Human relations management, expectations and healthcare: A qualitative study

Despite substantial evidence for a relationship between human resource management (HRM) and the performance of individuals, relatively few studies have examined the role of employee expectations. This article reports on a study involving six National Health Service (NHS) organizations across England. Healthcare employees expected their employers to provide: infrastructure, HR practices and support, which they linked to improved performance especially in relation to patient care and service innovations. Counterintuitively, effort was maintained towards immediate patient care when expectations were unmet, seemingly, because of public service values. The findings indicate that public service values may be a strong determinant of performance as it relates to patients, moderating potential short-term adverse effects of unmet expectations. In contrast, longer term effects on patient care and service development were less readily moderated by these values. This study offers differential accounts illustrating effects on performance gained through improved working conditions and through work intensification.