NHS and the Challenge of Performance Management

This report discusses the challenges faced by the National Health Service (NHS) in performance management and their impacts on the organization. It explores the Competing Value Framework (CVF) and the management approach of NHS. The report also provides recommendations for overcoming these challenges and improving performance.

NHS and the
Challenge of
Performance
Management
(Assessment - 2)

Table of Contents
INTRODUCTION...........................................................................................................................3
COMPETING VALUE FRAMEWORK (CVF).............................................................................3
Introduction............................................................................................................................3
THE COMPANY.............................................................................................................................4
a) Company Profile.................................................................................................................4
b) Management Approaches...................................................................................................7
THE BUSINESS CHALLENGES..................................................................................................8
a) Description of the challenges.............................................................................................8
b) Impacts of challenges on company....................................................................................8
RECOMMENDATIONS.................................................................................................................9
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Performance management is a critical aspects of business in which top layer of the
organisation works in the favour of keeping the company highly productive and performing with
focus on keeping employee performance high as it directly links with the company's ultimate
performance. The report is based on National Health Service (NHS) which was founded in 1948
and funded through general taxation as it is an organisation for public welfare (Grossi and et. al.,
2019). The report will be dealing with certain aspects of performance management which are
looked over on the basis of National Health Service (NHS). To begin with Competing Value
Framework (CVF) is examined and company's management culture is determined and moving
along the discussion is conducted for identifying the challenges of the firm and digging the
reasons behind them as well their impacts over the performance of the organisation that is
National Health Service (NHS).
COMPETING VALUE FRAMEWORK (CVF)
Introduction
Competing Value Framework (CVF) which is classified into four segments or quadrants
highlighting four corporate cultures and reflects upon how a company works, how the workers
collaborate and what are the corporate value of the organisation. The four quadrants and
represented cultures are as follows: Clan Culture is the one with utmost flexibility and the relationship between people is
central with friendly work environment. This culture is most commonly adopted by small
family businesses or small ICT companies. Hierarchical Culture is the one with extreme formalities and highly focused on having
effective control systems in place. The government agencies and administrations is the
appropriate example.
 Market Culture is the one adopted by businesses which are directed towards the end
results by completion of work in the best possible manner. Workers in such organisations
are very competitive and goal oriented.

Illustration 1: Competing Values Framework, 2020
(Source: Competing Values Framework, 2020)
 Adhocracy Culture is a management style which is flexible enough and operates on the
factor of innovation. The agenda of such brands is to stay in focus and visible in market.
Thus, the most suited example is marketing and advertising agencies.
THE COMPANY
a) Company Profile
 Activities
National Health Service (NHS) was established in 1948 and managed or funded by
general taxes but engages in several activities. The Department of Health is responsible for
number of activities to conduct beginning with a comprehensive service, available to all
irrespective of gender, race, disability, age, sexual orientation, religion or belief (Pollitt, 2018).
 Size
National Health Service (NHS) is a large organisation which according to its last 2019
results can be demonstrated. The company had 112,031 doctors, 311,380 nursing staff including
volunteers and 34,556 managers. In total the brand has around the workforce of 1,093,638 which
signifies its large size.

 Finance
The finances of National Health Service (NHS) are commonly raised from general taxes
and few from different donations by external parties and general public. In 2018, the UK spent or
invested around 9.8% of its GDP over health sector which in comparison to other is way more.
Illustration 2: Key facts and figures about the NHS, 2019.
(Source: Key facts and figures about the NHS, 2019)
 Analyses
SWOT ANALYSIS
Strengths The biggest strength of National Health Service (NHS) is lack of
competitor that is the brand do not have monopoly in market but there is no
one strong and big enough in size in regards to NHS (Ingrams, 2018).
Another strong suit of National Health Service (NHS) is its healthy and
long lasting relationship with other health service providers and partners in
the region.

Weaknesses National Health Service (NHS) is a huge brand working for saving lives of
people and offering them the best health care service. The weakness ignites
as the organisation have lack of people to serve their agenda and this
creates low manpower and inefficiency of the brand to fulfil demands of
public.
Opportunities National Health Service (NHS) is a world famous and known brand and
organisation have significant value in market too. But at present the most
critical advantage and opportunity available to it is increasing the
company's profile by raising awareness in market by using separate
marketing techniques and aspirations.
Threats As determined the weakness of lack of skilled staff, sooner or later it will
become the biggest problem of National Health Service (NHS) as the
organisation has very high employee turnover ratio. This results in
increasing inefficiency and ineffectiveness of the company as plan are
strong but to implement them people are either unskilled or the
organisation suffers from under staff (Rogan and Boaden, 2017).
PESTLE ANALYSIS
Political The organisation National Health Service (NHS) is segmented into three
systems which makes it NHS. The incorporated systems are NHS England,
NHS Wales and NHS Scotland. The concerning political factor of National
Health Service (NHS) is Brexit which will bring varied uncertainties in
polices and political reactions and causing uncertain environment for the
organisation to work. As the organisation is divided into segments it will
be more critical.
Economic The economic fallout of 2008 the company is facing huge consequences
till date for it. Due to increasing pressure and regular economic regulations
the company is dealing with number of negative impacts which caused
increased employee turnover.
Social National Health Service (NHS) is a health care service provider and in

United Kingdom the population is increasing on a rapid pace as well the
diseases are increasing too. This change in social factor have brought the
severity to NHS as the demand and supply of services graph fluctuates
regularly and demands are not fulfilled as per the expectations.
Technological Advancement in technology industry has brought positive aspects for
number of industries and NHS is positively impacted too through it.
Technology resolved the problem of lack of employees by supporting it
through better equipments which are faster and more productive.
Legal The legal environment of UK is always in favour of NHS as it is a
voluntary organisation which is established for welfare of people, legal
laws and policies are technically in support of it (Mawed and Al-Hajj,
2017).
Environmental Lastly, for environmental factor National Health Service (NHS) works
with the cautiousness and it polices and work practices are sustainable.
Thus, the environmental factor do support the organisation in raising it
brands goodwill in market.
PORTER FIVE FORCES A NALYSIS
Threat of new
entrant
This component has really low force as NHS is the company which was
established with proper planning and it is a reason of its regular success.
Thus, any new entrant will have to beat the planning resource of NHS and
therefore, this force is low.
Threat of
substitute
The threat of substitute is low as well as in service sector the substitutes
can not really make any difference.
Bargaining power
of suppliers
National Health Service (NHS) is a self dependent organisation which
signifies the power to be low as suppliers are very few in numbers.
Bargaining power
of customers
The power of customers is huge over National Health Service (NHS) as
this is customer oriented brand established for serving people and beings in
need (Gore and et. al., 2019).

Existing rivals The power of existing rivals is low too as National Health Service (NHS)
does not really have any significant competitor in market.
b) Management Approaches
The Competing Value Framework (CVF) is elaborated above in which there are four
types of work cultures which are most commonly adopted by businesses in case of dealing with
people and operating most productively in market by keeping their performances on the best.
The management approach of National Health Service (NHS) in relation with Competing
Values Framework (CVF) is Clan Culture. The reason behind is with this culture model NHS
can provide the best suited environment to employees and make sure of keeping the firm
flexible. People in NHS are not permanent specially those who are working by their will on
temporary basis. Thus, the National Health Service (NHS) make use of Clan culture to keep
people mingle up and make sure to have a safe environment around themselves for helping all in
working with motivation and with keeping their performance high (Ashdown, 2018).
THE BUSINESS CHALLENGES
a) Description of the challenges
Business challenges are those components and variable which causes problems for
management and leaders of organisation to deal with the market and attain all agendas. These
challenges are of various type and forms such as Financial Management, Performance Challenge,
Regulation and Compliance Challenge, Technological Challenge and so on. These components
becomes barriers for the organisation and make several hurdles in operations and functioning
(Iacobucci, 2017).
In regards to National Health Service (NHS) the most significant challenges which are
being faced or encountered by it is of Human Resource management and Performance
Management which is ultimately impacts upon the overall objectives of the company and leading
to reducing overall performance of the firm. The people within National Health Service (NHS)
are majorly working on temporary basis as volunteers but other permanent employees are also
leaving job and the employee turnover ratio of NHS is regularly increasing.
With increasing employee turnover, the overall cost of the administration is increasing
most specifically the recruitment and selection cost and training and development cost of the

entity. The incremented expenses and cost of National Health Service (NHS) is reducing the
efficiency of the firm and leading it to suffer in attaining it agendas (Moullin, 2017).
b) Impacts of challenges on company
The company that is National Health Service (NHS) is always focused on providing the
best type of health and care services to public and funded through general taxes so it aims at
making the best possible use of resources and money provided. The Human Resource and
Performance Management challenges are directly affecting and impacting over company's
performance and then over the agendas of National Health Service (NHS). Once a employee
leave or bunch of people leave together, National Health Service (NHS) have to make plan and
activities to recruit more people and fulfil its HR needs (Greener, 2019). Then the organisation
have to provide them trainings and make the best use of them. But when they leave the job the
company's overall balance sheet and Profit and Loss statements are affected with increased cost
and reduced profits. Along with it, the goodwill of the brand fluctuates as well because of
increased employee turnover ratio.
RECOMMENDATIONS
As per the evaluation and dissect conducted above in the report the possible solution
which is recommended to National Health Service (NHS) in case of overcoming the problems
and respective challenges of Human resource management and Performance management is
more researched and effective plans. The company has the strength of effective planning and
development. With changing employee needs and for increasing performance National Health
Service (NHS) is suggested to work more over their planning in regards to human resource and
making them work with utmost motivation and enthusiasm in favour of working for attaining the
objectives of National Health Service (NHS) and offer the best to public according to their
expectations from the firm.
CONCLUSION
The discussion and evaluation in the report above concludes the role of management and
separate aspects for making the best use of resources within the organisation in regards to
increasing company's performance and dealing with certain challenges. In the assignment
analyses is conducted for seeking the knowledge about the challenges of the organisation in

relation to its performance and their impacts over the company are studied as it do impose a
critical and resource consuming influence over the brand.
REFERENCES
Books and Journals
Ashdown, L., 2018. Performance Management: A practical introduction. Kogan Page
Publishers.
Gore, O. and et. al., 2019. Not every public sector is a field: evidence from the recent overhaul of
the English NHS. Public Management Review, 21(4), pp.559-580.
Greener, I., 2019. Performance management that works? Improving public services by making
use of intrinsic motivation. Social Policy & Administration, 53(1), pp.99-112.
Grossi, G. and et. al., 2019. Accounting, performance management systems and accountability
changes in knowledge-intensive public organizations. Accounting, Auditing &
Accountability Journal.
Iacobucci, G., 2017. NHS in 2017: the long arm of government. Bmj, 356, p.j41.
Ingrams, A., 2018. Transparency for results: Testing a model of performance management in
open government initiatives. International journal of public administration, 41(13),
pp.1033-1046.
Mawed, M. and Al-Hajj, A., 2017. Using big data to improve the performance management: a
case study from the UAE FM industry. Facilities.
Moullin, M., 2017. Improving and evaluating performance with the Public Sector
Scorecard. International Journal of Productivity and Performance Management.
Pollitt, C., 2018. Performance management 40 years on: a review. Some key decisions and
consequences. Public Money & Management, 38(3), pp.167-174.
Rogan, L. and Boaden, R., 2017. Understanding performance management in primary
care. International journal of health care quality assurance.
Online:
Competing Values Framework, 2020. [Online] Available Through:
<https://www.toolshero.com/leadership/competing-values-framework//>
Key facts and figures about the NHS, 2019. [Online] Available Through:
<https://www.kingsfund.org.uk/audio-video/key-facts-figures-nhs/>