Facilitating Health and Social Care

This report examines the factors driving change in health and social care services, focusing on the NHS. It analyzes the challenges, recent changes, and proposes service responses. The report also explores change management principles and monitoring strategies for effective implementation.

Facilitating health and
social care

Table of Contents
INTRODUCTION...........................................................................................................................3
TASK 1............................................................................................................................................3
1.1Key factors that drive change in health and social care services .....................................3
1.2Challenges that key factors of change brings to health and social care services..............5
TASK 2............................................................................................................................................5
2.1Strategy and criteria for measuring recent changes in health and social care...................5
2.2Impact of recent changes on health and social care services against set criteria..............7
2.3Overall impact of recent changes in health and social care ..............................................7
2.4Propose appropriate service responses to recent changes in health and social care services.8
TASK 3............................................................................................................................................8
3.1Key principles of change management .............................................................................8
3.2Explaination about how changes in health and social care are planned .........................11
3.3Assessing about how to monitor recent changes in health and social care services.......11
CONCLUSIONS............................................................................................................................12
REFERENCES..............................................................................................................................13

INTRODUCTION
Changes refers to the techniques in which transformation of current situation take place
so as to attain the desired future outcome which can help in boosting up of opportunities. Such
changes are taking place in health and social care industry too so as to render better services and
treatment to users as well as to achieve high competitive advantage in marketplace. Moreover
NHS of UK is being taken into consideration in this assignment which specifically deals in
public health care organisation and renders services worldwide. This report is being presented as
per King's Fund and Nuffield Trust give current information related to the factors that drive
changes in health and social care and criteria for measuring recent changes in HSC with
principles of management.
TASK 1
1.1Key factors that drive change in health and social care services
In modern era every sector need to create changes in there working structure, policies and
procedures so that the they can render better services to its customers. If a company is able to
assess the changes which is important for them to implement it then it will help business concern
to achieve greater sustainability and higher profitability as compared to its competitors in
marketplace. In context to health and social care institution like NHS (National Health Services)
also adopts modification in the type of services they render to their patients. Additionally there
are numerous key factors which drives changes in health and social care services like cultural,
demographic, technological and many more etc. Therefore in order to understand this concept,
PEST and Force Field analysis is being taken into consideration and is being explained briefly
below (Battilana and Casciaro, 2012)
Political factor: This factor refers to those rules, regulation, legislations and code of
conduct which are being enacted by the government of the country. These standard of
government assist institution like NHS to treat their patients with care and dignity by meeting
their preferences on time as well as by rendering safe and clean environment. People are facing
problem from these institution due to poor quality of services and less workers in the office. So
taking this concept into consideration government of country has enacted a new Act “Care Act
2014” on 15 may 2014. This act describes about significant reform of social care for older citizen
who fall in the age group of above 60 years. Additionally it consolidates the legal framework by

stating the legal responsibilities and rights for older peoples who deserve special support and
care.. Accordingly London council provides funds for supporting to organisation like NHS so
that these care firms can render better services to its user specially to older people. Thus, it will
also help in rendering better treatment to peoples and to improve their performance level too as
well assist employers of the service sector management to adopt the changes in structure.
Economical factors include factors like inflation rate, currency fluctuation, taxes, demands
and supply etc. It is being identified that in order to meet the demand of local community on time
NHS render near about 75% of its budge to primary care trust. Demand of poor older people are
not being given any importance as major portion of money had being given to primary
institution, because of which thousand of older people live in care homes of UK and are getting
high quality services
(Coleman and et.al., 2012). It has lead to increase in the vulnerable conditions of older peoples.
Thus, it put greater emphasis on organisation like NHS to adopt the changes in system and to
render better services to people by taking into consideration the demand and preferences of
older people patients. For instance, if inflation rate of company is increasing then it would create
a positive impact on NHS as customers prefers to save money which could be use in some other
purposes. Aim of NHS is to provide services with minimum cost so to enhance the betterment of
society.
Social factor: Refer to the behaviour of users, minority ethnics, service providers and
many more. This, it leads in driving change in health and social care service sector like NHS.
For example as per NICE guidelines NHS should focuses on the changing behaviours of the
patients who can turn to be dangerous for staff users. Behaviours of patients can be related to
alcohol abuse, sex related diseases, smoking and lack of physical exercise etc. So if consumption
of prohibited products is increase then it would also increase the number of patients NHS is
seeing. As due to advancement in technology up-gradation it has become easier for every
organisation like for NHS to store and records data of patients. According to care quality
commission(CQC) NHS has revise its management policies related to health care record in a
more accurate manner which result in-taking complete information about patients like output of
each ward are recorded and result in fluid intake as well. For instance, if NHS acquired advanced
and latest technology then their quality of services to the needy person would increase to a
certain level.

1.2Challenges that key factors of change brings to health and social care services
Different types of challenges faced by NHS is given below with functional examples,
(Fillenbaum, 2013) One of the challenges which they might faced is financial problem. As HSC
requires high amount of funds for various activities like acquiring of new technology of better
treatment, medicine for needy person, payment to doctors, nurses etc but on the other hand they
were not getting enough amount of funds. Besides this, according to case study, HSC sector
would face shortage of workers which is a negative sign for growth of NHS. In case of
emergency in same case there may exist shortage of equipments, tools etc. which are required at
the time of operations which is termed to be the other challenge which forces health care
institution like NHS to bring changes in health care services. Thus changes can be brought upon
by acquiring enough of funds from councils so that to make available the required equipments on
time like robotic surgery, ultrasound machines etc.
TASK 2
2.1Strategy and criteria for measuring recent changes in health and social care
Strategy refers to step by step by actions taken by organisation so that pre set goals and
objectives would be achieved with highest productivity and efficiency. It is important for NHS to
implement the changes efficiently as then only their pre set goals and missions would be
achieved. Different types of recent changes in HSC are as follows training and development for
the nurses, technological advancement, door to door services etc. RCN principles and CQC
guidelines would be used measure the effectiveness of change.
First guidelines talks about safety, are the new changes in the sector is safe for patients or
not because if it wasn't then they should remove or modify it. After that, is the change effective
for users and organisation or not. For instance, if new technology is not helping the patients to
get high quality of services then it is of no use to implement it. Then third guidelines is caring, it
involves kindness, respect, dignity or staff towards patients as if they are not treating their
patients in a professional way then it would decrease the quality of services given to them. After
than responsive and management is the factors through which changes is measured.

RCN Principles:
It specifies the five principles along with CQC standard which must be taken into
consideration by all nursing staff of NHS so as to render better health services to patients and
they are given below: Principle 'A'(Dignity and humanity) specifies that nursing staff should treat
each patients in their care with humanity and dignity as well as should understand their
individuals needs. Principle 'B' (Person centred care)says that all nursing staff of NHS should
take the responsibility for the care they render and should be liable to answer for their own
judgements and actions (Golden and Earp, 2012). They should carry out these actions in such a
way that it is accepted by the patients and carers of patients as well. Principle 'C'(Safety)
specifies that nursing staff of NHS should be able to mange risk ans should also keep everyone
safe in the places in which they receive health care. Principle 'D'(Consent) specifies that nursing
staff of NHS should promote and provide care that should put people at the centre, involves
services users, patients, their families as well as should help them to make informed choices
about their care and treatment. Principle 'E'(Safeguarding of abuse) specifies that nursing staff
and nurses of NHS should posses up-to-date skills and knowledge and should make their use
with intelligence and understanding of needs of each individuals. Principle 'F' specifies that
nursing staff and nurses of NHS should work closely with their own team and with other
professionals as well as should make sure that patients treatment and care is coordinated is of
high standard. Principle 'H' specifies that nursing staff and nurses of NHS should lead by
examples and should develop themselves and other staff too.
In addition to this generic model can also be best useful for measuring organisational
change which is explained below:
 In the first step present stage is being diagnosed and required future state need to be
identified.
 In the second stage strategic vision need to be created.
 In the third stage plan the change strategy in an appropriate manner.
 In the fourth stage ownership, commitment and involvement need to be secured.
 In the fifth stage implementation of the change strategy need to be managed as well as
momentum need to be sustained.
 Whereas in the last step in order to ensure perpetuation of the change project need to be
stabilise, integrate and consolidate.

2.2Impact of recent changes on health and social care services against set criteria
As per the CQC report of Westminster Home-care Limited it is being analysed that the
service rendered by NHS trust were good but one aspect were identified which they need to
improve on and that was the communication from office team. Thus, Quality assurance audit
were term to be effective enough in identifying the area of improvement and by identifying those
area actions were identified and were assigned to each members of management team so as to
follow up. Therefore as per the Care quality commission report of Westminster Home-care
Limited it was being analysed that in some aspects the service was not well-led.
As per the internal audit report of Care quality commission which was based on five key
question of CQC and that is: Is the service safe, is the service effective, is the service caring, is
the service responsive and is the service well-led. Among all the five question first four were
rated as good and the last one were require some improvement in the communication process
with team members which were ineffective. Thus, in the overview of audit it was identified that
some areas of improvement need to be done such as training, medicine administration records
charts, care worker file were supervised and daily record were need to be maintained. So in order
to improve quality of care and support for people safe medicines audit were done, six care
workers file were audited, daily record sheet and training were maintained and six service user
files were also looked at under responsive.
Moreover NHS had made the other required improvements as well which is related to
infections and cleanliness control and will now lift the condition it had imposed on the trust
registration. Moreover NHS trust is termed to be one of the trust which is registered with the
condition to improve certain aspects of safety and quality.
CQC has collected evidence from hospital during inspection and it was found that staff
members of hospital were not aware of policies to prevent and control infections as well as it was
also identified that some areas were not adequately clean (Grol and et.al., 2013). Different types
of problems which NHS is facing are complaints of patients regarding the quality of services,
ineffective clinical practices of nurses and doctors etc. It can be measures through different
means like feedback of patients in context of quality of services and behaviour towards them,
performance of the employees working in there so that efficiency and productivity of employees
would be find out etc.

Therefore NHS trust has thought of making improvements to infections and cleanliness
control within and outside of an organisation and such changes is being done because there were
taking place increase in infections diseases in people and complaints were filed up against NHS
trust by the key stakeholders of trust like by staff members and patients as well as staff members
started appearing uncommitted towards their roles and responsibilities. So in order to measure
these problems management of NHS needs to go through the existing records, should take into
consideration the perceptions of services users that is of patients as well as should notice the staff
behaviour and staff performance data so that improvement can be made on time without any
delay. After going through existing records and staff performance data it was being analysed the
age group of 60 old-age people mainly suffering from several infectiousness diseases just
because cleanliness were not maintained properly as well as staff members were not showing full
enthusiasm and passion towards performing there roles and responsibilities in rendering good
services to service users. Thus, after considering this aspect NHS trust has decided to make
improvement in cleanliness as well as decided to render training session to staff members so that
they can render better quality and hygienic services to patients so as to reduce the level of
infection taking place.
2.3 Overall impact of recent changes in health and social care
It is being analysed that after enactment of social care Act 2014 council of London and
the local authority have provided support to organisation which are working to render health and
social care services to patients. Moreover they have also rendered financial support and funds to
health care service sector like NHS so that cleanliness and infection control had improved in
system. Latest technology in the sector would increase the quality of services provided to the
patients. Moreover, it would decrease or removed the human error while doing clinical practices.
More financial funds would help them to increase the training sessions to the doctors and
nurses so that they would become more efficient in nature which leads to higher motivation level
of employees.. (Laranjo and et. al.,2016). . Taking Social care Act 2014 into consideration NHS
provide home nursing facilities to older people above age group of 60 years so as to treat them
with special care services, which is termed to be the biggest impact of recent change and is also a
opportunities for people who live in residential care home on cheapest cost.
Lastly it can be said that NHS health care institution make sure that they monitor, inspect
and regulate services by taking into consideration the fact that they meet the fundamental

standard of quality and safety. As well as patients and staff members now experience a cleaner
environment and are better protected from healthcare-associated infections.
2.4 Propose appropriate service responses to recent changes in health and social care services
There are different kind of service response which are essential to be proposed by NHS
service centre specifically those related to changes. Adoption of changes in working environment
will be helpful in creating more appropriate environment so as to render better treatment to its
patients. As per the report of King Fund and Nuffield Trust there were different issues faced by
old peoples specifically such issues are related to not getting proper services from health care
service institution (Lefebvre, 2013). Entity should establish quality controlunit so that quality of
services can be improved and can be monitored timely. Besides this, standards of quality would
be made so that performance of employees will be measure. Apart from this, continuous
motivation is important and to attain this, financial and non financial benefits would be given to
them. It will help them to maintain their motivation which will enhance their productivity and
efficiency to a certain level. Additionally management should also adopt experience staff as
well as should render efficient training session to staff member so that they get to know how to
render services and treatment to patients.
TASK 3
3.1 Key principles of change management
Management of change is related with creating modification in the working environment
and in the system of an organisation. It is the process which provides s structured approach for
supporting the individual in the NHS that will enable them to move from their current state to
future position . In this context, some of the principles of change management which are required
to be considered while implementing change in NHS are discussed below (Miller and Rollnick,
2012): Involve at every level : Changes in the organisation are inevitable and so these are to be
implemented with due care. It is also important because they exist at all the level in the
organisation and people need to accept those changes for smooth functioning of the company. So
management of NHS need to implement certain strategies and methods by analysing the effects
of some of these levels. Training: It is very crucial to provide people with effective and efficient
training at workplace so that change can be implemented and executed effectively and

efficiently. It helps in providing people with knowledge and skills which are needed to work on
changes.
Kotter's 8-step model (Moorhead and et.al., 2013) Create urgency: This step helps in
identify threat and opportunities in order to develop the sense of urgency among service
providers. Form a powerful coalition: This is useful in convincing people of organisation in
order to accept the changes so that support of staff members can be gained. Create a vision for
change: It makes people understand about the need of change and decide to work on same in
order to render effective services to patients and poor old people. Communicate the vision: After
creating a clear vision management of NHS must communicate it to the staff members so that
they can work on it.
(Source: Kotter's eight step model, 2009)
Remove obstacles: This identifies the obstacle which may take place or which is taking place
while performing rendering social care services to patients. So that if any take place they can be
sort out immediately by finding out best solution. Create short term goals: It creates short term
goal as well so as to accomplish long term goal of an organisation. As wins are the molecules of
Illustration 1: Kotter's eight step model

result so they need to be recognized, collected and communicated often and early so as to track
progress on time. Build on change: By building on change which can be build only if
management will press harder after its first success which will result in increase in credibility
and also in improve in policies, structures and system. Reinforce the change: At this last stage of
change management, the need to articulate the connections between new behaviours and
organizational success and should also make sure that they continue until they become strong
enough to replace the old strategies and policies.
3.2Explaination about how changes in health and social care are planned
To implement the changes in the administration of NHS successfully organisation is
required to make a appropriate action plan. In order to construct a plan organisation is required to
figure out requirement and impact of changes that will occur on service quality
(Prochaska ,2013). Changes in health and social care services are adopted to modify the medical
equipments. It is crucial from the patients point of view as they need better assistance with them
in their treatment. To develop these changes some adequate plan for NHS are described as
follows: Effective communication procedures- the management of NHS is required to organise
meetings and various conferences with employees and stakeholders to explain them the
importance of communication in implementing change. Effective communication involves the
message which is being sent by the individual must be clear and vividly presented. It must emit
authenticity and genuine in nature. It further needs involvement and motivation of key
stakeholders so that change can be implemented with effective communication with them.
Communication is important so that people will get clarification regarding the changes in
mission and vision and they will work in NHS in accordance with them.
One of the other plan which need to be developed so as to pan effectively for changes is
stakeholder management plan, as changes don't take place in vacuum because a lot of peoples
will be get affected through the process. Therefore proper stakeholder management plan is put in
practice so as to identify different individuals who will be affected and who will affect by the
chnages. In case of NHS trust there are several stakeholders of interest as far as changes aspects
is concerned and one among them is CQC of which the role is to ensure compliance with
national standards which can be termed to be the rich source of input so as to effect the changes
effectively. Whereas the second best plan is action plan which helps in stating the aims and
objectives of the change programs as well as better action plan helps identifying carious

activities which are need to be carried out appropriately. In NHS trust the action plan should
address several issues including setting up of objectives which are needed to be achieved in each
change process. For example plan of NHS trust should should specify the set objectives related
to change improvement that need to be achieved in cleanliness and decrease in level of infections
among old age people. Staff quality and quantity among others. Therefore various activities need
to be carried out by NHS trust like training staff, collecting and recording of data, refurbishing
wards all should be identified at equal level.
3.3Assessing about how to monitor recent changes in health and social care services.
Changes are meant to be bringing improvement in organisation according to requirements
of market and the social factors. The recent condition of healthcare industry in UK are facing
different issues related to the financial problems which is leading in shortage of funds to sectors
like NHS (Riekert, Ockene and Pbert, 2013). Monitoring changes mainly involves continuous
and routine collection of information so as to make clear identification of what is working and
what is not. There are various monitoring strategies which will be used by NHS for monitoring
and controlling and they are like Feedback: They will regularly take feedback from the people
regarding their operations. This will help NHS in analysing that whether they are operating as
per their plans and if not then they will opt for changes. Survey : NHS will organise survey on
regular basis to know whether people are satisfied with their services or not. If people have any
doubts or problems then through survey such problems can be effectively eliminated.
Some of the changes in NHS trust hospital can also be monitored through observation
and spot-checked. As observation mainly involves studying and recording data on changes that
the management seem experience or hear. In NHS trust, management can observes in several
area like changes in staff behaviours, attitudes etc. so as to monitor the impact of changes on
them. Therefore in order to make best use of this approach management of NHS need to be
trained on what to observe, how to do and record it. Thus, it will helps in effectively monitoring
of changes taking place in health and social care sector.
CONCLUSIONS
From the above report it can be concluded that every business concern needs to make
same changes in policies and tactics so as to accomplish goals on specified time period.
Specifically there is a greater requirement for NHS foundation to make changes so as to render

better health and social care services to users. In order to make changes in an organisation,
management needs to identify the factors that drive change in health and social care services.
Additionally, Strategy and criteria for measuring recent changes in health and social care is
being specified as well as overall impact of recent changes in health and social care is also being
explained in this report. Lastly. Key principles of change management and assessing about how
to monitor recent changes in health and social care services is also being concluded in this report.

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