Facilitating Change in Health and Social Care: A Comprehensive Analysis

This assignment explores the complexities of change management within the UK's health and social care sector. It examines key driving factors, including political, economic, social, technological, legal, and environmental influences, and analyzes the challenges they pose. The impact of recent changes, particularly the Care Act 2014, is evaluated, highlighting its effects on service providers, users, and carers. The assignment delves into the principles of change management, utilizing models like Kotler's eight-step model and McKinsey's 7S model, and explores how NHS plans and monitors change initiatives. It concludes by emphasizing the importance of effective and sustainable change management for the well-being of the health and social care sector.

HEALTH AND SOCIAL CARE FACILITATING CHANGE IN H&SC

Table of Contents
Introduction.................................................................................................................................................3
Part 1...........................................................................................................................................................4
Part 2...........................................................................................................................................................8
Part 3.........................................................................................................................................................14
Conclusion.................................................................................................................................................18
Reference List:..........................................................................................................................................19

Introduction
Health and social care sector in UK have been addressed with many types of
changes. To deal with these types of changes the organisations have to take
proactive steps so that the change can be facilitated systematically and
effectively. The sustainability of these changes is also a matter that needs to
be discussed as well. In this assignment the different factors that influences
change and how they affect the organisations will be discussed. The
challenges that are faced due to these factors will be discussed as well. This
assignment will also consist of strategy for measuring these changes as well.
The impact of recent changes will be evaluated in this study as well. The key
principals of changes and how these changes will be planned will be part of
this study.

Part 1
Essay on factors that drive change in health and social care services
(Task 1 AC 1.1,1.2, and MI,M2 and M3)
Introduction
Organisational change happens due to the experimentation or starting new
arrangements in an organisation. Organisational change is a factor that
affects the different aspects of operations and functions of a health and
social care organisation. A good organisation should be able to adapt to
these changes quickly and effectively and in this essay the key factors that
drives changes in a health and social care services will be discussed. This
essay also assesses the challenges faced in the health and social care due to
these key factors as well.
Explain the key factors that drive change in health and social care
services (1.1)
Changes in an organization can happen due to both internal and external
environment. People, event, organizational structure and condition part of
internal environment of a health and social care organization. A lot of the
factors like organizational activities, decision making and employee
behaviour can be influenced by the change in internal environment. For
example changes in the organizational culture and leadership style can
impact the organization very heavily. These kind of major changes happen
when a health and social care organization changes their business strategy
or goes through a merger. Merger can change their business strategy and
affect the already existing process and procedure of the organization.
External factors are something that cannot be controlled by the organization
but effects the organization very much. There are 6 main external factors
that influence the any health and social care organization like political,

economical, social, technological, legal and environmental factor. Other
factors like customer and market competition is also a very influential
external factor. Following is the analysis of these factors and how they affect
the health and social care organisation (Laird et al., 2015).
Political factors-Political influence is one of the key influencing factors of
change. Legislations of EU and Brexit are some of the factors that
influence health and social care organisation. Lack of natural resources is
also a factor that influences the organisation. Not only Brexit but various
health and social care act like 1999, 1990 and 2014 are also affecting
and influencing change in the health and social care organisations. The NHS
certified organisations need funding and they are feeling the demographic
pressure all due to these political influences.
Economic factor-The uncertain economic condition is something that
influences change in the health care organisation. Strong economy boosts
the health and social care organisations very much.
Technological factor-The technological advancement will be an effecting
factor as well. Technology will impact the health and social care
organisations with better facility to provide their service user.
Social factor-Social factors are something that influences service user’s
values and behaviours so it is also an influencing factor for the health HSC
organisation. Legal factor is also something that influences the HSC
organisation.
Legal factors-New laws of the government of the needs to be implemented
in the HSC organisation and the employment law is also something that falls
in this category. Labour market is something that is also part of the external
factors (Cameron et al., 2014). Legislations like care act 2002, Care act
2014 has impacted the health and social care organisation tremendously
and employees of the health and social care are being affected by these laws

very much. The stress of this legislation is hampering the quality of the
service given to the users and at the same time the amount of people
depending on the health and social care service in UK is a lot.
Environmental factor- The environmental factor in recent times have
became a huge issue and with the rise of users who are more into
sustainable living it is causing some serious impact on the health and social
care sectors of UK as well. The waste management of the health and
social care has become an environmental concern as well.
Assess the challenges that key factors of change brings to health
and social care services (1.2)
As a challenge of political factor, legislations of EU (European Union) have
significant influence on the NHS or any other health care organisation Brexit
for example will have huge impact on the UK’S health and social care
organisations. Staffing is going to be one of the huge impacts that NHS has
to face. Almost 55,000 of the NHS worker come from EU countries. Brexit will
impact the NHS and the workforce will be hampered as well. To rectify the
issue NHS has to take necessary steps for fulfilling the needs of the staffs
and they have to invest more in welfare measure of the staffs.
Though UK has relatively better stability in economy but uncertain
economic condition is something that can also influence change in the
health and social care organisation like NHS. As an impact of this issue the
operation and functions of the health care organisation gets affected

immensely. This is unpredictable and cannot be always supported by action
of the organisation.
A lot depends on the values and priorities of the service users, which is
a socio cultural factor. If the service users are not satisfied they might not
avail the service in the organisation, which will hamper the organisation
reputation. Update the functions and operations of the organisation as per
the demands of the service users (Davis et al., 2015).
Technology in the current times one of the chief factors of change in HSC
organisations. Technological advancement is very much necessary and
facilities like e business and assisted technology are something that affects
the all the NHS certified organisation. This will impact the organisation in a
good way but the difficulty might be faced when implementing these
technologies in health and social care organisations. Training and
development of the staffs can be helpful in for implementing technological
advancement of the organisation (Ho et al., 2014).
Legal factors are very important for HSC organisations. Laws like NHS and
Community care act 1990, Health and social care act 2000 and care
act 2014 will have immense impact on the health and social care
organisation. Employees will be really stressed and the entire NHS certified
organisations will have to facilitate this change. Organisation will be given to
welfare measurements for the staffs (Barkauskas et al., 2015).
Environmental factors are also very important and people are now being
conscious of the impact of health and social care centres have on the
environment. The waste management of the health and social care
organisations have been a controversial issue for a long time. The
organisations have to abide by the regulations of UK regarding this matter.

Conclusion
To conclude with it can be said that the external factors have huge influence
on the health and social care organisations. Political and legal factors
specially have huge impact on the health care organisations, which have
been discussed in this essay and also other important factors like
economical, environmental, technological and social factors also discussed
and assessed as well.

Part 2
Essay on recent changes in health and social care services (Task 2 AC
2.1, 2.2, 2.3, 2.4M1, M2 M3 and D1)
Introduction: On 15Th May, 2014, Care Act 2014 was passed and became law (Penhale et al.,
2017). According to the act the local councils are given responsibility to take care of the carers
welfare. The service users were responsible for the same before the act came in effect. The act
also makes the users to practice Human Rights Act 1998 whenever they are under the care of the
health and social care service provider (Bates et al., 2015). The users also allowed using their
care fund independently. The users are also allowed to create new appeal system opposing the
council after they prove their eligibility to care fund. Now, the legal guidance will be issued
instead of no secret guidance to protest the vulnerable adults. While the Act has some positive
effect on the system, the service providers on other hand are facing some issues especially on the
financial management due to the application of the act.
Devise a strategy and criteria for measuring recent changes in health and social care (2.1)
In order to measure the impact of the recent changes in the health and social care sector, it is
essential to understand the key stakeholders involved in the whole process. The main
stakeholders are the users, the service providers and the funding trusts. Royal College of Nursing
(RCN) follows few core strategies for the better service assistance such as creating comfortable
and healthy environment for the users, better communication and care for the patients, using
latest technology and equipments for the treatment procedures, keeping patients fully aware of
the steps of the treatment process and providing all possible assistance to the patients during their
course of treatment. The same policies can be considered for minimizing the effect of the recent
changes.
The service providers face the most difficulty in taking care of the older patients. They are the
most vulnerable patients as they are unable to convey their requirements on their own and need
constant support from the carers (Blumenthal and Collins, 2014). Older people often feel that
they are burden to their families and also neglected by their family members. Hence, other than

physical support, they often need psychological and emotional support too. The carers need to
make them feel important from time to time, so they feel less insecure. The older people also
expect respect from people around them. Hence, it is imperative that while providing care, the
carers should respect their privacy and wishes. Helping the older people can be tricky as some of
them can deem the help negatively. If the help is provided without their permission they feel that
they are considered to be dependable and helpless which hurts their self-esteem.
The legal guidance aspect of the act will help the providers to help the older users in better way
as now they can request the close family members to take decision on the patient’s behalf. The
recent changes have impacted the financial aspect of the service providers the most (Heintzman
et al., 2017). The service providers are expected to provide the users inexpensive and proper care
on-time while maintaining the quality of the service.
The goal and target of the providers are to provide best quality service to its users. Providing a
healthy and efficient healthcare service to its users is main motive of the providers. However, the
recent changes in the health and social care scenario have made it difficult for them to maintain
the service standard.
Measure the impact of recent changes on health and social care services against set criteria
(2.2).
According to the Care Quality Control report the number of complaint from the users against the
service providers is increasing rapidly. The users are not happy with the way the carers are doing
their job. They are expecting more professional service from the carers and as a whole from the
providers.

Figure 1: Ratings of the Adult Health Services
(Source: Mays et al., 2018)
Previously, the users were supposed to take care of the carers and promote their interest. It was
often proved to be very difficult for them as along with the taking care of their own treatment,
taking care of someone else’s interests is a huge task. Hence, the carers often used to get
neglected in the process (Barne et al., 2017). Now that the local authority is given the
responsibility, it can be expected to be more effective process and more beneficial for the carers.
The users are now more protected and empowered under the protection of Human Rights Act
1998. They are given power to access legal help if the service provider is not following the
guidelines imposed by the authority. Also if the service provider is not delivering what they have
promised before admission of the patient, the user can file complaint against them to the
appropriate authority.
The legal guidance will allow the service provider to take necessary step for taking care of the
older patients, especially who are not mentally fit to take their treatment decision or show

resistance in following instructions given by the medical team. According to this, any relative
who is appointed by the user can take decisions on their behalf. This will make the work much
easier for the carers and medical team.
Lastly, the users now can access their care fund easily once they prove their eligibility. They do
not need to depend on the service providers for using the fund anymore. This will make the user
more independent and feel secured financially (Sommers et al., 201.).
However, the new act has put some restrictions on the service providers on using the trust funds
which has ultimately resulting in the financial crisis for them. It has also increased the number of
competitors vying to access the same trust funds.
Evaluate the overall impact of recent changes in health and social care (2.3).
After the Care Act 2014 came into affect the health and social care scenario changed drastically.
The Care Quality Control has identified various deficiencies in the quality of service given by
the health care service providers. The service providers need to improve their quality standard
drastically if they want to carry on with their good name and continue their business in the
sector. However, the falling standard is the result of the recent changes that took place due to the
activation of Care Act 2014.
Especially the financial aspect has taken a huge hit for the service providers. Many service
providers are approaching the trust funds at the same time, which is making it difficult for the
trust funds like The King’s Fund and the Nuffield Trust’s Home Truths to select from the
contenders. It is even limiting the amount of fund per provider. Since, most of the providers are
dependent on these trust funds for the financial assistance; there is a fair chance of shutting down
of many such providers in future if the scenario does not change immediately in favour of the
service providers (Beronio et al., 2014).
The recent pay structure for the carers is also very low. This is creating a huge dissatisfaction
among the carers. Many of them are threatening to leave the job resulting in a crisis of skilled
workforce. The decreasing number of workers and increasing demand of the service users are
creating an imbalance in the ratio of number of workers per user.

Dissatisfaction of the workers regarding the low pay is reflecting on their work too. The workers
seem uninterested and inattentive in their work. The de-motivated workers becoming a huge
problem for the service providers as they are unable to deliver the quality of service promised the
users. Also the users are now under the protection of Human Rights Act 1998, which makes the
service providers vulnerable to legal actions taken by the users for not delivering the promised
quality of service (Dzehtsiarou et al., 2015).
In other words, the users are in a much better position than the service providers. The users are
also getting benefit of using the trust fund directly. Though they need to prove their eligibility for
accessing to the appropriate authority, but once the eligibility criteria is met, the expense of the
treatment is covered by the fund.
The no secret guidance which is replaced by the legal guidance has worked in favour of the
service providers (Shaw et al., 2014). Previously they were unable to take necessary steps
towards taking care of the mentally unfit patients as they had to respect their privacy and could
not interfere in their treatment without their permission. Now, after the act is passed anyone who
is the legal representative of the patient are able to take decision on the patient’s behalf and
service provider’s function has become smoother.
Propose appropriate service responses to recent changes in health and social care services
(2.4)
While in one hand the wellbeing of the carers are much secured and structured in the hands of
local authorities, on the other hand the burden has increased for the local authority. The act has
also curbed the financial independence of the service providers and the number of service
providers vying for the same trust fund has increased many folds (Anka et al., 2017). Naturally,
the burden of the financial crisis of any organization falls on the workers immediately. In this
case also the pay of the carers has been decreased drastically, resulting huge dissatisfaction
among them. The low pay structure is compelling them either leave their jobs or deteriorating
their performance level. The users also feeling the brunt of the change as the quality of care they
expect are not being fulfilled by the organization. They seem inattentive and careless about their
job. If the situation does not change for better, the service providers are at risk of facing serious
legal issues from the users for their inefficiency. In order to mitigate the issues the service

providers can make some changes in their operations. Following are the few recommendations
for the service providers that are listed below.
The service providers should look for other options to raise money instead of solely depending
on the trust funds for financial assistance. The service providers can approach wealthy
individuals or corporate organizations that are eager to donate money for social cause as a part of
their CSR activity. They can be act as sponsors for the service providers. Also, since the users
are now can access the care fund directly, the service providers can request the users to pay for
certain services availed by them. This can also help them to raise money to overcome the
financial crisis.
In order to handle the worker related situations, the service provider should take some measures
to motivate them. Since, they are not being paid as per their expectations; the providers can grant
them some other perks, so they do not feel neglected. For example, less working hours or
flexibility of duty hours can make up for the low pay. The providers can hire unskilled staffs who
agree to work in low pay and train them on the job. The training programs and seminars can be
taken by the existing skilled staffs, this way the existing staffs will also feel that they are
important part of the organization.

Conclusion: In this section, the impact of Care Act 2014 has been discussed. Reactions of the
various stakeholders of the health and social care sector have also been discussed in the section.
The researcher has also recommended some steps that the service provider can take to face the
situation.

Part 3
Essay on the principles of change management (Task 3 AC 3.1, 3.2,
3.3, M1, M2, M3 and D2, D3)
Introduction
There are certain principals that help in facilitating change in health and
social care organisation. Based on these principals the facilitating change
becomes much easier. In this essay the key principals of change will be
discussed and how these changes are planned based on these principal is
discussed in this study. NHS in particular how plans the change in their
organisation is taken as an example for better understanding of the process.
Lastly how these changes are monitored for effectiveness and sustainability
discussed in this essay as well.
Explain the key principles of change management (3.1),
There are different ways people will react to change in an organisation
depending on the situation. It the process of change is very complicated it is
bound to fail and also if the vision is unclear for the organisation about what
they want to achieve through this change it will be a failure as well.
Therefore there are two different theory of principal that can be utilised by
NHS and NHS certified organisation for better implantation of changes in the
organisation. One of the models that can help the organisation in facilitating
change is John P Kotler’s eight step model. As in the case study the laws like
care act 2014 has created a lot of difficulties in the health care organisations
(Salman and Broten, 2017).
According to the Kotler, 1st step is establishing the need for urgency of the
change. 2nd step is creating a group for example, which can be used as a
guide for change. 3rd step is building a vision for everyone which they can
follow in order to facilitating the change. 4th step is the communicating the

vision with the other member of the organisation. 5th step is very important,
which say empowering the staffs. Making sure there are short term goals to
achieve as well, which is the 6th step. 7th step is to consolidate the gains and
the last step is to insert the culture in the organisational culture(Van den
Berg, and Pietersma, 2015).
McKinsey’s 7s model is another model that can be used as principal guide for
facilitating change in any health and social care organisation. Seven S in the
model are structure, strategy, shared values, system, staff, skill and style. All
these can be used to facilitate any major changes from consolidation to
economic and legal factors as well. The NHS certified organisation should
implement these principals to implement the change in the organisation.
This will also create a help the staffs and make them adapt to the change
gradually (Channon and Caldart, 2015).
Explain how changes in health and social care are planned (3.2)
Following are the steps of planning process for facilitating change in NHS
The first step is to understand who is involved in this and how they are going
to be affected by this change. It is the responsibility of the management to
motivate these employees and provide them with necessary support to
accept these changes. Engagement to mobilise means asking the right
questions to determine a common goal for achievement and understanding
the values of the people as well.
Leadership of change is the first step of plan. A successful leadership is
necessary for facilitating change. Leadership plays a huge role in delivering
change. Depending on the leadership style the success of the implementing
change can be determined as well and the large scale change is definitely
can be done with an effective and efficient leadership style (Lumbers, 2018).
Spread of innovation is also a step that helps the implementing the change.
Innovation accelerates the process of change. Proper tools and approach if

delivered to the staffs of the health and social organisation like NHS, they
will be able to reach the organisational goals much easily as well. The
innovation tools can be adopted from outside of the organisation as well.
Improvement of methodology needs to be evidenced based so that the
change can be delivered in a planned way. The large-scale change and small
scale change needs to be catered with different approaches of methodology
as well. There are different approaches like lean model and Total Quality
Management to facilitate the large scale change in the organisation (Hayes,
2018).
Project management is necessary for rigorous delivery of delivering change
in health and social care organisation. Setting roles and responsibilities,
frequent inventory of progress towards the set objective, better control of
finances of the organisation is also part of this step. This step of the NHS
change model requires discipline and focus.
Transparent measurement is another step that is required for implementing
change in health care organisation. Transparent measurement is necessary
to identify if improvement is happening as per the plan and judging the
performance of the employees in the organisation. Also informing the
research evidenced is also required and by making the data public the
organisation will be able to show transparency in the process.
System drivers create suitable condition for facilitating change in health and
social care organisation. System drivers need to be determined by the
considering the change initiative taken by the organisation. The design of
the system driver has to be flexible so it can evolve and respond to the
change initiative properly.

Following on from this assess how to monitor recent changes in
health and social care services (3.3).
To make sure the change is affective and long lasting, it needs to be
monitored. To monitor recent changes in health and social care organisation
NHS has developed three methods. First is intrinsic and extrinsic motivation,
which motivates the employees for working toward a shared purpose. Asses
the change the organisation has to measure the change and see how it has
affected the employees and the service users for better. Next is monitoring
the anatomy and physiology of change, meaning comparing the structure
with life giving forces of change. For an effective change the anatomy or the
structure of the change and the physiology of change is also necessary. Last
but not the least is balancing compliance with commitment. Compliance is
the basic performance standard for the employees and commitment is the
goal that is set collectively. Both of them is important and help in monitoring
how effectively the transition is happening in a health and social care
organisation (Bowling, 2014).
Conclusion
To conclude with it can be said that the key principals of change are very
important and helpful in facilitating change. The process of the change
model that NHS has used is discussed here. The planning process of
facilitating change is discussed here as well. The planning process is very
important and plays a huge role in facilitating change in health and social
care organisation. The organisation can effectively measure and monitor
these changes as well, which have been discussed here as well.

Conclusion
Facilitating change needs to be done effective and if the change is done
poorly it will never be effective and sustainable. In this task the change that
care act 2000 has caused to the health and social care sector have been
taken as a case scenario. The internal and external factors that affect the
health and social care organisation have been discussed in this assignment.
The challenges faced due to these factors have assessed as well. The recent
changes in the health and social care organisations in UK have been
discussed as well. The impact of the recent changes in the health and social
care organisations have been discussed well. The key principals of change in
health and social are explained and how these principals are used to plan an
effective change in NHS has been explained. Monitoring these changes is
also a very important task and how properly these plans can be monitored to
understand the effectiveness of it will be also explained in this assignment.
This assignment will be in the form of essay as well.

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