Leadership and Threat Management in Meta Organizations: Case Studies from English Primary Medical Care

Meta Organizations (MOs) comprise individual organizations which retain their identity and a high degree of autonomy. MOs are reliant for their survival on maintaining commitment from their member organizations. A key aspect of the offer from MOs to individual organizations is strength in numbers, far beyond that enjoyed by individual organizations. Membership is more likely to be attractive when organizations are feeling threatened and where organizations perceive themselves to be better able to defend against threats by joining forces with other organizations. Whilst in some sense, threats are objective, there is also a strong element of perception involved. This paper reports findings from a study of 4 MOs in England each comprising primary medical care organizations. The data collected comprises 132 interviews and observational data of 55 meetings over a period of 14 months. The study examined the ways in which respective MO leaders attempted to maintain commitment of member organisations in the early stages of development of these MOs. We found that although all 4 MOs shared a common strategic aim, there were variations between MOs with regard to the ways in which they engaged members around this aim. Whilst the construction of threats by MO leaders was important, the ways in which this was enacted was an emergent and tacit rather than explicitly planned approach. MOs which constructed threats and linked them to solutions in a way which resonated with members’ immediate and self-interested concerns were more successful than those which focused on high level strategic aims and attempted to appeal to pro-social motivations. We suggest that this is not because the doctors in member organizations were inherently self-interested. Instead where MOs provided assistance in concrete terms and linked this to threat diminution, this enabled doctors and other staff in member organizations to engage in pro-social behaviours.