The implications for professional roles and occupational identities of an organisational change process in an NHS trust hospital

This thesis explores reactions to changing occupational roles and identities precipitated by a Business Process Re-engineering management change programme within a National Health Service setting. The thesis offers further understanding of the changing nature of professional roles and occupational identities within health care. Taking a qualitative approach, through the use of interviews and focus groups, the empirical core of the PhD examines professional employees' responses to changes in their own working practices. The main thrust of the argument is that work reorganisation that changes the role and scope of practice impacts on occupational identities. The empirical work demonstrates how the effects of change in working practice create a situation whereby there are clearly defined winners and losers within and between professions. This thesis links such a recognition with the multiplicity of interests and the complexities of professional occupational identities within health care. An added dimension is the extent to which disciplinary knowledge creates these professional roles and occupational identities. If health care professionalism is to be redefined there is a requirement for an agenda which addresses the issue of how knowledge and expertise are acquired.