...Managing Change in the NHS Organisational Change A REVIEW FOR HEALTH CARE MANAGERS, PROFESSIONALS AND RESEARCHERS Valerie Iles and Kim Sutherland Managing Change in the NHS Organisational Change A REVIEW FOR HEALTH CARE MANAGERS, PROFESSIONALS AND RESEARCHERS Valerie Iles and Kim Sutherland Contents Purpose and Acknowledgements Foreword 5 7 8 Introduction Part 1 The literature on change management Part 2 Tools, models and approaches: a selective review 1.1 1.2 1.3 1.4 Where does the literature come from? What kind of evidence does it provide? What is meant by ‘change’? Organisational change in the NHS 12 13 14 18 2.1 How to access the models 2.2 How can we understand complexity, interdependence and fragmentation? Weisbord’s Six-Box Organisational Model 7S Model PESTELI Five Whys Content, Context and Process Model Soft Systems Methodology Process modelling Process flow Influence diagram Theory of Constraints (TOC) 22 25 25 27 29 30 32 34 36 37 38 39 40 40 42 43 45 46 47 48 48 50 54 54 55 56 56 58 2.3 Why do we need to change? SWOT analysis 2.4 Who and what can change? Force field analysis ‘Sources and potency of forces’ ‘Readiness and capability’ Commitment, enrolment and compliance Organisation-level change interventions Total Quality Management (TQM) Business Process Reengineering (BPR) Group-level change interventions Parallel learning structures Self-managed teams Individual-level change interventions Innovation research...
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...This essay critically examines leadership style and change management strategy in relation to a particular change in clinical practice. The change made in practice was a move from open access at well baby clinic to an appointment system. The effectiveness of the leader will be demonstrated by focusing on the change process, applying leadership theory to the change and its implementation in practice. This essay also identifies implications for practice and developmental needs for the author, the team and the sphere of practice. It begins by outlining policy drivers relating to leadership within the NHS generally and health visiting specifically. It is interesting to note that despite the vast literature on leadership there is very little agreement amongst scholars on the definition of the term (Willcocks 2012; Alimo-Metcalfe and Lawler 2001). Contemporary government policies such as the Health Visitor Implementation plan (GBDH 2011) focus on the desirability of strong leadership to improve the quality of care but are equally vague on defining leadership (Willcocks 2012; Martin and Learmonth 2012). Some authors have found that the term “leader” has merely superseded the terms “administrator” and “manager” within the confines of the NHS (Martin and Learmonth 2012; Sheridan, Rastan and Foulkes 2008; Hodgetts 2012) as it confers an image of “heroism” and, as yet, carries none of the negative connotations associated with administration or management. It has been suggested that leadership...
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...CONTENT 1.0 HRM STRAEGIES AND PRACTICES RELATED TO MMC ………………………………………………………. 3 2.0 EXPLANATION ON THE FACTORS AND PRACTICES RESPONSIBLE FOR THE FAILURES OF MMC FROM A HRM PESPECTIVE …………………………………………………………………………………………………5 3.0 HRM STRATEGIES RECOMMNEDED FOR INCORPORATION BY NHS…………………………………….7 4.0 RECOMMENDED HRM POLICIES AND PRACTICES FOR IMPROVING THE FUNCTION AND PUBLICITY OF MMC………………………………………………………………………………………………………….10 2 MBAN-609DE, May 2015 1.0 r1411d521304 HRM STRAEGIES AND PRACTICES RELATED TO MODERNISING MEDICAL CAREERS (MMC) Human Resource Strategies set out what the organisations intend to do about its human resource management policies and practises and how they should be integrated with the business strategy and with each other. (Armstrong, 2006). The purpose of HRM strategies is to; Guide development and implementation programmes Provide a means of communicating to all concern the intentions of the organisation about how its human resource will be managed Enable the organisation measure progress and evaluate outcomes against objectives. (Armstrong, 2006) Modernising Medical Careers, MMC, was designed by the National Health Service, NHS, to reform postgraduate medical education and training to speed up the production of...
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...Welcome First of all I would like to congratulate you on your appointment and wish you every success in your new position. Contained in this briefing note is information which will help you gain knowledge and understanding of NHS Highland as an organisation services and how HR aims to support its strategy Introduction (purpose and goals) NHS Highland, in common with all Scottish health boards, has a huge advantage in being responsible for the total health needs of the population and for integrated care. This means it is responsible for better health of communities through population wide and individually focused initiatives to maximise health and prevent illness; for better care of its patients through quick access to modern services, in clean and infection free facilities, by well trained and courteous staff; and for better value for the use of the public money they spend by ensuring there is no waste and inefficiency, money is spent only on what is needed and has evident therapeutic benefits and variation from core care pathways is the exception. Products and services NHS Highland’s customer is the public and its vision is to provide quality care at all times; to support people and communities to maximise their own health; to develop precision driven services so that when people need care they experience timely, focused, effective services that minimises the duration and frequency Our approach embraces the Healthcare Quality Strategy for Scotland. At its...
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...Environment to Budgeting[pic]National Health Service Structural Changes in the National Health Service [pic]Accounting and Budgeting Practice [pic]Financial Framework[pic]Developments in NHS Budgeting[pic]Sources of Further Information October 2005 External Environment to Budgeting: NHS This section identifies the external factors and developments which influence budgeting in the national health service, summarising the main developments which have taken place in recent years. Introduction The information in this section refers to the NHS in England. There are substantial organisational differences in the NHS in Scotland and Wales The NHS is the biggest organisation in Europe in terms of the number of people it employs. At the top level of the structure is the Department of Health (DOH) the government department which makes decisions on the future direction of the NHS and secures funding. Further down the structure are Strategic Health Authorities (SHA’s) which oversee services on regional basis. At local level Primary Care Trusts (PCT’s) are responsible for assessing the needs of people in their area, commissioning the appropriate services and monitoring General Practitioners (GP’s). Actual delivery of services are carried out by Primary Care services (GP’s, Dentists, Opticians, pharmacists , NHS walk in centres) and Secondary Care Services ( Acute Hospitals, mental hospitals and ambulance trusts). The NHS operates on a purchaser/ provider split. On the purchasing...
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...innovation is in relation to implementing mandatory Mental Health Training on a yearly basis which would include a 6 month refresher. The training would comprise of learning about postnatal depression and other mental health illnesses, a one off 2/4 week perinatal placement, available guidance on how to access mental health services and the recognition of signs and symptoms within Maternal Health. Through implementation and evaluating the process of events the Transformational Leadership theory, will be used along with the Kotter’s Model to incorporate and deliver the vision, towards improvement of management for change; within the public health sector. Within this assignment Transformational Leadership will be critically analysed, in relation to the leadership role of the specialist public health nurse. Leadership within the National Health Service (NHS) continues to play an essential role and historical leaders such as Florence Nightingale (Kitching, 1993) had an effect on policy. This influenced change towards development and an up to date change would include the Darzi Review (2008) that discusses improvement of quality of care. Leadership is discovering the route ahead, while making others feel enthusiastic about following (Bass, 1985). This would include an influential and inspiring attitude along with other personal attributes that are needed; such as emotional intelligence, that addresses the effect of people’s feelings whilst being in tune with their own emotions and...
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...An NHS Confederation leading edge report Lean thinking for the NHS Daniel Jones and Alan Mitchell, Lean Enterprise Academy UK A report commissioned by the NHS Confederation The voice of NHS leadership The NHS Confederation brings together the organisations that make up the modern NHS across the UK. We help our members deliver better health and healthcare by: • influencing policy and the wider public debate on the full range of health and health service issues • supporting health leaders through information sharing and networking • working for employers to improve the working lives of staff and, through them, to provide better care for patients. For more information on our work, please contact: NHS Confederation 29 Bressenden Place London SW1E 5DD Tel 020 7074 3200 Fax 020 7074 3201 Email enquiries@nhsconfed.org www.nhsconfed.org Disclaimer All views and opinions in this publication are those of the author and are not the authorised views or opinions of the NHS Confederation. The NHS Confederation shall not be liable for any indirect, special, consequential, or incidental damages or defamation arising from any views, opinions or information contained within this publication. Registered Charity no. 1090329 Published by the NHS Confederation © NHS Confederation 2006 ISBN 1 85947 127 7 Ref: BOK 56701 Acknowledgements This report was written by: Daniel Jones and Alan Mitchell, Lean Enterprise Academy UK with David Ben-Tovim, Flinders Medical Centre, Australia David...
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...identifies any problems with a pubic service and monitors progression in the form of improved performance. It is important to establish whether performance management systems will improve public services because they affect every individual in the UK. A good example of where a performance management system is needed for better quality of safety, reliability, punctuality, and comfort is on UK railways and on the London Underground. This essay aims to establish whether the successful implementation and use of performance management systems will lead to a higher quality of education, health, police force and public transport system. The Prime Minister’s Speech in 2001 stated that UK public services were still in need of modernisation and change in order to meet the changing needs of a 21st century public. He suggested that investment alone was not enough to increase the quality of public services and he believed that society was driving the focus away from the 1980s financial focused businesses to focus on successful public orientated businesses. Tony Blair also explained that teachers, doctors, nurses and police officers amongst other professional public servants were satisfied with their job which suggests that it is possible to introduce successful performance management systesms as public service employees strive for improved performances however, that could be the...
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...Briefing Note on NHS Highland for New Staff Members National Health Service Highland (NHS Highland) is a public sector organisation and is classed as being in the Tertiary Sector as it provides a service to the public rather than producing a tangible product. NHS Highland serves a population of approximately 310,000 residents and provides a wide range of services across the largest land area (~40%) of any health authority in Scotland. NHS Highland is managed by a Board of Executive and Non-Executive Directors and is accountable to the Scottish Government through the Cabinet Secretary for Health and Wellbeing. The main services provided by NHS Highland are: Healthcare, in the form of General Practitioner Surgeries, Hospital services, Adult Social Care and Dentistry. The main customers (patients/service users) are the general public within the Highland Region and also to provide services to visitors to the region too. Additionally, NHS highland have internal customers to whom we provide services. NHS Highland’s purpose and goals are to place quality first to deliver better health, better care and better value. They have “The Blue Triangle” (see fig 1.) which captures the key elements of the Highland Quality Approach (HQA). “The Highland Quality Approach captures the spirit of how NHS Highland is working to improve care and outcomes for people in Highland Region. It describes ways of working, values and behaviour. It recognises how important it is to improve the...
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...analysed using the PESTLE framework. The impact of the macro - environment is evaluated. 2.1 The PESTLE is a management tool that involves identification of the political, economic, sociological, technological, legal, environmental factors that had an impact on an organisation in the past, and could affect organisation in the future. Carry out PESTLE along with SWOT analysis, assist in strategic decision- making, and setting realistic objectives. 2.2 The PESTLE analysis is attached as Appendix 1. 2.3 The SWOT analysis is attached as Appendix 2. 2.4 The evaluation of high impact environmental factors based on PESTLE analysis. 2.5.1 The Department of Health is making provisions to a number of changes to the NHS dental contract, based on capitation, quality and registration, rather than UDA system. The two prototype contracts will begin operating in 2015-2016 for a two year trial, before a general new contract is introduced for everyone, in consequence it is difficult to predict a full impact on our organisation until the trial is finished. This requires contract monitoring for the time being. 2.5.2 Due to providing assurance and reporting to the commissionaires in line with CQC and GDC requirements, our practice has been forced to invest over £100000 to meet mandatory standards by the end of 2012. This involved building of an extension and allocation of separate decontamination room, along with a staff training. Failing in compliance...
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...INTERNSHIP PROJECT FINAL REPORT DES/SBTAP Automotive Repair and Refinishing Environmental Compliance On-Site Evaluations Ali Etebari INTERNSHIP PROJECT FINAL REPORT DES/SBTAP Automotive Repair and Refinishing Environmental Compliance On-Site Evaluations Ali Etebari (603) 868-1447 E-mail: aetebari@vt.edu Facility: New Hampshire Department of Environmental Services (NH DES) Small Business Technical Assistance Program (SBTAP) 64 North Main St P. O. Box 2033 Concord, NH 03302-2033 Contact: Rudy Cartier NH DES Small Business Ombudsman Phone: 1-800-837-0656 Fax: 271-1381 E-mail: cartier@desarsb.mv.com Faculty Advisor: Dr. Ihab Farag 255 Kingsbury Hall University of New Hampshire Durham, NH 03824 TABLE OF CONTENTS Executive Summary 3 Introduction/Background 3 Goals/Objectives 4 Approach/Methodology 4 Chemical Usage, Equipment Needs 4 Releases/Wastes Generated at the Facility 5 Details of Work Accomplished/Project Results 5 Pollution Prevention Benefits 5 Recommendations for Future Efforts 6 References 6 Appendices: A. Sample Report 6 B. Evaluation Checklist 10 C. Microsoft Excel Spreadsheet 13 Executive Summary: SBTAP is offering small-scale automotive repair and refinishing businesses free confidential on-site inspections in order to increase their awareness...
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...analysis will discuss the relationship between organisational values, stakeholder engagement and the delivery of quality patient care, before relating this to his professional practice, prior to drawing and presenting conclusions. The author having worked in the NHS for a number of years as a Commissioning Manager in a non-clinical role has often found it difficult to see the impact that sound organisational values and robust stakeholder engagement can directly have on the delivery of patient quality, experience and care, working through Module 3 has been a truly eye opening experience for the author. Having completed Module 1 and 2 of the EGA course and now coming to the end of Module 3, there have been many opportunities for self-reflection and time to make sense of how and why organisational values, engagement and service delivery are all interlinked. Analysis Engaging Stakeholders to Improve Care & Quality “Stakeholder engagement is the process by which an organisation involves people who may be affected by the decisions it makes or can influence the implementation of its decisions.” The notion of engagement with patients in their care has been a growing focus of health and social care policy. In 2000 the NHS published their plan (Department of Health 2000) which spoke of moulding services around the needs and desires where possible of patients themselves. Seven years on,...
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...discuss the factors that facilitate change in health and social care. This can be achieved by assessing the challenges that the major factors of change bring using the Care Quality Commission of the Quality Care Commission for the Royal United Hospital Bath NHS Trust (RUHB). The second task aims to evaluate contemporary changes being inaugurated in the provision of health and social care services. In addition to this, a strategy and criteria will be devised in order to measure these recent changes including how the impact of these changes can be measured and evaluated. LO1 1.1 Explain the key factors that drive change in health and social care services ‘Change’ within an organization sometimes refers to organizational change in health and social care is the movement from a current state through a state of transition to a state in the future (Richards, 2012). The impetus of change within an organization may come from within and outside. These are known as the internal and external drivers of change. This can be explained using PEST and SWOT analysis. PEST analysis (Political, Economic, Social and Technological analysis) describes a framework of environmental factors considered in the strategic management of an organisation (Friesner, 2014). Political factors of change include change of government and policies within the NHS in the form of legislations. For example, when the Coalition government came to power in 2010, it embarked on reforming the NHS. The flagship of these reforms...
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...Business Ownership P1 Organisation 1 – NHS The NHS is a national public sector health service maintained and paid for by the UK. The NHS was founded in 1948 in an attempt by the then heath secretary, Aneurin Bevan, to bring good healthcare to all. It was founded to provide affordable healthcare to the citizens of the UK who need it. Today the NHS has a very good reputation as it continues to provide good healthcare to those in need, they currently employ over 1.6 million government people to achieve this endeavour. The NHS is a national business as it only operates in the UK and only provides its services to those living in the UK. It only operates in the tertiary sector as they provide a service for the public but do not manufacture, sell or harvest raw materials. Because it is a public business it doesn’t make a profit instead it uses it’s funding to help with the financial burden of medical procedures. There are down sides to this for example the NHS don’t always have the most up to date equipment. Because the service is maintained and paid for by the government they are the ones that will be held liable for any problems with the way the NHS runs or if it overspends. The NHS is limited by their annual budget for the year 2015 their budget was £115 Billion. Organisation 2 - Starbucks Starbucks Coffee is a privately owned American global coffee company and coffeehouse chain. Public limited companies become a legal entity whose assets and liability are separate from their...
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...The Final Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry – Chaired by Robert Francis QC On the day briefing by the Foundation Trust Network (FTN) 1. Background The following briefing provides a summary of our action to date, the Francis recommendations and an initial response from the FTN. 2. Initial Reaction from the FTN In the run up to publication of the Francis Report, our Chair, Peter Griffiths and Chief Executive, Chris Hopson wrote an open letter to members acknowledging that pockets of poor quality care can exist in all types of trust, but emphasising that failures as serious, protracted and devastating as Mid Staffordshire are rare and isolated. We recognised that the FTN and the wider NHS need to do much more to identify and share best practice on improving quality of care and to provide practical tools to support trusts in doing so. Our work programme will identify how the FTN can help develop sector led support to complement government led initiatives, focussing on: • • • • The drivers of quality identified through research such as culture, ward level leadership, team effectiveness, staff satisfaction and support; The role of the board; Defining what support could be provided to trusts finding it difficult to meet standards; Exploring the link between increasing financial pressure and quality. Clearly, today’s announcements and recommendations will have a major impact on everyone in the NHS. We are committed to engaging fully in the evolving...
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