Structural Change and Culture in Nuffield Health

This report discusses the impact of structural change on the culture of Nuffield Health, a non-profit healthcare organization. It explores the advantages and disadvantages of the current hierarchical structure and proposes a change to a functional structure. The report also recommends considering the impact of the proposed changes on employees and the overall organization. The goal is to expand operations and improve healthcare services.

You are a Health Care
Manager and Your Job is to
Secure New Funding You must
Present Report to Present Your
Ideas on How to Change the
Organisation

TABLE OF CONTENTS
Introduction......................................................................................................................................1
Explicate probable impact of structural change on culture.........................................................2
Explicate ideas for change...........................................................................................................4
Recommendation.........................................................................................................................5
Conclusion.......................................................................................................................................6
References........................................................................................................................................7

Introduction
The administration of firm either it is non-for-profit, government body or any business in
which activities that are involved within setting of strategies of firm along with coordination
among efforts for their employees is referred to as management. They are liable for
accomplishing objectives via application of resources like natural, technological, human
resources along with human resources (Bazyar and et. al, 2020). Basically, it implies vulnerable
force which is under pressure for attainment of desired results. Healthcare managers are liable
for planning, directing along with coordination of other departments, groups and practitioners.
They deliver their services in different hospital settings that ranges from human resources those
are specialized within clinical areas. They collaborate around different disciplines for managing
budget of organisation along with finances and leads to team development. Healthcare managers
are liable for handling business operations along with requirements of medical needs. The basic
roles and responsibilities of healthcare manager comprises of supervising supervisors who are
liable for looking into day to day activities that are being carried out by team of employees,
overlooking department managers who are liable for overseeing all departments.
This report is based on Nuffield health which is a largest healthcare charity and was founded in
1957 with their headquartered in Epsom, UK. It is a non-profit organisation which comprises of
medical centres, health clinics, rehabilitation centres, nutritional therapy, and employee
wellbeing, hospitals, fitness and wellbeing gyms. This is independent National Health Service
that has around 1100 employees who render their services for people. Their objective is to
advance, promote as well as maintain health and healthcare of all descriptions for preventing,
relieving along with curing sickness and ill health of any kind for public benefit. The healthcare
manager of Nuffield health is liabe for managing their staff as well as supervises whether they
(employees) are carrying out their responsibilities as per desired standards or not. They also
make sure that people to whom services are being given are treated adequately and are listened to
as per their requirements instead of ill treating them or behaving in inadequate manner. Along
with this manager ensure that resources of Nuffield health are not misutilised like lights, etc.
Furthermore, they also take into consideration that they fulfil the financial commitment in terms
of ways services are being delivered and made sure that there is adequate budget that will lead
them to deliver their services in an impelling manner (Broome and Marshall, 2020).
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Nuffield health is following hierarchical structure, in this employees are being grouped with each
employee having their clear supervisor and they are answerable to them. The major advantages
that are being attained by this structure are: there is a clear communication structure, multiple
layers of authorities are there, it is liable for establishment of transparent picture for authority
and it aids within specialisation (there will be clarity with respect to what particular department
is responsible for). But on the other hand when it is used by Nuffield health, then there are
certain limitations which organisation will have while rendering their services. This involves
lack of collaboration, internal innovation is restricted, managers become territorial due to power
possessed by then which leads them to be defensive and power structure is also being structure
(Christensen, Lægreid and Rovik, 2020). The manager is looking forward to expand their
operations for social enterprises to whom CCG can fund, the reason behind this is that such kind
firms work for welfare of people and it will also enable Nuffield health to reach wide range of
people who need to have services but due to certain reasons both the entities are not able to reach
them. By expansion, they can have surveys to identify which sector of society is affected and
needs help in terms of adequate healthcare services.
Explicate probable impact of structural change on culture
Nuffield health delivers their services as non-for-profit organisation which furnishes their
services across United Kingdom. The above section clearly illustrates the details of
organisational structure that is being used by them (Eriksson and et. al, 2020). Though each
structure have their own advantages and disadvantages but when employees do not have open
communication with management and even do not what is being conveyed to along with in what
manner it is being done then it becomes mandatory that there has to be some change within ways
services are being delivered by them. Employees are being overruled by their higher official as
they have power though these can be probability with each organisational structure. Change is
essential aspect for each organisation which must be acknowledged by organisation for making
sure that they are able to accomplish their goals as well as needs of employees. Along with this,
to cope up with alterations in market aspects related with healthcare are also altering. The
concept of change can be depicted by making use of John Kotter’s 8 step change model. This has
identified as well as extracted success factors which are combined into methodologies for
bringing in leading change (Glied and Frank, 2020).
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Nuffield health can opt for functional organisational structure the reason behind change is
that within hierarchical structure there they do exist appropriate method for communication with
lower employees as lot of levels comes in between and there ii high probability that while top-
down or bottom-up approach there will be multiple tongue twists which means that exact
interaction will not take place and this can have adverse impact on working of both (Green and
et. al, 2020). Thus a change is required in ways operations are being carried out within working
structure of Nuffield health. Functional structure refers to classification of people with respect to
skills and knowledge. Here each department will have different roles like customer services,
finance, etc. Here, employees need to report to top management.
The major benefits that can be attained by management of Nuffield health by this change
are: specialisation which will ensure that activities are being carried out in an adequate manner,
high operational speed can be attained, operational speed along with clarity to employees what
they have to do instead of wasting time with respect to what they are supposed to do. But along
with this, there are certain disadvantages that need to be acknowledged. They involves
segregation, each department have their own specialised team and other teams do not get
opportunity to share their perspectives with each other and there be a lack of coordination among
these departments (Liebler and McConnell, 2020). But en effective communication can be
attained between management and employees of Nuffield health. The steps involved within this
model in context of Nuffield health are illustrated below:
 Creation of urgency: It is essential for organisation to identify probable threats along
with their repercussions to cops with future. Nuffield health needs to examine
opportunities that are being tapped via efficacious interventions along with this, it is
necessary that employees and people must be involved while bringing in change.
 Forming powerful guiding coalitions: Determination of effectual change leaders within
organisation and by involving stakeholders within the process their commitment can be
attained (Maniatopoulos and et. al, 2020). Along with this, Nuffield health needs to
identify weak areas within distinct levels of firm.
 Formulation of vision & strategy: Identification of core values by defining values as
well as formulating ultimate vision and strategies for attaining them through which
change can be realized. It has to be a clear statement that be understood by people easily.
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 Communicating vision: Communication of change is essential aspect so that all can
connect with essential aspects like training, performance reviews etc. Manager of
Nuffield health needs acknowledge all the aspects as well as issues of people by effectual
involvement.
 Elimination of obstacles: Manager of Nuffield health needs to ensure that structure along
with organisational processes is aligned with overall vision of organisation. Furthermore,
people are being rewarded for endorsing change as well as support within process
(Nembhard and et. al, 2020).
 Creating short-term wins: Through creation of short term wins within change process
feeling of victory can be created in early stages of change. For this manager can
formulate short term goals as it becomes easy to attain them instead of having one long
term goals.
 Consolidating gains: Continuous improvisation can be attained through analysis of
success stories individually as well as improvise them from individual experiences.
 Anchoring change within corporate culture: Manager need to acknowledge stories
associated with successful stories associated with alteration initiatives with respect to
opportunities they have.
Through this manager can have clear insight into ways the entire process of change can
be executed within the Nuffield health. Here, emphasis will be laid on acceptability as well as
effectual involvement of employees as well as other major stakeholders for success of change
(Robert and et. al, 2020).
Explicate ideas for change
Change is an inevitable process that must be acknowledged by organisation. This has to
be carried out with respect to requirements of people, employees and trends which prevail within
market (in context of healthcare like COVID-19). These are major aspects which are regarded
while bringing in change in ways operations are being conducted by Nuffield health. This creates
an impact on culture of organisation; this can be understood by making use of Handy’s culture.
There are four distinct cultures that can be considered by management of Nuffield health while
delivering their services:
Power culture: In this context, power is being possessed by few individuals whose
impact spreads within firm (Young and Guo, 2020). Here, there are some regulations and rules
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that need to be followed by employees of Nuffield health. Employees are being judged on basis
of their attainments instead of ways in which they work.
Role culture: This is based rules that imply that employees are controlled in which they
know what they have to do and this is being determined by position they uphold within
organisation (Bazyar and et. al, 2020). Decision making takes time as with respect to this, flat
structure is being accomplished by organisation.
Task Culture: It is being formed when teams are being formed within organisation for
addressing peculiar project. Power will shift on basis of team’s members as well as project they
are working on.
Person Culture: Individuals look at them as superior and unique to organisation. Here,
firm exist in form where employees can work.
Healthcare Manager of Nuffield health can make use of task culture with respect to new
functional organisational structure. This is an apt culture for respective structure, like within task
culture employees will be allotted project on basis of skills and knowledge same goes with
functional structure. This will makes it easy for employees to render their services as per
required standards (Broome and Marshall, 2020). It also creates an affirmative impact on ways in
which decisions are being formulated such as within task culture depending upon takes
employees have to be carrying out, they can formulate their own objectives as per need of
project. This imply that it is quick process as decisions can be formulated by team itself instead
of waiting for approval for higher authorities as it can be a time taking process. Thus, both
structure and functions have direct impact on ways in which organisation like Nuffield health
deliver their services in context of healthcare so that adequate offerings are being provided to all
people.
Recommendation
It is recommended that while looking for funds for their expansion from CCG, Nuffield
health needs to take into consideration various factors like impact of doing this, what benefits
people and their employees or both organisations can have probable influence on people and how
this can be carried out. Along with this, adequate changes must be carried out within their
working structure in context of services they have to deliver and to objectives they are looking
forward to attain. By taking into consideration these aspects it is crucial that they acknowledge
culture which prevails within as it will also have probable influence on employees as they have
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to work. It is recommended that employees must have clear knowledge about reason behind
change and what Nuffield health is looking for by implementation of those changes.
Conclusion
From above it can be concluded that, as per conditions that prevails within organisation it
is necessary to bring in change within their working structure. To furnish services to ample
number of people healthcare sector can expand their operations so that adequate offerings can be
delivered. For this, firm may need to alter their workings but before doing so employees must
have relevant knowledge about these aspects.
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References
Books and Journals
Bazyar, M. And et. al, 2020. Combining health insurance funds in a fragmented context: what
kind of challenges should be considered?. BMC Health Services Research, 20(1), pp.1-
14.
Broome, M.E. and Marshall, E.S., 2020. Leading Across Systems of Care and in the Larger
Community. Transformational Leadership in Nursing: From Expert Clinician to
Influential Leader, p.319.
Christensen, T., Lægreid, P. and Rovik, K.A., 2020. Organization theory and the public sector:
Instrument, culture and myth. Routledge.
Eriksson, E. And et. al, 2020. Collaborative public management: coordinated value propositions
among public service organizations. Public Management Review, 22(6), pp.791-812.
Glied, S.A. and Frank, R.G., 2020. Economic Perspectives on the Organization and Governance
of Mental Health Care. In The Palgrave Handbook of American Mental Health
Policy (pp. 49-68). Palgrave Macmillan, Cham.
Green, T. and et. al, 2020. Use and reporting of experience-based codesign studies in the
healthcare setting: a systematic review. BMJ quality & safety, 29(1), pp.64-76.
Liebler, J.G. and McConnell, C.R., 2020. Management principles for health professionals. Jones
& Bartlett Learning.
Maniatopoulos, G. and et. al, 2020. Implementing the New Care Models in the NHS:
Reconfiguring the Multilevel Nature of Context to Make It Happen. In Transitions and
Boundaries in the Coordination and Reform of Health Services (pp. 3-27). Palgrave
Macmillan, Cham.
Nembhard, I.M. and et. al, 2020. Moving organizational theory in health care forward: A
discussion with suggestions for critical advancements. Health care management
review, 45(1), pp.E1-E12.
Robert, G. and et. al, 2020. Exploring the sustainability of quality improvement interventions in
healthcare organisations: a multiple methods study of the 10-year impact of the
‘Productive Ward: Releasing Time to Care’programme in English acute hospitals. BMJ
quality & safety, 29(1), pp.31-40.
Young, S. and Guo, K.L., 2020. Cultural diversity training: the necessity of cultural competence
for health care providers and in nursing practice. The health care manager, 39(2),
pp.100-108.
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