This dissertation aims to understand and delve deeper into the nature of organisational commitment in a public funded healthcare organisation.

by tinaoberoi (student)

University Degree Business and Administrative studies

Title

Commitment and non-cooperation in NHS – A qualitative case study in NHS, UK.

Chapter 1

Research Questions

This dissertation aims to understand and delve deeper into the nature of organisational commitment in a public funded healthcare organisation. It also aims to explore if non-cooperation exists in such organisations and what forms does it present itself in.

The research questions addressed in this dissertation are as follows:

Does commitment exist in a public funded healthcare organisation?
What are the bases of commitment in a public funded healthcare organisation?
If commitment does exist, what is the kind of commitment found in such an organisation?
Does non-cooperation exist in a public funded healthcare organisation?
If it does exist, what is the form of non-cooperation found in such an organisation?
Is there any connection between commitment and non-cooperation in a public funded healthcare organisation?

To find the answers of the above research questions, a case study was carried out at the National Health Service (NHS) in the UK. Accessing data within NHS was easy as the researcher works with NHS and this would help collect information easily for the purpose of this dissertation.

Chapter 2

Introduction

This dissertation will aim to understand commitment and non-cooperation in a public funded healthcare organisation. This research study will be carried out in the National Health Service (NHS) in the United Kingdom, which is mainly funded through collecting taxes from the public. It does not need insurance payments from its patients unlike healthcare facilities in other countries. This is a very comprehensively networked healthcare facility and it provides a wide range of free health services to the residents of the UK.

The literature available on public funded healthcare organisations suggests that workers are committed to their profession as well as to the cause that NHS works towards achieving, i.e. working with other so as to ensure faultless service to its patients, keeping its patients healthy, reducing inequalities in the provision of healthcare services, prevention and treatment of diseases, etc. In addition, according to the literature non-cooperation in organisations is linked to frustration in workers, etc. Together with the proposed research questions, the relationship between commitment and non-cooperation in a public funded healthcare organisation is aimed at being explored by means of this dissertation.

Chapter 3

Literature Review

The National Health Service (NHS) is the vast health care unit spread in the UK. It controls the health sector in UK. The National Health Service was established by the Health Minister Anreuin Bevan in the year 1948. This service is available for the whole population of the United Kingdom. NHS also works towards providing social services to the needy and helpless people. It provides residence and free home care to them. NHS can be bifurcated into the part, which deals with the strategy, policy and managerial issues and the other, which works on all the medical facets. The one dealing with the medical facet can be further categorized into, Primary care (which involve GPs, dentists, pharmacists, etc), Secondary care (which is based in hospital and can be accessed on GP reference) and Tertiary care (in this highly specialized doctors are involved who deal with particular critical conditions).

However, with the structural changes taking place in NHS, the division between the different care units is less distinctive. The system gives the right to express their views about the service to all service users in all the four countries; England, Scotland, Wales and Northern Ireland. The NHS is the world’s largest public asset to the health services. The main reason for the establishment of the NHS was that the government aim to provide better health care service to all citizens in spite of their less income. Although some sectors like optical, dental and prescriptions are paid services. NHS is financially supported by the tax paid by the employees from their income. NHS is itself governed by DH (Department of Health, 2012).

The History of NHS

In the fifth decade, it became difficult to operate for NHS. There was a kind of agitation in people. Everybody became skeptical about the performance of NHS. The youth thought that whether they should trust on NHS and older ones felt that things were better in the past. Hospital throughput had risen and new radical treatments demanded great stamina of patients. Prior to 1990 Act, a massive bureaucracy administered all the sectors of the NHS. When the internal market established and the purchaser-provider came apart, the 'purchasers' (i.e. health authorities and family doctors) had to buy the health care within a limited budget from the 'providers' (i.e. hospitals, organization providing treatment for the mentally ill, and people having learning disabilities and the elderly, and ambulance services). In order to become a ‘provider’ in the internal market, health organizations became NHS trusts, which were independent organizations having their own management. Initially it was a collection of 57 NHS Trusts, which came into existence in 1991. By 1995, it was NHS who provided all health care

There were some changes in the arrangement and the working pattern of the NHS trust. 10 Downing Street became integral part of the NHS. The decade was specialized by the Organisational chaos that involves the configuration, termination and reshuffle of the structure and responsibilities of NHS authorities and trusts, and the NHS Foundation Trust. The workforce in the NHS decided that if the NHS is a service without payment, the infrastructure should also be not publically owned. Then the private sector associations came for the construction of the hospitals under PFI, and run their clinical services as Independent Treatment Centers and some NHS Walk-in Centers.

The Performance of the National Health Service in the UK

While making a policy it’s very important to note that how it is executed. The NHS implies with the focus in health policy in UK. After it’s inception since 1948, NHS has become the world’s largest health service unit. Here the question clearly arises that “Does NHS truly is the most competent, most. The question that obviously arises is: is it truly one of the most efficient, most unrestricted unit?” If we review the performance of NHS, the findings are as below:

The NHS is managed by the Department of Health (DoH). If we watch the data of NHS’s official website, it shows a huge scale; more than 1.7 million people employed in NHS, of those, just under half are clinically qualified, including 120,000 hospital doctors, 40,000 general practitioners (GPs), 400,000 nurses and 25,000 ambulance staff. It works on following core principles: The NHS provides a worldwide service for all needy persons who are not able to pay, it also provides wide-ranging services to its patients, it forms its services as per the needs and inclination of the individuals, their families, and their cares, it takes action to different requirements of diverse populations, it works continuously in order to improve quality services and to reduce errors, it supports and values its staff, its patients are treated by the monetary support provided by the public for the purpose of health care, it works together with others to provide an ideal service to the patients, it strives as far as possible to keep people healthy and it respects the privacy of individual and provide open access to information about services, treatment and performance.

Commitment in Organisations

There is a considerable amount of research material available on commitment in the healthcare sector (Allen and Meyer, 1993; Buerhaus, 1999). It has been seen that in the case of health care organisations employees are more committed to the cause that the organisation stands for rather than the organisation itself (Paton and Cornforth, 1992). According to Rebecca Smith, a leaked document reveals a startling fact that the managers at the National Health Service are forcing its workers to accept a pay cut of around five percent. They are also ending overtime payments for night shifts, weekend, bank holidays, etc. They are reducing holidays and are introducing long working hours for each shift (Smith, 2012). Similar research shows that the workers in this sector are paid much less as compared to what they might receive if they were working for an organisation in the private sector for the same work (Hems and Passey, 1998). A large number of researchers state that organisational commitment is related to the commitment of workers to the cause of the organisation rather than the organisation itself. This is another reason why they are willing to accept lesser pay for the work they do and yet be committed to the work they are doing for patients. Workers may also be committed to the organisation they work for because when they decide to work for a particular organisation they pick one that has causes, aims, goals, etc. that are in sync with the workers own values, goals and aims. The workers are interested in what the organisation does and stands for and they feel that by being a part of the organisation they are making a successful contribution to the society and at the same time are fulfilling their own aims and goals. The underlying reason why a worker would choose to work for such organisations still remains unexplored. Hence, by means of this research study I aim to delve deeper in order to answer such questions in terms of a public funded healthcare organisation in the UK.

If we look at it from one perspective, organisations in the healthcare sector seem to provide its workers with numerous conditions for being very committed to the organisation they are working for in the form of shared goals, values and aims. However, if we look at it from another perspective, such organisations have several problems that their employees are faced with such as low pay, unpaid overtime, long working hours, etc. (Alatrista and Arrowsmith, 2003).

According to Legge, commitment in organisations is extremely significant as only with the help of committed employees can an organisation achieve its goals ...

This is a preview of the whole essay

According to Legge, commitment in organisations is extremely significant as only with the help of committed employees can an organisation achieve its goals and aims fruitfully (1989). Same is the case for organisations in the healthcare sector as well because these are public funded healthcare organisations and they have to ensure that the aims and the goals that the organisation stands for are fulfilled because for such organisations that run primarily on public funds, high levels of commitment in employees is of utmost importance so as to ensure that these organisation run smoothly.

According to Alatrista and Arrowsmith, commitment in workers is not one-dimensional. It is quite complicated to explain or define (2003). It may be seen that a worker is deeply committed to one particular cause that the organisation supports but not the others. There are a large number of internal as well as external factors that have an effect of commitment in healthcare organisations. A union, the profession they are in, national institutions, etc., anything can be related to organisational commitment (Baruch, et. al, 2002). If it is assumed that only internal and external factors impact organisational commitment in workers, it will not be correct. Therefore, this will need to be researched further to understand it better.

Here, it must be known that commitment in workers is not the only reason that results in workers performing better for their organisation. Hence, in the healthcare sector if a worker is performing very well, it might not only be related to increased commitment, it could be owing to any other factor such as the cause that the organisation stands for, the colleagues that the employee works with and so on. (Newell, 2002).

Other than organisational commitment, it is necessary here to understand what commitment really is. This literature review will now discusses and explores the different types of commitments.

Affective Commitment

This type of commitment can be seen when a worker is emotionally connected to the organisation he/she is working for. In case of affective commitment, the workers ensures that he/she dedicates himself/herself to serve the company he/she is employed in. The worker strongly believes in the values and the aims of the organisation and strives to work hard so as to ensure that the organisation is successful, hence, displaying affective commitment to the organisation (Allen, et al, 1990; Mowday, et al, 1979).

Normative Commitment

In this type of commitment a works understands that his/her work is their duty and they feel responsible towards the organisation they are employed with. This kind of commitment demonstrates an obligation to do well. The worker feels compelled to work so that his/her duty towards the organisation is fulfilled completely. A worker demonstrating normative commitment stands out owing to the fact that they work hard not just to perform well in their job to get benefits out of it but they work hard because they know that they are morally obligated to do so (Wiener, 1982).

Calculative Commitment

In this type of commitment as the name suggests a worker works because he expects something in return. In 1981, a researcher stated that this type of commitment is a give-and-take affair (Etzioni, 1981). A worker only works hard as he/she expects some kind of return such as a reward, a promotion, etc. from his/her superiors. This type of commitment is only called calculative because it is calculated strategically by the employee as the employee works hard and in return he/she calculates that he/she will get something back from the organisation he/she works for (Randall, et. al, 1997).

Altruistic Commitment

In this type of commitment, the worker gives a lot of significance to the organisation he/she is employed with. The primary reason why a worker is connected to his/her organisation is because he/she identifies with the organisation and feels a strong connection towards it. Therefore, altruistic commitment is mostly related to others, i.e. the worker is connected with the organisation due to his/her strong commitment and connection with it (Peccei, et al, 1997). It will not be wrong to say that in this type of commitment, the organisation a worker is associated with is truly the one to benefit from such a commitment. Therefore, this type of commitment is very different to the other types of commitments discussed earlier.

At this point, it is beneficial to understand the term psychological contract. This is owing to the fact that due to the nature of the healthcare sector, such a contract with the organisation is not simply work related; it goes beyond the terms of service present in the contract of employment. Such a contract focuses on employment relations that link the employer and the worker at the same level (Guest, 2004). Such a contract encourages workers to not just focus on rewards, benefits, etc. linked to their jobs but also to their duty towards organisations operating in the healthcare sector. Therefore, workers must have some say in how that organisation functions so that they do not feel that the psychological contract between them and the organisation is being disturbed due to any reason (Paton, 1992).

Non-cooperation in Organisations

Non-cooperation in organisations or conflict is present in very organisation. A large number of organisations may deny having any conflict but it still exists. Management of an organisation may say that other than some workers in our company most workers within our company co-operate with one another. Also, they may say that they are the part of a successful team only because they get along with one another and are successfully able to work with one another forming a successful organisation (Von Haller, 1971). A large number of researchers have claimed that literature on non-cooperation in organisations exists but it is so limited that non-cooperation, conflict, etc. need to be researched further, especially in case of the healthcare sector. Many researchers have carried out chapters of research related to non-cooperation in organisations but those researches are very limited. Most literature does not even index the term non-cooperation in organisations (Rosenfeld, 1990; Thompson, et al, 2003).

Problems linked with non-cooperation, conflict, etc. are covered by researchers under the term “change”. A vast amount of research focuses on dealing with non-cooperation in organisations (Likert, et al., 1976). Non-cooperation has also been discussed as frustration in workers that results in absenteeism, not being able to accomplish goals and aims of the organisation, etc. (Luthans, 1972).

A large number of researchers such as Robinson, et al. and Boye, et al., define non-cooperative behaviour as “voluntary behaviour” that impacts the rules and regulations of a particular company and together with that it also has an impact on the well-being of the workers of the organisation as well as the organisation. Other researchers add saying that non-nonoperational behaviour is counterproductive to the functioning and to the success of the organisation (Robinson, et al., 1995; Boye et al., 1997).

According to researchers such as Taylor, et al., and Thompson, et al., the literature related to non-cooperation has seen a decline since the 90s (Taylor, et al., 2003; Thompson, et al., 1995). However, in the present scenario where the interests of the workers and the organisation’s management are similar to one another especially in the healthcare sector, it is significant that non-cooperation be clearly comprehended (Flemming et al., 2003).

Many researchers have studied non-cooperation and conflict in organisations in other sectors but non-cooperation and conflict in healthcare organisations that are publically funded is still largely unsearched.

Not only does non-cooperation include union activities, strikes, etc. it also includes workers who do not perform well, fiddle during work, day-dream during work and so on (Flemming et al., 2003; Noon et al., 2002).

Many researchers have conducted studies that point towards a link between commitment in organisations and non-cooperation in organisations. In cases where workers are feeling less committed to the organisations they work for there is a possibility that the worker will display behaviour resulting in non-cooperation, conflict, etc. The extent to which this happens in organisations will be delved deeper into by means of this dissertation exploring this in the context of the healthcare sector.

Chapter 4

Research Methodology

Methodological Approach

Owing to the nature of the dissertation and the topic selected for the research a phenomenological approach has been adopted for this study. This means that detailed information is collected by means of interviews, discussions, observations, etc. If we speak epistemologically, a phenomenological approach is based on the paradigm of knowledge and subjectivity. According to researchers, there is no specific reason why a particular worker feels more committed towards the organisation he/she is associated with (Arnold et al., 1998). To know why this happens, it is important for this research to understand and delve deep into what workers have to say and draw a conclusion based on that. As stated earlier, a phenomenological approach gets an insight into what a worker is actually thinking and therefore it will not be wrong to say that this approach is apt for this dissertation.

Research Design

This dissertation uses the case study method for research. The reason why the researcher has chose this method is because this would help the researcher to study the data related to this dissertation in its actual context. Researchers state that a problem can only be understood completely if the surroundings that the problem exists in is also understood completely (Yin, 1994; Cavaye, 1996).

In addition, the case study method provides the opportunity to carry out detailed studies and help in answering “how” and “why” questions that would otherwise need a lot of detailed study in order to explain. Case studies are exploratory and this would help in answering questions about organisational commitment and non-cooperation in organisations in the healthcare sector in a much better way.

The case study method has some limitations as well. One of the limitations that stands out the most is that such a study cannot represent results from the complete sector in question (Yin, 2003).

Another significant limitation related to this dissertation was limited time. This is the reason why only the NHS where the researcher works was studied in order to find answers to the research questions. In addition, owing to the fact that the researcher was associated with the organisation, led to a good understanding of the problems related to workers in the organisation. The research was carried out at all levels of the organisation; this was done so that the findings and the results would correctly portray what the workers felt. Therefore, a sound conclusion could be drawn out based from the findings of this dissertation.

Research Methods

According to researchers, a large number of case study researches use qualitative methods for collecting data (Bryman, 2004). It has been seen that using qualitative method for data collection is very context sensitive as compared to quantitation method for data collection. When qualitative method of data collection is used, the data that is collected is very detailed and is very true to reality. Qualitative data is more flexible and subtle (Whipp, 1998). The method of qualitative data collection would be very beneficial when a researcher is making an attempt to uncover hidden aspects of employment relationships by means of interview questions, etc. Therefore, the significance of using qualitative data collection method in order to find out from employees about organisational commitment and non-cooperation in organisations is very clear. So, this dissertation study used qualitative method of collecting data, which included observation, interviews, etc.

The researcher chose to carry out semi-structured interviews so that the interview questions could be more or less open ended and the respondents could feel free to answer the questions in which ever way they deemed fit. The researcher also wanted to make the respondents comfortable by having a semi-structured interview process, as this would let the respondents and the researcher to turn the interview into effective communication, thus resulting in the flow of conversation divulging information that could prove beneficial to the researcher for answering the research questions with ease. When a researcher has to prepare a questionnaire for the respondents, the questions have options and are very closed. They also have to be prepared much in advance. A lot of money is involved in printing and posting of the questionnaires and a lot of time is involved in collecting the questionnaires and deciphering the results. Hence, the researcher chose to use the semi-structure interview process with a lot of general questions and topics leading seamlessly to the research questions. Most questions were formed during the interview itself keeping in mind the research questions. This was very helpful to the researcher as well as the respondent as it seemed like a conversation and the respondents felt comfortable in expressing themselves with ease.

Another reason why interviews were chosen for this research was because with the help of interviews the respondents would be able to share their experiences at NHS and in the healthcare sector in general. This is a much better way of getting an answer to research questions that participant observation as that involves moving around in places that are meant for employees and observing what they are doing without actually making conversation with them (Bryman, 2004).

Since the researcher is a part of NHS a lot of time was spent on the premises of NHS in order to observe what was going on in various departments. The relationship shared between the workers and the management was observed in great detail. In addition, the way in which workers interact with one another and with the management was observed and taken into account, together with the atmosphere and the work environment of employees, etc.

As time available for this research was not a lot, therefore, ethnographic observation was not carried out but the researcher did learn a great deal about the working of the healthcare sector, commitment, non-cooperation, conflicts, etc. (Thomas, 2004). It must be known that a good research cannot be conducted only through observation, hence, the interview process was significant in this study to get opinions of workers on issues related to commitment, non-cooperation and so on.

The interviews began by making the respondents comfortable and striking a conversation about their background, hometown, educational qualifications, family, etc. They were then asked questions about their working hours, work environments, etc. The questions then became more detailed and were directed towards commitment and non-cooperation within their organisation. The questions kept getting more detailed in an attempt to understand how an employee’s day at work looked like, the way the management was with them, the breaks they were given at work, the overtime they were given, etc. The workers were also asked questions like if was intentional that they decided to work for an organisation within the healthcare sector or not. The researcher asked them questions in detail about commitment in an attempt to understand how they were committed to the organisation. Many short and open-ended questions were asked so that the employees could elaborate and add stories and events explaining organisational commitment and non-cooperation within this sector. The interview ended when the researcher asked the respondents to add any additional comments, stories, incidents that would aid in understanding how they felt for the organisation. The respondents were made very comfortable and they were given complete freedom to express their opinions, share incidents, etc. to aid the research.

Limitations of the Study

Every research has some limitations linked with this and this research study was no different. The biggest issue here was that the researcher worked in the organisation where the study was being conducted hence the researcher’s opinion on things may be coloured and could have impacted the results drawn out of the study conducted. Therefore, any bias that may have occurred due to this was attempted to be avoided, so as to ensure that the results of this study reflected the actual opinions of employees working in this organisation. There were other limitations such as issues related to confidentiality, etc. since the researcher was a part of the organisation in question she understood the importance of confidentiality in the organisation. Knowing this was very helpful and it proved to be very advantageous as the researcher made sure that the data gathered by interviews was carefully interpreted and any bias of any kind was kept at bay.

This research was conducted in a very short span of time and hence every important worker was not interviewed. Only some selected employees were interviewed which is why the information obtained could be considered to be somewhat incomplete. If time permitted more employees could be interviewed and a better analysis could be carried out for this dissertation.

Chapter 5

Research Findings

Bases of Commitment in Organisations

The research questions aimed at understanding the bases of commitment in a public funded healthcare organisation. The literature available on bases of commitment was primarily available in sectors such as manufacturing and customer service and very little literature was available on a public funded healthcare organisation. This research aims to delve deeper into understanding if commitment exists in such an organisation and if it does what kind of commitment is found in workers.

The National Health Service provides a large number of services to its patients, therefore, it would not be wrong to say that workers at NHS demonstrate many types of commitment within this organisation.

Therefore, in order to understand if workers showed a particular type of commitment, questions were asked related to that particular type of commitment in order to see if they were committed to that organisation in that particular way. For instance, to see if a worker was displaying calculative commitment to the organisation, questions related to rewards, benefits, overtime, etc. were asked. The respondents stated that they were working for a healthcare organisation like NHS because they desired to work there owing to the satisfaction they felt in being associated with such an organisation. The statement, “I travel 1 hour to reach my workplace, I think that shows how committed I am to my work”, clearly demonstrates the altruistic commitment of the worker to the organisation. However, some workers did suggest during the interviews that they were associated with this organisation as NHS is a very recognisable brand and they would move on if they found a better opportunity elsewhere. “This is a brand, a big company, I will gain experience and move on if I have the opportunity to leave.”

Another worker who had just joined NHS said:

“I am not attached to NHS now, I’m still new here, in a few years maybe, let’s see how things pan out. Right now I just see that the pay is good for a person like me!”

Most workers at NHS did not show calculative commitment to the organisation. However, the new employee was attached with the organisation due to the benefits associated with it, hence demonstrating calculative commitment to NHS. When a worker is new to a company the only attachment he/she may feel to the company may be related to money and benefits, etc. However, as time passes a worker may feel more attached to the organisation and the causes it stands for.

The next set of questions was aimed at finding out if workers showed affective commitment to the organisation. Mixed responses were received to questions related to affective commitment. Workers that were associated with the organisation for a very long time were deeply or emotionally attached to it. However, workers who had just joined the company did not obviously seem very attached to it. The given comments substantiate the above statements, “I have spent my life working here at NHS.” and “No, I have not been with NHS long enough to be emotionally attached!”

By means of the detailed research findings it would not be wrong to state that workers associated with the healthcare sector are not just committed to the cause that the organisation stands for. As a matter of fact, through this research it was seen that there are many kinds of commitment that are present in the workers of the healthcare sector. In the present research study it is clear that workers show many different bases for organisational commitment but there is a variation in the degree of commitment that is seen in these workers. On the one hand some new workers at NHS were seen to demonstrate calculative commitment to the organisation, others who had been with NHS were deeply connected with it demonstrating affective commitment to the organisation. It was also observed that normative commitment was the most common type of commitment that was seen in most workers at NHS, i.e. most workers felt a sense of moral obligation to their patients and in turn to the organisation.

Non-Cooperation, Types and Causes

To truly understand if non-cooperation exists in a public funded healthcare organisation and if it does exist, what form it exists in; the respondents were asked many questions related to non-cooperation, conflict, etc. The literature related to area states that when a worker is not feeling very committed to the organisation they may indulge in non-cooperation and acts of conflict. Due to the current economic situation, the workers are being made to work extra long hours, overtime, etc. They work on bank holidays too and they are not compensated for it. In addition, they are also experiencing pay cuts. The workers at NHS are very calm and composed and understand to a great extent the situation of the economy in the United Kingdom but prolonged hours, unreasonable shifts, etc. may result in non-cooperation and conflict in NHS. By means of this research isolated incidents of non-cooperation, conflict, etc. were observed but by and large the workers at NHS are facing the current situation and developments in a very professional manner.

The last research question was, is there connection between commitment and non-cooperation in a public funded healthcare organisation? In the context of NHS, it will not be wrong to say that employees are committed and if due to the acts of management commitment is reduced, workers are likely to demonstrate non-cooperation and conflicting behaviour.

Chapter 6

Conclusion

This section will summarise the main points, answers to research questions and topics covered in this dissertation study. This dissertation aimed to delve deeper into the bases of organisational commitment in a public funded healthcare organisation. This has also aimed to understand what is the kind of commitment is found in a healthcare organisation. Finally, the study also tries to uncover if non-cooperation exist in a public funded healthcare organisation and if it does exist, what form of non-cooperation found in such an organisation.

This study has uncovered that in the healthcare sector importance is given to commitment which is related to the cause that the organisation stands for, i.e. caring for patients, etc. This research has shown that there are other bases of commitment in healthcare organisations as well. It was seen at NHS that workers were committed to the organisation for different reasons and a very strong connection to the organisation was related to the length of the time they were associated with NHS. It was uncovered that all kinds of commitment are found in NHS including calculative, normative, etc. but they were present in the organisation in fluctuating degrees. New workers in the company were associated with it due to calculative commitment, i.e. to get good experience from such a reputable organisation and workers who had been working with NHS for years were associated with it due to a very strong emotional bond with the organisation. A large number of workers felt morally obligated to be associated with the organisation owing to the work NHS does.

The study also goes on to discuss non-cooperation and conflict in a public funded healthcare organisation. There were a lot of instances uncovered during the study that indicated that non-cooperation, conflict, etc. does exist in the organisation. However, the degree to which non-cooperation and conflict were found to be very low. There were certain employees who did not follow all the rules, however, the number was so limited that it did not stand out.

Overall, it can be stated that this dissertation indicates and demonstrates that while commitment related to what healthcare organisations stand for could be one of the reasons for worker’s commitment, it is not the only one. Workers at NHS portrayed all different kinds of commitment in the organisation. Also, it was seen that even though employees were committed to the organisation, NHS was not free of acts of non-cooperation and conflict. This demonstrates that it is not necessary that if an employee is committed to the organisation they will not act deviant manner, or engage in conflicts. Conflicts, non-cooperation are a part of an organisation and commitment and non-cooperation do not seem to have any real connection or link with one another.

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This dissertation aims to understand and delve deeper into the nature of organisational commitment in a public funded healthcare organisation.

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