Nursing power and practice in the United Kingdom National Health Service


Justin Keen Health Economics Research Group Brunel University, Uxbridge, Middlesex UB8 3PH, England.


Over the last decade the National Health Service (NHS) in the United Kingdom has experienced major organizational change Successive government initiatives designed to improve local management of hospitals have tended to marginalize nurses Resource Management, a major initiative, which is the model adopted in the NHS Review for hospital management for the 1990s, appeared initially to offer nurses an opportunity to influence decision-making directly In practice, nurses’ experiences of Resource Management were mixed This study of the six hospitals which piloted the introduction of Resource Management showed that nurses did not always grasp the opportunity to enhance their power and practice There was evidence from the study that the introduction of information technology curbed innovations in practice, and removed nurses from patient care delivery