Although strategic human resource development (SHRD) is widely proposed for organisational effectiveness, its implementation in highly regulated industries, such as healthcare, may be adversely impacted.
Using McCracken and Wallace’s SHRD characteristics and Garavan’s model, the study investigated how human resource managers (HRMs) in a South African private hospital group understood and implemented SHRD.
In healthcare settings where professional hierarchies, centralised governance and regulatory pressures influence human resource development (HRD) practices, the study addressed research calls to capture practitioners’ perspectives in such complicated contexts.
A qualitative, interpretive design was employed. Five purposefully selected HRMs were individually interviewed about their SHRD practices. Data were analysed using Braun and Clarke’s reflexive thematic analysis process.
Human resource developments implemented SHRD, but in a fragmented and inconsistent manner, contradicting the integrated approach proposed by SHRD theory. Strategic human resource development was unevenly implanted in the hospital context, due to contextual constraints.
The findings suggest contextualised SHRD frameworks, enhanced cross-level partnerships, developing SHRD competencies and local HRD discretion in HRD planning and decision-making.
The study offers a more situated view of SHRD in practice, demonstrating that contextual factors, such as professional power dynamics, regulatory pressures and centralised control, influence implementation in healthcare, rather than merely highlighting implementation gaps.
Human resource development (HRD) is widely regarded as a key contributor to improving organisational performance and employee development (Irfan et al.,
In response to these demands, strategic human resource development (SHRD) positions HRD as a long-term, strategically aligned and environmentally conscious process (Garavan,
These dynamics are particularly evident in South Africa’s healthcare system. Both the public and private sectors are subject to ongoing reforms, such as the National Health Insurance (Department of Health,
This study addresses these gaps by exploring how HRMs understand and implement SHRD in a large South African private hospital group.
The study explored how HRMs in a private hospital group understand and implement SHRD in their organisational context by:
Exploring how McCracken and Wallace’s (
Analysing the strategic positioning of HRD practices using Garavan’s (
Human resource development is typically portrayed as a strategic level for organisational success; yet organisational structures and power dynamics may influence its practice. While SHRD is designed as a proactive and strategically aligned approach (Garavan,
Subject to stringent regulations and ongoing professional development, nurses are the predominant professional group in South African hospitals and are essential to service delivery (Blaauw et al.,
The broader healthcare system is also highly regulated, resource-constrained and compliance-driven (Department of Health,
McCracken and Wallace’s (
Based on SHRD theory, HRD is closely aligned with the organisational mission and strategy, and top management actively supports and promotes HRD (McCracken & Wallace,
Environmental scanning is positioned as a shared responsibility across organisational levels, enabling HRD to anticipate and respond to external changes (Garavan et al.,
Strategic partnerships with line managers and horizontal integration between HRM and HRD are considered fundamental to SHRD. These partnerships are expected to be collaborative, with shared accountability for workforce development (Garavan et al.,
Strategic human resource development considers human resource development practitioners (HRDPs) as strategic agents who can influence organisational culture, learning and transformation (Garavan et al.,
Strategic human resource development theory emphasises systemic evaluation to demonstrate return on investment (ROI) and organisational impact (McCracken & Wallace,
Taken together, these characteristics provide a structured framework; however, they do not account for how SHRD is negotiated in environments that are resource-constrained, power-laden and professionally diversified contexts, such as healthcare. The study also draws on Garavan’s (
Garavan’s (
Instead of a blueprint, the model was used as an analytical benchmark in the study to support the investigation of how SHRD is applied differently across the organisation and how it is influenced or limited by contextual factors such as centralised decision-making, regulatory requirements and professional hierarchies within the private hospital group.
We used an interpretivist qualitative research approach (Creswell & Creswell,
A framework-guided thematic analysis research strategy, adapted from Braun and Clarke (
The research method comprised the research setting, entrée and researcher role, participant selection and sampling, data collection, recording, analysis and strategies to ensure trustworthiness. Ethics and the reporting style are outlined below.
To improve understanding and minimise physical distance (Creswell & Creswell,
The researcher obtained permission from the private hospitals to conduct the research. The researcher used an interview schedule with predetermined questions and conducted, organised and transcribed all interviews, using recordings and field notes. Reflexive memos were written throughout to document analytical decisions and consider potential influences arising from the hierarchical context. With supervisory input, the researcher hand-coded the data to identify common themes.
Given resource limitations and the countrywide geospatial spread of 54 private hospitals, the researcher focused on Gauteng, the most populous province, with the highest concentration of private hospitals. Consistent with qualitative research that focuses on in-depth exploration rather than generalisation, the study population consisted of five HRMs employed at Gauteng-based private hospitals.
Biographical profile of participants.
| Participant code | Gender | Ethnic group | Location of the private hospital |
|---|---|---|---|
| P1 | Female | White person | Pretoria |
| P2 | Female | White person | Benoni |
| P3 | Female | Indian person | Vaal Triangle and Johannesburg South |
| P4 | Male | Black African person | Johannesburg Central |
| P5 | Male | Indian person | East Rand |
Human resource managers were selected through non-probability purposive sampling, using Nieuwenhuis’s (
Semi-structured individual interviews were conducted to allow flexibility, probe participants’ responses and elicit rich, personal accounts of their SHRD experiences (Geyer,
Using a tape recorder, participant permission was sought before the interviews and recording (Geyer,
Reflexive thematic analysis (Braun & Clarke,
To ensure trustworthiness, transcripts were validated, codes were consistently defined, and cross-checked against the data (Creswell & Creswell,
Findings are presented thematically, consistent with interpretative qualitative writing conventions that emphasise clarity, coherence, contextual sensitivity and meaning-making (Creswell & Creswell,
The study received ethical clearance from the faculty ethical committee (EMS-REC, approval number: EMS16/03/03-01/01). Informed consent, voluntary participation, confidentiality, the use of pseudonyms for anonymity and protection from harm were upheld (Strydom & Roestenburg,
The findings are presented into two overarching themes reflecting HRMs’ experiences of SHRD in practice: (1) experiences with SHRD characteristics and (2) experiences with SHRD models, with related subthemes. Although some characteristics were combined in the literature review, they are presented independently here to show how HRMs experienced them. Selected illustrative quotations are included.
Human resource managers’ experiences indicate that strategic alignment was mainly achieved through performance management, training needs analysis (TNA) and individual development plans (IDPs). These tools linked organisational priorities with individual and job-specific needs:
‘… your mission … and your objectives and your strategic things of the company are directly linked to a person’s objectives … will be linked back to the organisational goals.’ (P1)
‘Yes, it is aligned … it starts with the IDP, which is driven by EPD [
‘… it’s important that you engage with them [
Taken together, these accounts suggest that alignment was mainly experienced through compliance-driven processes rather than strategic involvement in organisational decision-making.
Although executives considered HRD as strategically important, HRMs perceived this support as selective. Nursing staff had significantly more development opportunities than non-nursing staff:
‘… on the nursing side only …, on a non-nursing side, no. Somehow, emphasis is never paid too much on non-nursing staff.’ (P3)
Budget constraints and priorities reinforced the perceived unevenness. Despite management’s expectation, these constraints limited HRD’s ability to address overall organisational needs:
‘… we complain about the [
‘… we don’t have sufficient funds to cater for non-nursing staff.’ (P3)
This subtheme suggests that management’s support for HRD was primarily symbolic, resource-dependent and selective in nature, limiting HRD’s ability to support development across all occupational groups.
Although environmental scanning occurred, it narrowly focused on nursing and nursing-related regulatory requirements instead of organisation-wide capacity development:
‘… especially for nursing, where we need to do the new nursing qualifications … we need to look at … what is happening nationally in nursing, new qualifications … of SANC [
Beyond nursing, scanning and planning were centrally driven at the group level, leaving hospital-based HRMs with limited discretion to identify and address emerging skills needs:
‘Basically, you don’t have to think [
Centralisation also restricted HRD’s ability to address site-specific and non-clinical skills development needs, resulting in limited alignment with wider organisational and national priorities. This also created lost opportunities for HRD to develop internal technical capacity:
‘… we pay a service provider … whereas we have [
Line managers were primarily responsible for employee performance development (EPD) reviews and ongoing performance evaluation. Human resource managers emphasised that HRD effectiveness relied on line management engagement and accountability:
‘Good relationships with your line managers is very important. They [
However, in some hospitals, line managers viewed HRD as an HR responsibility rather than a shared one:
‘Line managers do not understand that it’s their responsibility [
While line management partnership is assumed in SHRD literature, these accounts suggest partial implementation of this characteristic, due to hierarchical relations, role ambiguity and managerial understanding.
Most HRMs agreed that HRD support was evident. However, this support was mainly centralised and periodic, limiting site-specific strategic HRD planning. Participants experienced support as advisory instead of embedded:
‘… we get feedback from head office … if we don’t get those reminders, not a lot will happen … I think it might really help for a hospital to have that access for a day or two for the specialist [
‘It will be quite beneficial for the training team to meet with the business and come to the hospitals and speak to the top management team … (To) engage on a different level … at a site-specific level, you look at site (private hospital) specific initiatives.’ (P5)
Although HRD structures exist, limited on-site presence and periodic engagement restricted the formation of strategic partnerships. The lack of shared planning also reinforced HRM’s dependence on central structures.
Training facilitators’ roles were mainly confined to classroom delivery, with little authority to engage strategically. Professional boundaries further constrained their involvement. Especially, clinical facilitators lacked autonomy to engage proactively with workforce planning:
‘The CFs [
Occasional collaboration between HRMs, training teams and line managers enabled more responsive initiatives, although such practices were infrequent:
‘There’s a team that sat with us to discuss what [
While SHRD theory assumes expanded strategic roles for training facilitators, these accounts suggest that their involvement was constrained in practice by limited authority, organisational structures and professional hierarchies.
Human resource development practices focused on communicating organisational values through orientation and onboarding, instead of shaping or challenging organisational culture through strategic development:
‘… the orientation programme and the on-boarding programme, so new employees definitely are on-boarded quite well, one-on-one with my HR staff and then in orientation… in the departments as well, we have our … values and our way [
The accounts suggest that HRD’s cultural influence was limited to organisational entry levels, in the form of transmission rather than transformation, across all professional groups.
Human resource managers reported limited use of HRD metrics to assess the ROI. Evaluation was primarily informal, and HRMs expressed uncertainty on how to measure training impact:
‘I don’t think that we’ve ever sat and said, this is the training we’ve done for the year, and this was the return on investment.’ (P2)
In the absence of ROI metrics, HRD value was primarily demonstrated through cost savings:
‘… if you take ten or more, I can give it to you at almost half the cost.’ (P3)
Although SHRD theorises evaluation as important, this subtheme demonstrates the difficulty of applying ROI measurement in practice. Moreover, HRD’s value was tied to cost containment rather than evidence of long-term capability development.
All HRMs experienced limited familiarity with SHRD models, and only one HRM relayed partial exposure to SHRD models:
‘I want to link it to a model, and which one would fit the best. I’ve also read about some of the models, but I can look at the Peterson model.’ (P1)
They also expressed uncertainty and limitations in aligning HRD with strategic models:
‘My [
Implementation was also limited by organisational and governance arrangements. Some HRMs reported feeling disempowered by rigid policies, which discouraged innovation:
‘We are too scared to go outside the policy here … … if you do something wrong, you are referred to the policy …’ (P5)
Human resource managers also reported broad generalist workloads that limited time for strategic SHRD:
‘I’m involved in everything from training and development to strategic leadership, consultation … the very operational transactional processes, staff well-being, and a complete generalist function.’ (P5)
Overall, these accounts suggest that SHRD models were experienced as aspirational rather than actionable. Although HRMs expressed a commitment to development, they were constrained by limited authority, time, resources and centralised governance.
Alignment between strategic human resource development theory and findings.
| SHRD framework element | What SHRD proposes | Findings | Nature of enactment |
|---|---|---|---|
| 1. Integration with organisational vision, mission and goals | HRD aligns with organisational goals through integrated planning | Alignment mainly through TNA and IDPs | Partial: procedural rather than strategic, driven by compliance |
| 2. Top management support | Senior leaders actively champion HRD across functions | Recognised HRD importance but uneven support, nursing prioritised with limited resourcing for non-clinical staff | Constrained by professional hierarchies: symbolic and selective |
| 3. Environmental scanning | Shared by HRD and top management to identify opportunities and threats | Focused on nursing and compliance; other needs were overlooked; limited hospital-based HRM discretion. | Fragmented: narrow, centralised, limited site-level responsiveness, |
| 4. HRD planning and policy formulation (strategy development) | HRD develops proactive, strategic plans aligned with organisational needs | Standardised top-down planning limits local adaptation | Constrained: centralised, limited HRM discretion to address local skills needs |
| 5. Line management partnership | Shared ownership of employee development, collaborative HRD planning | Partnership inconsistent, some line managers perceived HRD as HR’s responsibility | Partial: uneven across sites: dependent on local role clarity and authority |
| 6. HRD partnerships across partnerships (HRM–HRD partnership) | Cross-functional collaboration across stakeholders | Limited cross-functional engagement beyond nursing; corporate HRD’s advisory role acknowledged, but periodic | Constrained: uneven, partnership depends on role clarity and authority distribution |
| 7. Expanded roles of trainers and facilitators | HRD acts as a strategic partner and change agent, not only a trainer | HRDPs confined to instructional and administrative roles; lack autonomy and strategic involvement | Minimal: mainly operational roles, organisational hierarchy restricts role expansion. |
| 8. HRD influence on organisational culture | HRD shapes and influences organisational learning culture | Communicate values only (orientation and/or onboarding), | Minimal: surface-level influence; transmissive, not transformative |
| 9. Evaluation and ROI | HRD demonstrates strategic value through evaluation systems | No formal ROI; value is demonstrated through cost savings rather than outcomes | Minimal: financial justification replaces strategic evaluation |
| 10. Use of SHRD models | Models guide strategic integration across global, organisational, job and individual levels | HRMs have limited knowledge, models perceived as abstract; constrained by workload, limited resources, centralisation and difficult to apply in a centralised, resource-constrained context. | Aspirational: recognised conceptually but not applied |
SHRD, strategic human resource development; HRD, human resource development; TNA, training needs analysis; IDPs, individual development plans; HR, human resources; HRM, human resource management; HRDP, human resource development practitioners; ROI, return on investment.
The findings suggest that HRMs at private hospitals applied SHRD characteristics in a fragmented manner, rather than uniformly, contrary to McCracken and Wallace’s (
While inconsistent application of SHRD is well-documented (McCracken & Garavan,
Human resource managers’ experiences reflected strategic integration of HRD practices with the private hospitals’ vision, mission and objectives through HRD tools such as TNA and IDPs. This alignment demonstrated HRM’s efforts to align organisational goals with job-specific and individual needs. As these mechanisms are mostly compliance-driven, this suggests that alignment was more procedural than strategic in nature. These findings mirror Sthapit’s (
Although top management acknowledged the importance of HRD, their support appeared selective and largely symbolic. Nursing was prioritised for development, while non-clinical staff received far fewer resources and career development opportunities. This uneven distribution of training priorities and budgets demonstrates how professional hierarchies influence what constitutes ‘strategic’ HRD in private hospitals. These dynamics extend SHRD theory by illustrating that strategic alignment is not neutral but mediated by entrenched professional power structures. In this context, nursing, due to regulatory demands and clinical dominance, anchors HRD decision-making, while marginalising other occupational groups. Shaari et al. (
Human resource managers confirmed that while the external environment was scanned for regulatory requirements, trends and best practices, this was only evident in formal nursing-related education and training. As scanning was primarily driven from the head office, it functioned more as a compliance mechanism than as a tool for strategic foresight. This top-down approach limited HRM’s involvement and ability to respond to site-specific needs or identify broader organisational development opportunities. Similar patterns were noted by Wahitu and Muhama (
Human resource managers expressed the need for HRD strategies to address human and financial resource constraints. However, the highly centralised and standardised process in private hospitals restricted HRMs from adapting HRD plans to site-level workforce needs. This reinforces earlier findings that HRDs operate within narrow boundaries set by governance structures. As Alagaraja and Egan (
Human resource managers believed that line managers should share responsibility for developing staff; however, this expectation was not consistently met. Line managers were often perceived as disengaged from their developmental role, while HRMs themselves felt they lacked the authority to influence this. These findings complicate the SHRD assumption of shared ownership, showing that partnerships depend on clarity of roles and power, both of which are uneven in clinically dominated environments. Yim (
This research identified a second layer of partnership, where HRMs depend on corporate HRD for strategic guidance, adding to existing SHRD theory. Though not a formal SHRD characteristic, this vertical dependency reflects the centralised nature of hospitals. Human resource managers’ limited direct engagement with corporate HRD, together with limited decision-making authority at the site-level, demonstrates how organisational structure shapes SHRD implementation.
Contrary to SHRD expectations (Alagaraja,
Human resource managers reported that HRD contributed to organisational culture mainly through onboarding and orientation, indicating a transmissive rather than a transformative influence. This aligns with the broader compliance-oriented culture, where maintaining standards takes preference over experimenting with new learning approaches. Mitsakis (
Human resource managers confirmed that they do not use formal ROI tools to measure the impact of HRD, mainly due to tight budgets and operational pressures. As a result, evaluation was mainly used to justify spending rather than to support learning or inform strategic decisions. This limited HRD’s potential to develop as strategic partners and strengthened the transactional view. Mitsakis (
Human resource managers had limited familiarity with and experience in SHRD models, viewing them as abstract and aspirational rather than practical, actionable guidelines. They cited limited authority, time, resources and highly centralised governance as key barriers to applying the models. Similar challenges were reported in Woolworths (UK), where the lack of a transparent strategic approach to HRD hindered implementation (McCracken & Garavan,
The findings have several practical implications for HRD practice in healthcare settings. Human resource development leaders should prioritise development initiatives that align with core SHRD competencies and organisational priorities, while recognising how professional hierarchies and centralised governance influence what is possible at the site-level (for example, missed development opportunities for non-nursing technical staff). Consistent leadership support and appropriate resources are essential for applying SHRD holistically across all departments and integrating it with strategic planning and performance evaluation.
Human resource managers and HRDs who proactively engage with senior leadership are better positioned to build credibility and demonstrate the value of HRD initiatives, particularly when supported by clear business cases and appropriate measurement tools. These may help demonstrate broader organisational outcomes, such as workforce capability, employability, career progression, cost-effective service delivery and improved employee experience. Strengthening internal partnerships across HRD, HRM, line managers and training teams remains critical for shifting HRD from a transactional function to one that contributes to longer-term organisational outcomes.
The study highlights the need for targeted development to deepen HRM’s understanding of SHRD and strengthen the consistent application of its characteristics. Private hospitals and similar organisations would benefit from implementing formal SHRD frameworks that reflect both organisational goals and regulated requirements.
Repositioning HRMs as strategic partners, rather than administrative role-players, is essential for HRD to contribute meaningfully to organisational sustainability. Human resource development practitioners and HR leadership should adopt or adapt SHRD models that are suited to regulated healthcare environments and utilise these frameworks to secure executive support. Human resource development practitioners must develop the necessary strategic skills of change agents and culture influencers to move beyond transactional and reactive HRD services. To realise SHRD, HRD and HRM partnerships and collaboration require strengthening to enable a deep understanding of business needs. Co-created SHRD strategies should respond to environmental changes, organisational structures, culture, leadership expectations, job demands and career pathways, ensuring alignment with all internal and external stakeholder needs.
The study was limited to one private hospital group, which excludes public-sector enterprises and may restrict the transferability of findings. Including HR professionals from other hospital groups nationally may have revealed a broader range of SHRD practices. Participants occupied lower organisational levels than the researcher, which may have influenced their responses due to power imbalances. Future studies could include multilevel perspectives, particularly from senior executives, to deepen insight into how SHRD is shaped and enacted across hierarchical layers.
This study demonstrates that the uneven implementation of SHRD in private healthcare is not merely a result of weak implementation. Instead, SHRD practices are influenced by professional hierarchies, centralised governance and regulatory pressures that privilege certain groups, most notably nursing, over others. In this context, SHRD operates selectively, with limited influence on broader organisational capacity development, particularly for non-clinical staff. The study, therefore, argues for a reconceptualisation of SHRD in healthcare as a politically embedded and uneven process, rather than a universally applicable framework. By demonstrating how context mediates strategic intent, professional power and HRD agency, the study extends SHRD scholarship and highlights specific challenges of enacting SHRD in highly regulated, resource-constrained environments.
This article includes content that overlaps with research originally conducted as part of Sanjay Khoosal’s master’s dissertation titled ‘Exploring strategic human resource development at a private hospital group’, submitted to the Faculty of Economic and Management Sciences, School for Industrial Psychology and Human Resource Management, North-West University, South Africa in 2019. The dissertation was supervised by Prof. Helen Meyer. Portions of the data, analysis and/or discussion have been extensively revised and updated for journal publication. The original thesis is publicly available at:
The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
Helen Meyer: Conceptualisation, Formal analysis, Methodology, Project administration, Supervision, Validation, Visualisation, Writing – review & editing. Sanjay Khoosal: Conceptualisation, Data curation, Formal analysis, Investigation, Methodology, Project administration, Resources, Validation, Visualisation, Writing – original draft. All authors reviewed the article, contributed to the discussion of results, approved the final version for submission and publication and take responsibility for the integrity of its findings.
The data that support the findings of this study are available from the corresponding author, Helen Meyer, upon reasonable request.
The views and opinions expressed in this article are those of the authors and are the product of professional research. They do not necessarily reflect the official policy or position of any affiliated institution, funder, agency or that of the publisher. The authors are responsible for this article’s results, findings and content.