Unfinished business : a study of how middle managers with nursing and accountancy backgrounds manage identity in changing UK health care

People need to maintain or adopt identities that enable them to feel comfortable within the social structures that make up their world.
However, frequent organisational change makes this self
management project increasingly difficult, particularly for the middle manager who is neither a worker nor an executive but moves between a plurality of organisational positions. This thesis takes a social constructionist interpretation of reality and links this to hegemonic power relations in order to provide some insights into the management of identity.

In order to test out this theoretical approach, the empirical work for the thesis was set in one NHS trust and one private health care/insurance company. The study was about middle managers who were also professionals, with a nursing or an accountancy background. The results showed that these managers were able to exercise choice on the identities adopted from amongst a number available to them. The structural organisational features of the private company were more constraining than the NHS trust while the
preferred personal styles of the managers were also influential on how identity was managed. Articulations between ideological clusters were important in forming group alliances that protected identities. There were hints that the current hegemonic groupings of male, old managerialist and old professional identities were being
undermined by the development of updated maternal identities and the growth of a new entrepreneurial managerialism.

Conclusions suggest that a focus on ideological alliances is useful in adding to the literature on identity management in times of change.
A hegemonic perspective explains not only how current alliances preserve threatened identities but also how the development of new alliances can better serve the interests of many middle managers in their search for secure identities. In this way, Berger and Luckman's theoretical approach to identity is strengthened.

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