Managing within the challenges and tensions facing the twenty‐first century UK National Health Service (NHS): the dilemma of a managerial identity within the context of a socially responsible organization

Purpose - The purpose of this paper is to identify and explore tensions and challenges experienced by NHS managers while working for a socially responsible organization and the implications this has for the (re)formation of their work and self identities. The consequent impact on their performance and commitment is considered along with the implications this raises for the recruitment and retention of NHS managers. Design/methodology/approach - The approach takes the form of primary research based on interviews with 20 NHS managers. The paper draws on theoretical frameworks and literature relating to identity theory, institutional theory, organization culture and social responsibility. Findings - The NHS managers feel that they are driven by an altruistic NHS value system, although they feel that the public do not share this belief. As a consequence some managers with a clinical background had concealed or were defensive about their managerial titles, demonstrating a tension in their identity work. Research limitations/implications - The study is based on a relatively small sample of London‐based NHS managers and may not necessarily represent the views of managers London‐wide or nationally. Practical implications - It is suggested that an explicit recognition of the NHS managers' commitment to behaving in a socially responsible manner within the NHS's CSR strategy may contribute towards challenging and alleviating some of the identity work tensions experienced by the managers. This may also contribute towards mitigating the current recruitment and retention difficulties associated with nurse‐managers within the UK NHS. Originality/value - The paper attempts to provide a more holistic insight into the (re)formation of the NHS manager's self and work identity through drawing on theoretical frameworks and literature relating to identity theory, institutional theory, organization culture and social responsibility in an integrated manner. The paper would be of interest to a wide range of readership including NHS policy formulators, NHS practitioners, academics and students.