Daft (2006 p. 353) defines span of control as the number of employees reporting to a
supervisor. The higher the span of control, the more the number of employees the
supervisor has under his charge. A high span of control is suitable for organisations where:
- Work is routine and repetitive
- Subordinates perform similar work tasks
- Subordinates specialises in a few tasks
- Rules and regulations are clear
- Little time is needed in non supervisory work like planning
High span of control is only desirable in an organisation where little interaction is needed.
On the other hand, the NHS is unlike a production line where little communication is
required, employees have changing job requirements and information to be passed along.
Daft (2006, p. 375) relates organisation structure to the environment. The following will
happen in an uncertain environment:
- There would be increased differences occurring amongst departments. Each major
department will only focus on their own responsibilities, and hence distinguishes
themselves from the other departments. Departments work autonomously, creating
- The organisation will need increased coordination to keep departments working together.
- The organisation must maintain the flexibility to change. Changes in policies or other
factors require even more cooperation departments.
Therefore a vertical organisation structure is unsuitable in an uncertain environment like
the NHS, where new policies are always implemented and crisis outbreak regularly. This
structure will further worsen the communications and decision making process.
The NHS consists of many trusts, hospitals and infirmaries. These entities are spread
across the United Kingdom. Each entity has the management of their own like the
Leighton Hospital and Infirmary in Figure 1.1. This configuration is described as the
Mintzberg (1981) discussed that divisional structured organisations top management often
uses performance control systems over each divisions but leave the details to the division
management. This system adds extra paper work and slows communications. Tasks are
duplicated across divisions, increasing costs and efficiency. These problems also lead to
increasing the span of control of the managers. Problems associated with a divisional
organisation structure are typically: