Abstract
Managerial work in National Health Service takes place in a highly complex and volatile emergent context. National Health Service senior managers play a crucial role in implementing structural and cultural change. They make sense of their social, political work environment and their expectations for role efficacy in an individual and highly contextual manner. It is increasingly vital for those responsible for major organizations to understand and manage organisational processes such as directing senior managers more effectively to better enhance organisational capability. This study adopts a social constructionist interpretive approach to identify the unique constructs senior managers use to describe the facilitative and inhibitory contextual factors influencing role efficacy. A repertory grid technique developed by George Kelly (1955) and based on his Personal Construct Theory is applied to a group of National Health Service senior managers at a large District General Hospital to elicit their unique constructs. The study reveals that senior managers believe leadership, team effectiveness and clarity of role and organisational strategic objectives are vital to their role efficacy as change managers. These findings corroborate those of extant literature that has explored factors conducive to change, innovation and entrepreneurship. This study makes a unique contribution to change management literature by presenting rich qualitative descriptions in the words of the senior managers. The study also endorses the repertory grid technique and underlying Personal Construct Theory as productive and appropriate frameworks for use in management research to access valuable tacit knowledge and eliminate researcher bias. These results contribute to the growing body of literature that associates organisational effectiveness with senior and middle manager role efficacy. Suggestions are made for further research.