Facilitating Change in HSC: Analysis of Key Factors and Challenges

This report examines the facilitation of change within the Health and Social Care (HSC) sector, with a focus on the Royal United Hospital (RUH) Bath NHS. It begins by identifying internal and external drivers of change, such as political, legal, demographic, and technological factors, and discusses the...Read More

Facilitating Change

Table of Contents
INTRODUCTION...........................................................................................................................1
LO 1.................................................................................................................................................1
1.1 Key factors driving change within HSC services.................................................................1
1.2 Challenges that key factors of change bring to HSC services..............................................3
LO 2.................................................................................................................................................3
2.1 Criteria and strategy to measure recent changes in HSC......................................................3
2.2 Measurement of impact of recent changes on HSC services against set criteria..................4
2.3 Evaluation of overall impact of recent changes in HSC.......................................................5
2.4 Proposing appropriate service responses to recent changes in HSC services.......................5
LO 3.................................................................................................................................................6
3.1 Key principles of change management.................................................................................6
3.2 Ways of planning changes in HSC........................................................................................7
3.3 Ways for monitoring recent changes within HSC services...................................................7
CONCLUSION................................................................................................................................8
REFERENCES................................................................................................................................9

INTRODUCTION
Change is an inevitable part of each and every organisation. In this regard, Health and
Social Care is a sector which undergoes frequent and rapid changes. These changes take place in
context of the business environment within which a healthcare centre operates (Rolls and et. al.,
2016). Such alterations owe to the changes taking place within the political, legal and
demographical state of a nation. The present assignment is based upon facilitating changes
within the HSC sector taking example of RUH (Royal United Hospital) bath of NHS. Also, it
includes factors that drive such alterations along with the challenges brought by them. Further, it
consists of criteria as well as strategy to measure changes together with the measurement of
impact in contrast to set criteria. Lastly, it illustrates the principles of change management, ways
to plan such changes and the ways to monitor such alterations.
LO 1
1.1 Key factors driving change within HSC services
Change can be said to be the response to an essential opportunity or threat paving the way
of health related facilities. Health and social care services are constantly subject to a number of
changes that take place in the business environment such as political, cultural, demographic,
legal and technological. This sector is immensely affected by such alterations as new ideas are
proposed and taken into use to ensure provision of care in the best possible manner (Holmes and
et. al., 2017). The latest and unique ideas that have been prevailing within the HSC sector are
restrictions on public expenditure, partnerships, technological advancements, collaborative
workings. All of these have a significant influence upon the staff, organisation and users of
services. In this regard, the factors that drive change within this sector of corporate world are
described below:-
INTERNAL DRIVERS
Such drivers are the internal factors of change whose origin is traced to management
perceptions, ideologies, beliefs, practices and actions. Manager within every entity constantly
monitors and evaluates the events or situations taking place within the organisation that gives
rise to the need of bringing about change. Such events can include ineffectiveness, inefficiency,
and level of customer satisfaction, organisational strengths and weaknesses (Nygårdh, Ahlström
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and Wann‐Hansson, 2016). These can significantly act as drivers of change within health and
social care sector.
EXTERNAL DRIVERS
Legal and Political Factors: The laws and legislations passed by government and legal
bodies act as drivers for facilitating change within HSC. In this regard, Modernisation Agenda
fosters organisation to bring about changes. This consists of the plans made by government of
UK to modernise the social care as laid out in the White Paper of 1998 named “Modernising
Social Services.” The key messages devised by such plans were to promote independence
through social services. Also, it proposed that services should foster convenience, enable
delivery with larger consistency and be emphasized upon specific needs of users. Also, the
existing legislations such as NHS and Community Care Act (1990), Health and Social Care Act
(2001) and Health Act (1999). Further, the funding issues also at times drive changes within the
medical sector (Dupuis and et. al., 2016).
Demographical and Cultural Factors: The socio-cultural and demographic factors of
population also act as drivers for change within the HSC organisations. Such factors comprise of
lifestyles and needs of users, their perceptions and ideologies. Also, it includes the ethnic
community needs of minority groups of people. In addition to this, ageing population also tends
to have different healthcare needs and demands than younger generations which drives health
centres to bring about changes with a motive of meeting the demands of users. Further, the
broadcast media such as news, radio and increasing awareness among public also strives
enterprises to come up with positive changes within the organisational premises so as to render
improved services to people.
Technological Factors: The advancements that are rapidly and constantly taking place
within the world of healthcare serve as drivers for change within the medical sector. In this
regard, new technologies such as Assistive Technology for the convenience and comfort of
disabled people have gained massive awareness (Wylie and et. al., 2016). Further other
technological advancements are electronic record keeping and electronic communication. All of
such innovative and technological initiatives foster HSC organisations to come up with the
changes.
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In response to the above drivers, healthcare entities alter their procedures, strategies or
organisational conduct. In the present case, failure to abide by the quality standards led to CQC
demanding for change within RUH bath NHS trust medical institution.
1.2 Challenges that key factors of change bring to HSC services
Introducing changes within an organisation is not an easy task. There are a number of
changes that need to be efficiently dealt with. In this regard, one of the biggest challenges that
the key factors of change present to the services of health and social care is lack of resources. It
is universally known that changes cannot be executed without making significant investment.
Thus, it becomes imperative to plan and set budget to implement the changes in HSC services.
However, planning becomes almost impossible in case need for change, for instance: it occurred
with RUH bath where the Trust did not foresee the need to bring about change implying that
there was no budget already stipulated to execute the activities to introduce change.
Yet another significant challenge posed by key drivers of change is gaining support as
well as cooperation from the affected stakeholder groups. This is because not all the stakeholders
get motivated enough to facilitate changes (Dupuis and et. al., 2016). Some of the organisational
stakeholders, specifically a proportion of workforce intend to keep Status Quo as it provides
them a sense of stability and security. For instance: Changes within RUH bath Trust Hospital
owing to pressure by CQC requires high level of coordination as well as support from employees
and management (Bee and et. al., 2015). But it is not possible every time that this assistance &
cooperation can be obtained from side of employees as they resist the alterations specially if
there exists threat of implanted relationship, job security and future is ambiguous as well as
unclear.
LO 2
2.1 Criteria and strategy to measure recent changes in HSC
To execute alterations within organisation take money and time. This process is not easy
and there are certain factors which makes it critical to make these modifications. Thus, it is
necessary to measure occurrences to identify whether changes are efficacious or not. To calculate
them in RUH bath trust a specific criteria and technique is needed to do so. This may include
identification of approach which can be used for measuring occurrence. In this regard, the
strategy to measure change can be to conduct regular inspections by way of audit. For this,
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supervisors from outside the organisation can be appointed. Further, the strategy can also be to
get the quality inspection done through governing agencies and bodies. As per nature as well as
situation which prevails within RUH bath trust, it comprises of a number of approaches, namely,
qualitative & quantitative. When numeric values are involved for measuring the extent up to
which alterations have been made is known as quantitative approach. With respect to RUH bath
case, quantitative approach can be utilised for measuring effectualness of alterations for
improvising services via user waiting time, response time and waiting time associated with
surgery unit. As per CQC, in existing structure there exists long instance before the patient is
being taken to other ward as it was risky and unacceptable. Therefore, it was necessary to
contribute within alteration program and this can be carried out by making use of statistical or
numeric calculations. Like amount of time taken by a service user while waiting within a line
after as well as before needs to identify so that any change which has occurred can be depicted.
Measuring alterations by utilisation of quantitative approaches render various assets (Dupuis and
et. al., 2016). This will assist RUH Bath hospital to acquire perception as well as feelings of
stakeholders which comprises of service user, employees and many others. This approach can be
cost effective which will lead to savings of money and time of the organisation. The standards
set by Care Quality Commission such as care and welfare of personnel, respect and involvement
of people, safeguard of people from abuse, assessment and monitoring of quality of services and
records help to set the benchmark for the effective measurement of impact of changes within
HSC sector. All of these were seen to be violated by RUH bath while functioning and thus it
received a warning from CQC (CQC warns Royal United Hospital Bath NHS Trust that it has
failed to keep patients’ records, 2019).
Qualitative approach must be merged with quantitative approach. This comprises of
calculation of effectualness of alterations by collection and analysis of facilities, events,
behaviour, actions or views of people. In context of RUH bath trust, qualitative approaches will
assist in measurement of various prospects associated with alterations that comprises of
perceptions of service user related with satisfaction of employees, changes and feelings of
management with this.
2.2 Measurement of impact of recent changes on HSC services against set criteria
The influence of the implementation of changes in RUH can be significantly measured
through a number of ways such as interview, survey and evaluation as well as analysis of
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feedback. There is a definite link between the changes and emotions, perceptions as well as
opinions. Thus measurement of impact can be done by analysing the feelings and perceptions of
people. Survey is found to be the most optimum technique for this. In context of RUH, survey
would provide assistance in gaining data about service users as well as feelings of staff when
changes get executed. Qualitative analysis and evaluation of feedback gained from them will
explain the influence of changes on these individuals. Analysis as well as calculation of statistics
also acts as an effective measure for understanding the impact of changes RUH. This can be
executed by gathering quantifiable data with the assistance of questionnaire or by way of
analysis of computer records.
As per quality report of RUH, the change program consequently led to improvements
such as more emphasized leadership, significant enhancement in services as well as equipments,
improvements in safety, safe and effective patient handling and enhanced arrangements for
provision of HSC services. With the help of before mentioned measurement techniques within
RUH bath, it has been ascertained that the service users of this trust are now satisfied with the
impact of changes within the entity. Also, the recent changes have ensured that employees
working within the entity are now content with the working atmosphere.
2.3 Evaluation of overall impact of recent changes in HSC
The elevation of warning notice upon RUH bath by CQC depicted that the trust had
successfully managed the change. Further, it illustrates the wholesome compliance with quality
standards of HSC. Such improvement would lead to delivery of high quality facilities. For
example: the course of action of inverting the Day Service Unit to a 23 hours ward reflected
higher Bed capacity to accommodate patients from surgery unit, thereby decreasing the risk as
well as time within unit (Thomas, 2017). The streamlining of collection of information as well as
management within RUH mean more effective and efficient offerings for patients.
As per the earlier report, CQC witnessed that during the busy schedule, the needs and
requirements of patients were not accomplished. This owed to the inadequacy of staff which
created pressure on current workforce. But these failures were effectively looked upon by the
hospital and the changes were brought. In response to the changes, it was evaluated that the
changes were effective enough to meet the needs and requirements of users against the set
standards and criteria.
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2.4 Proposing appropriate service responses to recent changes in HSC services
Changes showcase threats and opportunities that arise in an organisation from external
environments. In this regard a warning notice has been served to Bath hospitality by COQ that
clearly indicates that lack of trust is a factor that lead towards ineffective monitoring of
qualitative services in hospital. Thus, in order to ensure this, the most strategy proposed by RUH
bath is to get the audit done and ensure that the current level of changes are adequate and
sufficient to meet the needs and requirements of people. RUH has further proposed to properly
comply with National standards and adopt the quality monitoring and management (Dupuis and
et. al., 2016). In addition with this, HSC services are also being improved within the organisation
by way of implementation of effective training programmes in order to encourage the staff to
work in accordance with the standards stipulated by CQC. This will help the organisation in
effectively adopting the changes and enhancing the existing quality of services to meet the needs
and requirements of patients.
LO 3
3.1 Key principles of change management
Managing changes is not considered to be an easy task, but also inevitable as because fast
changes in culture of any health and social care organisation. On the contrary, this was realised
that change management in HSC sector is already under process which is implemented under
supervision of related or senior people to gather its outcomes for longer time duration. RUH bath
is under progress to implement certain changes in their HSC services to make people loyal about
their offerings or services at an ultimate level. For this, they have to undergo eight steps process
for successful implementation of change management, as follows. These eight steps are
categorised into three phases as described below:-
Phase one: Creating a sense for change
This involves two sides such as emotional people and situation side. This phase deals with
people’s emotional side. This can be done with help of establishing a sense of urgent need,
developing coalition and creating a strong vision.
Phase two: Engaging the organisation
This stage emphasizes upon involving workforce in the procedures such as planning,
implementation and evaluation of the program. Here, change management can be done by giving
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power to people in RUH bath to pursue full course of action for accomplishing change
objectives, communicating the vision associated with introduction of change and planning for
short term wins. Staff involvement is highly necessary in decision making process (Thomas,
2017).
Phase three: Executing and sustaining change management
This is the last phase of change implementation in which decided changes such as time
regulation, staff management and process sustainability is required to be undertaken. In this
change leader has the responsibility to ensure proper implementation of changes decided in
meetings. In this, decision making is necessary to be taken with respect to the problem area such
as improper services, lack of planning in treatment process etc.
These phases of the change management need to be evaluated with correct use of an
informative on how the changes can be brought into an existence to ascertain business outcomes
within HSC sector. In context with these phases, RUH bath have to evaluate their existing
process of working and in case any development is needed, that has to be changed and implied.
3.2 Ways of planning changes in HSC
Change is an ongoing process, irrespective of any industry whether HSC, people care etc.
Also, success of any changes program is completely dependent on the planning process. If
planning works upon a right strategy, implementation will not just be strong but also productive.
RUH bath has proposed to bring about changes in leadership, services, equipments, safety,
patient handling and arrangements for provision of services. In order to plan for effectively
executing such changes, the below mentioned plans are necessary to be developed:-
Stakeholder management plan: Changes generally do not happen easily. On the
contrary, a number of people get affected by same process. This makes sense, if stakeholder
management plan is put in right and at right time. RUH bath have option to protect common
interest of stakeholders to give change benefits to the society. Before plan, stakeholder
assessment is necessary to be done which groups such as customer, suppliers, investor, and
government etc., along with factors such as demand or supply are affected at bigger ratio. A
meeting is organised to communicate the proposed changes to all the stakeholders and their
views and opinions regarding the change have been taken into account. With the help of this
communication, RUH bath is planning to gain support from them and effectively execute the
changes.
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Communication plan: This plays an important role in implementation of changes in RUH
bath. Role of communication is important in HSC sector to raise changes as this acts as a
pathway through which changes are communicated to the staff. To be effective within HSC
sector, emerging processes for communication of one person with another gains importance for
the entity as this will significantly assists RUH in reducing the resistance from employees
(American Geriatrics Society Expert Panel on Person‐Centered Care and et. al., 2016).
Communication plan needs to be timely, concise and productive in order to ensure the successful
formulation of changes.
3.3 Ways for monitoring recent changes within HSC services
Change is necessary, but this will be necessary to monitor or evaluates the changes made
in the RUH bath and understand its obstacles and limitation. In the RUH bath, changes such as
channels of communication, productive management, patient or people care etc., are some of the
changes made. Monitoring of changes involves a kind of the systematic and routine collection of
a information which needs to be identify what level of changes are working and what changes
are not. In case of changes implemented in the RUH bath, several approaches of evaluation or
monitoring will be used (Schwarzer, Antoniuk and Gholami, 2015). These approaches are as
follows:
Observation: Many changes in the RUH bath have been observed such as spot check and
kind of an observation. In this techniques or tools, studying and recording of information has to
be undertaken to see changes. In RUH bath, observation can be in different area such as staff
management, patient treatment or satisfaction along with advance process or way of treatments.
For this, observer needs to be well-established and equipped with the skills to take observation in
the RUH bath in less period of time.
Survey: In this, interview and information from staff or patients of RUH bath will be
taken, in which description of the services provided to them, suitability & viability and changes
seen in that. In this facts or procedures have to be taken into existence to gather most suitable
and reliable info ti measure or monitor changes in given period of time (Giles-Corti and et. al.,
2016). Such information will be conveyed to the stakeholder and appropriate decision making
will be taken in that case.
All these tools or techniques are required to be maintained to use in the future to realise
its outcomes to make the process of change management to be works for development of HSC
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business regulation for a longer duration of period in the RUH bath to enhance long term
outcomes to gather productivity in this environment.
CONCLUSION
From the above report, it is concluded that change is an ongoing process in HSC sector
because of an influence which is levied on healthcare organisations by the regulatory
environment. Also, it is analysed that introducing proper changes as well as managing them is
not a smooth process. In this process, a number of challenges or obstacles are noticed. Along
with this, planning for the change is one of the most essential parts of change process in context
of any business sector. However, measuring and monitoring the changes is also very essential as
it helps in determining what is working and what is not working.
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REFERENCES
Books and Journals
Thomas, P., 2017. Integrating Primary Healthcare: leading, managing, facilitating. CRC Press.
American Geriatrics Society Expert Panel on Person‐Centered Care and et. al., 2016. Person‐
centered care: A definition and essential elements. Journal of the American Geriatrics
Society. 64(1). pp.15-18.
Dupuis, S. and et. al., 2016. Theoretical foundations guiding culture change: The work of the
Partnerships in Dementia Care Alliance. Dementia. 15(1). pp.85-105.
Wylie, D. and et. al., 2016. Serving transgender people: clinical care considerations and service
delivery models in transgender health. The Lancet. 388(10042). pp.401-411.
Nygårdh, A., Ahlström, G. and Wann‐Hansson, C., 2016. Handling a challenging context:
experiences of facilitating evidence‐based elderly care. Journal of nursing
management. 24(2). pp.201-210.
Giles-Corti, B. and et. al., 2016. City planning and population health: a global challenge. The
lancet. 388(10062). pp.2912-2924.
Holmes, B.J. and et. al., 2017. Mobilising knowledge in complex health systems: a call to
action. Evidence & Policy: A Journal of Research, Debate and Practice. 13(3). pp.539-
560.
Bee, P. and et. al., 2015. Professional perspectives on service user and carer involvement in
mental health care planning: a qualitative study. International Journal of Nursing
Studies. 52(12). pp.1834-1845.
Rolls, K. and et. al., 2016. How health care professionals use social media to create virtual
communities: an integrative review. Journal of Medical Internet Research. 18(6).
p.e166.
Schwarzer, R., Antoniuk, A. and Gholami, M., 2015. A brief intervention changing oral self‐
care, self‐efficacy, and self‐monitoring. British journal of health psychology. 20(1).
pp.56-67.
Online
CQC warns Royal United Hospital Bath NHS Trust that it has failed to keep patients’ records.
2019. [Online]. Available Through:<https://www.cqc.org.uk/news/releases/cqc-warns-
royal-united-hospital-bath-nhs-trust-it-has-failed-keep-patients%E2%80%99-records>.
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