NHS and the challenges of performance management

This essay discusses the challenges faced by NHS in performance management and how to overcome them. It includes the company profile, internal and external analysis, management approach, and business challenges. The challenges include capacity, demand, elective waiting time performance, and A&E performance. The impact of these challenges on the company is also discussed with recommendations.

NHS and the challenges of
performance management

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
The company profile........................................................................................................................3
Activities, size, finance, analysis of NHS..............................................................................3
Management approach (form CVF) and reason why.............................................................7
The business challenge....................................................................................................................7
Description.............................................................................................................................7
Impact of challenges on company..........................................................................................8
Recommendation.............................................................................................................................8
CONCLUSION................................................................................................................................9
REFERENCES..............................................................................................................................10

INTRODUCTION
Competing value framework are highly used in the health services which can used in
healthcare services research which are used for the implementation of improvement in the
healthcare quality. This provides satisfaction regarding services to patients and employees and
team performance which can lead to create better outcomes. Challenges management in
healthcare refers to dealing with day-to-day challenges which are there in the healthcare
environment through primarily or permanent proactive changes in behaviour or awareness. There
is high need to management challenges that can lead to create effective environment for better
dealing with other functions and challenges for smooth delivery of healthcare services. In this
essay there is discussion about the company profile which includes various activity like services
or products of the organisation related with trading organisation. NHS is the national
organisation which is there in the United Kingdom which provides treatment and care to their
people with effective quality. NHS is the public funded healthcare system which was established
in 1948. There is also discussion about the revenue and profit with internal and external
environment. It also consist of competitive environment of organisation. There is discussion
about the current management within CVF. There is also discussion about the business
challenges which includes description and impact of challenges within company (Serbic, 2017).
MAIN BODY
The company profile
National Health System (NHS) is the healthcare system of United Kingdom where all the
citizen can get their healthcare and there are number of healthcare services which are provides
free of cost to the people of this country. This is one of largest healthcare system in the country
which is able to deliver effective healthcare treatment to their people.
Activities, size, finance, analysis of NHS
This is the healthcare system of United Kingdom who delivers many services like dentist,
Opticians, online services, urgent or emergency care services, sexual health services or related
information and many more. There are number of activities or services which is delivered by this
organisation to make the country healthy. NHS also provides primary care services, ambulance,
mental health services, social care and hospital related services. This provides large level of trust

to the organisation which can lead to deliver effective healthcare services to the patient for their
improved health (Legge and Loffler, 2018).
This organisation works on National level and have the ability to deliver their healthcare
services to all over the United Kingdom. There are more than 112,031 doctors, 34,556 managers
and 311,380 qualified nursing staff which are there in the organisation for effective deliver of
healthcare services to their patient. This organisation have one of the largest employers in the
world and biggest in Europe with more than 1.3 million staff members.
NHS is primarily funded by the government and does not goes for the profit. It has the
aim to deliver their healthcare services by getting funded in the form of general taxation. It has
no any shareholders and due to this they doesn't seek for the profit they provides universal
services. So, NHS comes under criteria of services rather than any business.
Operating revenue of National Health service (NHS) foundation trusts in the United Kingdom
(UK) as of 2018/19, [Online] Available through <https://www.statista.com/statistics/490244/nhs-
foundation-trusts-operating-revenue-in-the-united-kingdom/>

Internal analysis- (SWOT Analysis)
SWOT analysis refers to the framework which is there able to deliver the information
related with strength, weakness, opportunity and threat of the related organisation. This is the
internal analysis which are there able to deliver better and effective understanding about the
internal environment of the organisation (Gardere and et. al., 2018).
Strength
 Country largest organisation which
deliver effective healthcare services on
large scale.
 Most of the services are free of cost and
focuses on effective of healthcare
services.
 Developed governance mechanisms.
Weakness
 Due to increasing number of obesity
patient increases the unnecessary
expenses on the organisation.
 Not control over the fraud within
organisation.
 High agency staffing cost.
Opportunity
 should focus on increasing the revenue
of the organisation for effective and
long term delivery of free healthcare
services.
 Increase public and service user
involvement.
 Opportunity towards research and
development (Boryshkevych, and et.
al., 2020).
Threat
 Loss of service user due to alternative
market and effective delivery of
services.
 Uncertainty of national funding or due
to change in economy.
 Fail to deliver effective healthcare
services to their patient for their
improved health.
Competitive Environment - (Porter's 5 Forces Framework)
Porter's five forces refers to the model which health to identify and analyse five different
competitive forces which can shape every industry related with their strength and weaknesses.
There is discussion about the five forces which are going to be discussed further.
Competitive Rivalry- This is the force which is able to provide the information about the
competitors which are there for the organisation which includes National institute for health and
care, Nuffield Health etc.

Supplier Power- This is the power which is there for the supplier who can impact the
organisation services by suppliers. There are number of supplier which provides less power to
them to impact the business by increasing their cost or prices which can alter the service delivery
due to altering of supply chain (Irawan, 2021).
Buyer power- There are large number of patient who receive healthcare services form the
organisation NHS. Due to this there buyer have the high power to impact the service delivery of
the organisation.
Threat of substitution- There is always the threat of substitution which can lead to create
the variation in the delivery of service and alter the healthcare services. There are large number
of substitute who also delivery better and effective healthcare services and can create threat to
shifting to other organisation.
Threat of new entry- There are number of competitors who deliver effective healthcare
services to patient for their improved health. There is always fear that other large organisation
can takeover the NHS and can attract large number of patient or client.
External environment- (PESTEL analysis)
PESTEL analysis refers to the framework which provide the information about the
external environment of the organisation. This includes Political, Environmental, Social,
technological, economical and legal factors which are going to be discussed further.
Political factor- This is the factor which can be impact by the change in the government
policy, taxation policy which impact the organisation ability of service delivery. Political
stability helps organisation to perform their role effectively (González-Rodríguez, and et. al.,
2018).
Economical factor- This is the factor which is impacted due to change in the inflation rate
and get directly impact due to change in the country economy. This is highly effective in
delivery of healthcare services to their clients or patients.
Social factor- This is the factor which can get impacted due to change in the social
environment and NHS deliver their services to the society which is highly able to impact the
delivery of healthcare services.
Technological factor- This is the factor which is directly impact due to use of latest
technology. NHS should use the latest technological equipment to effective delivery of
healthcare services.

Environmental factor- This is the factor which is related with delivery of healthcare
services which should not impact on the environment and support environment by utilizing
effective disposal of used material and should be maximum use of degradable substance.
Legal factor- This is the factor which can impact due to change in the legislation or any
law which can impact the delivery of healthcare services effectively. Legal factor impact the
organisational environment when there is change in the law or legislation which NHS need to
follow and should make the structure and implementation of services in that particular manner
according to new law or legislation (Hinde, and et. al., 2017).
Management approach (form CVF) and reason why
In NHS, there is use of systems approach which is based on generalization which is inter-
related and interdependent. This is the approach which is there able to deliver the better and
effective management of operation which are there able to deliver effective healthcare treatment.
This is the approach which is able to deliver effective healthcare treatment to their patient for
their improved health. In this, organisation get directly influenced by their environment. In this,
organisational environment is directly influenced by the different forces which includes social,
economic, political and many more. This is the system which is highly influence and flow of
information and energy within system. Here, in NHS, due to interrelationship with other function
and working independently leads to create the better effect of the management approach which
deliver effective healthcare treatment. In this, there is exchange of the feedback which can help
to evaluate the issues and help to overcome through applying the better management approach
effectively. This can help to deliver effective workflow within organisation. This is highly
applicable in delivering of effective healthcare treatment to their patient for their improved
health. This is highly effective and allow NHS to delivery their quality of services and better
implementation of health related services which can impact the service delivery and increase the
trust within client or patient (Iyengar, and et. al., 2020).
The business challenge
Description
There are many challenges which need to face by the NHS which need to be address
effectively. These challenge includes the capacity within organisation that includes beds, staff
members, community services, ambulance services, mental health services and many more.

There are some of the main challenges which required high effectiveness to delivery effective
healthcare services to their patients. Demand, elective waiting time performance, A&E
performance. These are some of the challenges which need to face by the NHS to improve their
quality of services and improving their patient attempting strength.
Impact of challenges on company
There is high impact of these challenges on the NHS which is going to be discussed
further according to challenges.
Capacity- There is less number of capacity which is there to full fill the demand of the
patients. Appropriate number of beds and staff are required for delivery of healthcare services.
Due to limited resources and increasing number of patient create challenge to effective manage
the capacity for optimum utilization of services (Zhang, and et. al., 2020).
Demand- There is increasing demand of healthcare services whereas fund is not
increasing proportionally. This impact the delivery of proper healthcare services and treatment.
To manage every patient effectively is major challenge for the NHS while increasing demand for
treatment and healthcare services.
Elective waiting time performance- There is increasing number of patient in respect to
their elective waiting time for delivering effective healthcare treatment. There is about 4 million
of patient who are there in waiting list which is one of the main challenges to delivery on time
treatment which is set the limit for on time treatment.
A&E performance- This the challenge for NHS to deliver or admit patient for treatment
before 4 hour which could not breach the 4 hour standard. This is challenge for the NHS to
deliver healthcare treatment for better health of patient (Rockliffe, and et. al., 2018).
Recommendation
It is recommendation that there is need to increase the fund for the NHS to deliver better
and effective healthcare treatment which can help to provide on time effective treatment to all
the patient. Increasing in funds can help to increase the number of beds and staff member which
is highly needed for delivering continuous healthcare services and treatment. There is also need
to follow the 4 hour standard which can help to attend more patient in initial 4 hour. Increasing
number of healthcare professionals can help to attend more patient at same time which can
reduce the increasing number of elective patients. There is need to focus on the effective delivery

of services which can be solved by increasing funds and increasing large number of staff
members to attempt more patient at the same time.
CONCLUSION
From above discussion, it can be conclude that there are number of challenges which
NHS need to face effectively for improving the quality of service delivery and decrease number
of elective patient for their treatment. There is also need to face A&E performance that is the
challenge for the NHS. In this report, there is discussion about the organisational profile
including activity, size, finance, organisational internal and external analysis, management
approach and reason. There is also discussion about business challenges for the organisation and
their impact with recommendation.

REFERENCES
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