Mental Health Professionals' Experience of Organisational Change in the NHS

Abstract

A study was conducted to investigate mental health professionals’ experience of change in three NHS Trusts in England. The aim was to understand the professionals’ experience of change, applying the psychological contract as a sense-making tool using an extended contract model (Guest, 1998; George, 2009). The concept of the psychological contract was first introduced within psychoanalysis (Menninger, 1958) to explain the relationship between client and therapist. The psychological contract has evolved over the years to be applied in occupational settings to explain social exchanges between employees and the organisation (George, 2009). Semi-structured interviews were conducted with 15 mental health professionals from community NHS teams, with one participant from an inpatient ward. A hybrid thematic analysis using inductive and deductive coding was applied to capture both the theoretical framework of the psychological contract and the subjective experiences of the participants. Results revealed that the psychological contract could serve as both a cognitive and emotional sense-making tool of change for participants. Findings also revealed the influence of contextual political and social factors around change in the NHS. Novel findings included mediators in the change process such as participants feeling supported to negotiate psychological contracts and upholding personal and team values. The findings are discussed in terms of clinical implications for managing professionals’ experience of change in the NHS.