A benchmark study and analytical framework, applying demography theory to research on NHS trusts' top management teams in times of change

Seminal research at the Camegie school sparked studies in the early 1980s by Pfeffer and by Hambrick and Mason. Their development of demography and upper echelon theory promised to explain organizational performance in terms of the demography of top management teams (TMTs), primarily the average length-of-service or tenure of team members. Later research brought in mediating and management processes, and intervening variables as explanations of performance. Building on this research, the present study surveyed TMTs in NHS Trusts, the data collection being conducted in the mid-1990s. At the time, the Trusts were new types of organizations, retreaded from earlier bodies (such as District Health Authorities) but with a remit to replace welfare subventions with enforceable contracts - so that funds came from buyers, and not allocations. A variety of pressures created a turbulent milieu for the Trusts, which were essentially organizations in transition. The research developed a methodology with an interplay of qualitative and quantitative techniques. The latter made use of a proven survey instrument, and developed a replicable framework for analysing and presenting the results - a benchmark for follow-up or longitudinal studies in the same field or across wider applications. The results brought out the importance of management processes, including those promoting coalitions and affective agreement, and those likely to lead to cognitive conflict and enhanced performance. Findings from the research provide a hierarchical profile of the factors influencing Trust and Management performance. The results create a new and substantive method of measuring heterogeneity and homogeneity in TMTs, and they form a basis for distinguishing high from low performers. Hypotheses on homogeneity and heterogeneity of groups, on management and mediating processes, on intervening variables, and on how sensitivities affect performance should enrich understanding of TMTs in organizations that are radically changing, within a rapidly changing environment.