The impact of the NHS internal market on the merger of colleges of midwifery and nursing: Not just a case of putting the cart before the horse

Presents and discusses the findings from a research project into the impact of the NHS internal market on the merger of colleges of midwifery and nursing. Begins by briefly describing the major changes which have been introduced in the NHS since 1979 and sets these within the context of the changing nature of the public sector in the UK. Second, describes the background to the research and the methods employed. Continues with a brief review of the approaches to the change management process, which in particular draws attention to the importance of the environment in which the organization operates, and of the relationship between management styles and the different approaches to organizational change. Presents a case study of the merger of five colleges of nursing and midwifery. Follows with a discussion of the case study and the conclusions drawn from it for the process of change within the NHS.