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Organisational development

Up to Additional Mental Health Information
November 28. 2011
Theresa Eynon

A handy quote from Harvard Business School's expert on organisational dynamics, Jeffrey Pfeffer:-

"Problems of performance and effectiveness are problems of power and politics - power imbalances, powerlessness and the inability of some groups to get their ideas or suggestions taken seriously.

These problems are more likely to occur in a setting....in which performance outcomes are difficult to assess at the organisational level"

When it comes to their future commissioning strategies, it seems that mental health services are still being asked to wait at home, with their feet in the ashes, while the Ugly Sisters of the big medical Trusts monopolise the young princes at the CCG.

We have heard the Government rhetoric - "No decision about me without me" - "No health without mental health".


We have seen the economic case put by David McDaid at the LSE.


and the King's Fund


I have heard local commissioning managers and public health consultants wail 'but we have all the evidence! Why is nobody listening?'

Good question.

Here is a paper that sketches out some of the landscape:-


It is not political rocket science. Strangely enough, innovations in mental health happen when there is a champion with a strong enough reason to overcome resistance.

Pfeffer points out that

"power and influence in organisations sometimes cause the development of a pathology in which information is either ignored or else sought in such a strategic focussed fashion that the process does not produce valid data."

He also reminds us that, "...innovation, adaptation and change almost always come from someone at least partly outside the mainstream'.

Whatever your opinion of Lansley's structural NHS reforms, he has certainly acted as a 'system disruptor', giving innovators an unparalleled opportunity to get their voices heard.

But, be quick. The clock is ticking, Cinderella. And, in real life, the Prince doesn't come looking for you. He marries your richer sister instead.



Pfeffer J (1992) Managing with power; politics and influence in organisations. Harvard Business School Press ISBN 0-87584-440-5

No health without mental health: a cross-government mental health outcomes strategy for people of all ages (2011) Department of Health http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_124058.pdf

Naylor C, Bell (2011) A Mental Health and the Productivity challenge: Improving quality and value for money. The King’s Fund http://www.kingsfund.org.uk/publications/mental_health_and.html

Knapp, Martin and McDaid, David and Parsonage, Michael (2011) Mental health promotion and prevention: the economic case. Personal Social Services Research Unit, London School of Economics and Political Science, London, UK d.mcdaid@lse.ac.uk">http://www2.lse.ac.uk/researchAndExpertise/Experts/d.mcdaid@lse.ac.uk

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