and an identity or sense of self as fluid, emergent, irrational and with multiple identities. It seems that their position(s) as managers, colleagues, friends and workers all coincide with the various intersecting aspects of being a manager that does not always fit the often ‘faceless’ aspects of management theory.

The paper drew on these studies looking at the the aesthetics of leadership and the introduction of talent management into the NHS, to explore how managers can move between a subject position (‘the rational manager’) and a living, embodied sense of self that is not only separate and distinct from the self as manager, but also contradicts that managerial self.  Harding suggested that intersectionality theory challenges the presumption of theories of control and resistance that are highly influential in critical approaches to NHS management. Control and resistance are shown to require theories of categorisation that are confounded by the lived experience of working as a manager in the NHS.

On 8^th December 2010 members of the academic nursing team hosted a research event in Bridge House, whereby current students were invited to listen to presentations of staff research activity. John McKinnon delivered a presentation about his PhD whilst other team members presented posters and reports from recent research projects.

Graduates from both the BSc Nursing and the BSc Health and Social Care also came along to meet and chat informally with current students about the process of conducting and writing up their dissertations.

The evening was well attended and well received. Similar events are being planned for the future.

Jo Gilmartin argued that there is a growing number of morbidly obese patients who are seeking surgical solutions to there problems, such as bariatric surgery. Significant weight loss often leads to excessive skin, which leads to QoL problems, such as problems with pychosocial and physical functioning. This coupled with the immense pressures of being slender and beautiful for women and slender and healthy for men add to a complex context for people who have recieved surgical interventions. Even though more and more people are accessing what is known in the literature as ‘body contouring’, little is known about the QoL aspects of life after this surgery in the UK.

Whilst some literature report good outcomes in relation to a number of aspects of QoL, Gilmartin argued that these were often drawn from case notes, and questionnaires administered that may not capture the complexity of this particular patient group. This reporting may also have a asymmetrical power balnce going on, which distorts the actual picture of the actual outcomes.

Jo Gilmartin and her colleagues call for a more patient centred approach to this patient group in which more psychosocial apsects are captured in the QoL studies alongside a clearer healthcare pathway.

In order to do this, Gilmartin and colleagues are conducting a pilot study to

1. identify tools & procedures to inform a large scale multicentre study.

2. to identify QoL outcomes from body contouring following massive weight loss.

to find out more about this study please refer to the presentation slides attached:A Pilot Study-Body Contouring Jo Gilmartin