| Summary: | In 1983 the National Health Service in England moved from a functional to a general
management philosophy. This fundamental change gained momentum with the
introduction of NHS Trusts in the early 1990s. Since this period, clinicians have
taken a greater role in the strategic leadership of their organisations.
This research considers the role of senior doctors (consultants) who have taken up a
strategic leadership role alongside their clinical role (role duality). This is a
qualitative study centred on the perceptions of individuals in this role in three NES
Trusts. A new understanding of the dual role is developed through a methodology
linked to frameworks from existing research. The role is viewed through a role theory
perspective and put into context by understanding existing research on the role itself
and relevant areas of the career, strategic leadership and management literatures. The
uniqueness of this research is to understand how individuals take up the challenge of
role duality; there is a need to comprehend how individuals perceive the clinical role
and the strategic leadership role in equal measure. This approach drives the
methodology and the design of interviews as the main source of data.
The findings are many with new insights and confirmation of some existing
understanding of how role duality is taken up and the differences and similarities
between the two main elements of the dual role.
The different approaches to taking up the dual role within and across the trusts are
seen as clustering around two dimensions, taking charge and managerial alignment.
Consequences of the different approaches range ftom a possibility of failure or being
ineffective, to a gradual development of the service and the development and delivery
of the organisation's strategy.
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