title: Reluctant but resourceful middle managers: the case of nurses in the NHS.
abstract: This study counters the widely held view that middle managers have little to contribute to strategic change in health care organizations. In particular, it argues that middle managers with a nursing background that manage clinical activity should be involved in strategic change beyond mere implementation of decisions made by executive management. Constraints upon this are noted - the power of doctors and central government intervention - that means middle managers enact a semiautonomous strategic role. Antecedents for the semiautonomous role are investment in organization and management development, developing lateral organizational structures that allow middle managers to make a contribution to the development, as well as the implementation of strategy and allowing middle managers to interact with other stakeholders outside the confines of the organization.
authors.affiliation: Nottingham University Business School, Jubilee Campus, UK. graeme.currie@nottingham.ac.uk
authors.forename: Graeme
authors.initials: G
authors.lastname: Currie
mesh_terms: D006801:Humans; D007857:Leadership; D009718:Nurse Administrators; D009726:Nurses / Q000458:organization & administration*; D009741:Nursing Staff, Hospital / Q000458:organization & administration; D011209:Power, Psychological; D017149:Private Sector; D013222:State Medicine / Q000458:organization & administration*; D006113:United Kingdom