The Management Centre
yvette@managementcentre.co.uk
yvette@managementcentre.co.uk
The culture of any organisation grows organically but is usually driven by people and small p politics that create an environment where people thrive or merely survive. Culture remains a factor which management consultants have acknowledged is key to how successful an organisation’s strategy can be.
One of the key goals in organisational development in both business and the not for profit sector has been to find a way of creating cultures that are flexible and innovative and where individuals take responsibility for results – moving away from bureaucratic silos where formulaic approaches dominate.
The challenge is how to first describe the culture, and then challenge two is how to change it. There have been over the years a number of models developed to help map culture. One of the most powerful and effective models however is the one developed by two UK academics Johnson and Scholes. This model is called the cultural web, and it’s the one we use most commonly when working with Management Centre customers on culture change.
Johnson and Scholes identified a number of linked elements that make up culture. Importantly, they didn’t try and specify any one best culture. Instead they argue that by analysing each element you can decide if the current approach either helps to deliver your vision and mission or hinder it.
Diagram adapted from “Fundamentals of Strategy” by G. Johnson, R. Whittington, and K. Scholes. Published by Pearson Education, 2012.
The six elements they defined are:
At the centre of the web sits the summary of these – the culture paradigm. (Johnston and Scholes call this ‘the paradigm’ or ‘the recipe’) – which represents the summary of how these elements interconnect.
One of the key elements of the web model is that all the above issues interact and even overlap. (So, for example, many elements are expressed in the symbols element).
The examples below show a cultural web drawn up by managers in one part of the UK’s National Health Service. In our experience it would be similar to many state-managed health care systems in other countries. Note, however, that the view expressed below is primarily that of managers. Clinicians or nursing staff might well have quite a different view. And so might you.
Many hospitals have routines for consultation and prescribing drugs. Rituals have to do with what the managers described as “infantilising.” These processes “sorted patients out” – putting them to bed and waking them up at certain times, addressing them informally, having fixed mealtimes/menus and so on. The subservience of patients was further emphasised by the role of clinicians with ritual-type consultation ceremonies and ward rounds. These routines and rituals emphasise it is the professionals who are in control. This is now changing with more person-centred care and patient involvement processes.
Many stories in the groups focused on ‘cures’, particularly from serious illnesses. (Notice too how many TV medical shows involve A&E). So the heroes of the health service may not have much time for palliative caring, which is maybe where the focus should be. During Covid’s global pandemic, medical heroes were recognised and thanked with an outpouring of public, royal and political applause.
However, in the aftermath of the pandemic, the constant stories about ‘villainous’ politicians trying to change the system and of heroic acts by medical team defending the system have continued. There is often a reference to a ‘golden age’ when the service was great – but no-one knows exactly when that was.
Symbols reflect the various roles in the health service. So uniforms are a key part of the role for some clinical and nursing staff. Senior clinicians have status symbols such as their own office with their medical certificates prominently displayed. Outside the building, senior staff may have designated parking places by name. Very senior clinicians such as surgeons even lose the ‘Doctor’ title and become plain but prestigious ‘Mr or Ms.’ The soubriquet ‘teaching hospital’ attached to an organisation makes it much more prestigious.
Power is seen as fragmented between clinicians, nurses and administrators and managers. Historically, senior clinicians were the most powerful while managers were seen as “admin” or “bureaucrats.” But as with other organisations, there was also a strong informal network of individuals and groups that coalesced around specific issues. Trades unions, for example, were at one time all-powerful and, although they still wield influence, modern day challenges mean negotiations aren’t always cut and dried. Similarly, patient power is talked about but can sometimes feel non-existent at an individual level.
Many services were and still are organised by diseases or even body “bits’: hence ENT or oncology. Previously however, structures were seen as hierarchical and mechanistic. There was a clear pecking order between services with “caring” services (such as community health professionals) low down the list. Mental health meanwhile was seen as well outside the mainstream, which is now changing. At the informal level there was “tribalism” between functions and professional groups. So different groupings would socialise separately after work. Organograms were complex with matrix reporting.
In hospitals the key measure has historically been “completed clinical episodes”, ie activity, such as operations completed, rather than results. There has also latterly been a focus on targets – especially for waiting times. Control over staff is exerted by managers based around these targets. Worse still there is pressure to be ‘seen’ to be achieving these targets – despite possible negative impact on other aspects of care. At the same time budget targets are often ignored – leading to huge overspends and losses in specific trusts.
So the assumptions which constitute the culture paradigm in the example above reflect the common public perception in the UK that the NHS is a “good thing” and that public service, which should be provided equally, is free of charge at the point of delivery. (Though almost everyone agrees that it’s too expensive to run.)
However, in our experience and from the case above, there is an emerging tension between a culture where medical values are central leading to the dominant view that “medics know best” and managers and patients need to “fit in.” On the other hand there is a growing view that the culture is changing to one where the energy and focus lies with meeting bureaucratic targets set by managers or worse still politicians. Sadly in both these cultures “patient need” is secondary.
Regardless of the overall power dynamic, the NHS is an organisation primarily concerned with curing illness rather than preventing it. For example, pregnancy is not an illness, but pregnant women often argue that hospitals treat them as though they are ill. Overall, the NHS is seen as belonging to those who provide or manage the service.
Of course the NHS isn’t the only sector in transition. In many charities fundraising is seen as a challenging but necessary factor. This viewpoint has prevailed in the UK’s arts and culture landscape until recently, but cutbacks in state funding mean that this is changing. In many development charities there is a move to a more “development in partnership with local people” culture away from a simple “emergency relief/experts know best” culture.
Is your paradigm changing? Do you want it to change? Does a change in your environment mean you have to change?
Understanding culture is not enough. The point is to change it. And to do this you need to follow five steps.
Job one is to sit down and work out accurately what the culture is now. There are a number of ways to do this. Focus groups, especially externally facilitated ones, can be a great way to get a real handle on this. You also might want to run an anonymous survey study. (See below for suitable questions to ask.) It’s essential that this is a candid ‘warts and all’ approach. You can map the results using the web model.
With the picture of your current cultural web complete, think next about how you would like things to be – ideally. (It will never be perfect in action). In the case of the NHS example above, we might suggest putting the patient literally at the centre of the culture to change the mindset. Who would be at the centre of your web?
Starting from your organisation’s strategy, think about how you want your culture to work if everything was correctly aligned. To make it concrete we often then list the key people likely to be affected and describe how things will be better for them in the new culture. This group of individuals might include: service users, supporters, donors, staff and others who are invested.
Now compare your two cultural web diagrams, and identify the differences between them. Consider your vision, mission and values:
You need an action plan to make sure that the culture change actually takes place. This plan should establish:
This plan should ideally be published and available to everyone. (Provided transparency is a part of your culture that is).
You need to track that your approach was actually implemented and that it has had the desired effect. (So what you do may not have had the impact you hoped for).
To undertake the mapping of the actual and desired culture it can help to have some questions to focus your thinking. Start by looking at each element separately, and ask yourself other questions that help you determine the dominant factors in each.
Example of an environmental campaigning charity:
Example from an environmental campaigning charity:
Example of an environmental campaigning charity:
Example of an environmental campaigning charity:
Example of an environmental campaigning charity:
Example of an environmental campaigning charity:
(This article draws on material from www.mindtools.com/pages/article/newSTR_90.htm)
If you’ve found this article interesting and would like to talk to us about transforming the culture at your organisation, email yvette@managementcentre.co.uk. We can offer you a no-fee discussion that talks through your organisation’s needs and where the behavioural and cultural shifts might need to happen.
