ABSTRACT

This chapter explains the rapidly changing environment for middle managers in a mental health care organization: 'Millfordshire Care Foundation NHS Trust' or 'MCFT'. Planned as a study of managerial work in changing economic times, not long into the study we found we were also analysing an organization under severe financial pressure in an environment where many non-mental-health community services for tender. The chapter illustrates why this was the case by examining the daily lives of junior and middle managers. It then explores management roles and behaviours in greater detail, thus providing an account of the realities of managerial work in mental health services, an under-researched type of NHS organization. At the time of our study, MCFT was unusual among UK mental health trusts: first, because it had achieved foundation trust status at all; and second, because it had managed to maintain and to grow.