Evidence-based organisation design in health care

Is NHS reorganisation always necessary? This report reappraises research on organisational change.


Published: 01/09/2000

ISBN: 1902089499

Download the report [PDF 194.7KB]

This essay is second in the Maureen Dixon essay series on health service organisation.

The NHS is always reorganising itself. But is this necessary? There is a danger in this continuing process that past knowledge and experience is devalued or even forgotten entirely. A victim of this process has been the work undertaken by the Health Services Organisation Research Unit at Brunel University.

David Hands states that when so much importance is rightly attached to evidence-based practice, we should remember just how important was the work of Elliot Jaques and his colleagues. By detailed studies of the way the NHS worked, they established appropriate principles on which to build effective organisational structures. As David Hands says, ' poor or inappropriate organisation or management will make the clinical contribution less effective'. This extended essay is a timely reappraisal of some of the most important organisational action research ever undertaken in the NHS.

Suggested citation

Hands D (2000) Evidence-based organisation design in health care. Research report. Nuffield Trust.