The previous chapter was concerned with the organisation of work over the Health Service units as a whole. This chapter moves down to what can be called level three work, which is always the most difficult to define and structure in any welfare organisation (Billis, 1984). This has certainly been true of nursing as discussed in Chapter 4, and has been observed by other writers (Kinston, 1987). In the last chapter, it has been suggested that there is a high level of dissonance between the images projected by the new structuring, the expectation of managers engendered by organisational change, and the reality of the experience for managers at middle levels of the units.
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