Facilitating Change in Health and Social Care (HSC201)

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Facilitating Change in Health and Social care
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Table of Contents
Introduction....................................................................................................................................3
Part 1. Essay on factors that drive change in health and social care services (Task 1- 1.1,
1.2)...................................................................................................................................................4
Part 2. Essay on recent changes in health and social care services (Task 2- 2.1, 2.2, 2.3, 2.4)
.........................................................................................................................................................7
Part 3. Essay on principles of change management (Task 3- 3.1, 3.2, 3.3).............................11
Conclusion....................................................................................................................................15
Reference List...............................................................................................................................16
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Introduction
Healthcare organizations are recently undergoing major kind of changes. Both small and
large organizations the process of change is gaining momentum. Change can be defined as
transition period and it is often motivated by various internal and external factors.
Healthcare organizations undergo multiple changes like restructuring, incorporation of new
tools and technologies and competition from markets. In this assignment, the factors that
drive change in a HSC organization as in expectations of patients and demographic or
economic factors will be discussed. The recent changes occurring in an organization will
also be highlighted. Lastly, the change management principles of Kotter’s eight steps and
McKinsey’s 7S will be explained in the context of the case scenario.
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Part 1. Essay on factors that drive change in health and social care services (Task 1-
1.1, 1.2)
Introduction
In this essay, the key factors behind driving change in health and social care services will be
discussed and the assessment of the key factors that brings change will be explained as well.
The operation of health and social care organization in a particular environment is changing
rapidly due to advancement in technologies, change in legislation mainly due to political
activities and social factors.
Discussion
1.1
In a healthcare organization, services are continuously subjected to various types of change
such as organization, legal or political, technological, cultural plus demographic (Salmond
et al, 2017). Change occurs because several related parameters as in advancement in
technology, need for collaborative working, funding issues etc. These factors can hugely
impact the people as service delivery gets affected when change is not properly managed.
Organizational change occurs when the structures and functions of an organization no longer
holds relevance (Alvesson et al., 2015). It is therefore necessary for organizations to adapt
itself according to the requirements of the external environment. The external environment
involves factors that are beyond the control of the organization as in competition, economy,
customer’s preferences, social conditions, availability of resources, political influences
(Epstein, 2018). As observed from the case scenario, local authorities have been dealing
with funding and demographic issues and therefore require change in system. Most
importantly, the implementation of Care Act 2014 in HSC organizations has been quite
difficult for the authorities. It is a legal framework that has existed for more than 60 years to
ensure rights and responsibilities of people who require support services however, its
possibility of existence is in a doubt because it is to be implemented within a real tight
budget. The Nuffield Trust’s Home Trust and The King’s Fund described the insanely
competitive scenario with the service and retail industries in addition to the NHS. Due to
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economic influence as in this case funding restraint, social care providers are unwilling to
work for such organizations that offer low pay. The other external factors that drive change
might include new EU legislations, impact of globalisation and as a result excessive
competition as noticed in the case scenario. The competitors fight for maximizing profits by
minimizing cost of resources (Goudie, 2018). All businesses aim towards maximizing client
satisfaction as well to gain competitive advantage in the market. Change also occurs due to
changing attitudes or preferences of customers with time. Their demand for high quality
services increase with changing times. As seen from case study, older people are now much
more in need of integrated care and support services around the world. The intervention
from the government causes organizations to renew its policies and regulations. It is
necessary to monitor all the external and internal environments to identify early signs that
require change or modification. The businesses have to make potential adjustments
according to that. For example, in the London boroughs the rate of STIs has been on rise
and in order to address this issue a collaborative approach has been taken collectively by the
councils. They introduced the “The London Sexual Health Programme” for ensuring better
health outcomes of people. The other related factors that induce change are modernization
agenda to improve delivery and quality of care services. Other political issues affecting
change are current legislations like Health and Social Care Act 2013 and NHS Community
Care Act 1990 to maintain effective workforce across public health institutions. The
demographic and cultural factors driving change involves ageing population, lifestyle
choices, awareness levels of the population and influence of media. Lastly, the technological
factors involve assistive technology, new and improved IT systems and other forms of
electronic communication.
1.2
The above-mentioned drivers of change often pose challenges to health and social care
services. Due to economic changes, the healthcare needs of older adults often are neglected,
as they cannot afford the money required for accessing services. They continue to suffer
from physical disabilities and mental health issues. These people often fall out of the
priority zones. They end up in the hospital however, their care needs go unnoticed. The
introduction of assistive technology has positively increased the efficiency of the services.
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For example, previously Hoist was not used and handling services used to be difficult for
care providers. After the integration of this safe tool, disabled people are now able to move
freely. One of the challenges in using updated technological tools is requirement of proper
training. Often employees cause damage or accident of patients occurs. Political changes
have posed challenges as well in the NHS. For example, older people are now required to
wait for weeks before they can receive proper treatment. According to recent reports from
CQC, the care providers at care homes claimed that they are often unable to get medicines
on time for older people and only about 40% of patients receive visits from the General
Practitioners (Baines et al., 2018). With reference to the case study, organizations are
recently facing fierce competition because it is now receiving low funding from government
bodies and as a result are unable to pay deserving wages to the care service providers.
Consequently, the care providers are unwilling to join HSC organizations and this might
create a gap of 1 million workers in the workforce by 2037.
Conclusion
In this essay, the primary factors have been discussed that drive change in health and social
care services. Mostly these factors includes political, legal, economical, technological,
social cultural as in preferences of people etc. Change in an organization occurs by the drive
and influence of various internal and external changes. Apart from that, the challenges that
organizations face due to the influence of these agents has been discussed as well.
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Part 2. Essay on recent changes in health and social care services (Task 2 - 2.1, 2.2, 2.3,
2.4)
Introduction
In this essay, the strategies and criteria that help in measuring changes in health and social
care organizations will be devised. The force of recent changes on the HSC organizations
will be measured thereafter. An evaluation (positive impact and negative impact) of the
recent changes will be done in this essay. Lastly, appropriate service responses will be
proposed in the context of the case scenario and by using other examples.
Discussion
2.1
In a healthcare organization, change can be measured by critically examining the external
and internal factors that affects its operations. For example, a PESTLE analysis would help
the care manager to measure the recent changes. The politico-legal factors involve policies
and recent laws of the government. The economic factors involve pricing and funding in the
organization. The socio-cultural factors involve the social-cultural preferences of the local
population who are currently using services. The technological factors that can have an
impact on HSC organizations involve new drugs as well as medical technologies. In the
context of the case scenario, the political and legal factors affecting HSC organizations are
the implementation of Care Act 2014. It deals with creating legal framework that is going to
protect the rights of care users (Barnes et al., 2017). However, its feasibility has been a
growing doubt. The economic factor includes low funding from government bodies that
restrain care providers to work for HSC organizations. In addition to that, Benchmarking is
also a strategy as well as criteria in measuring quality and analysing it critically. For
example, two organizations can compare its services and measure scope for improvement by
setting benchmarks. Data of any form (information) is a necessary indicator to measure the
quality of the changes made recently. The service providers can recognize changes and
forecast patterns. By analysing data, further investigation becomes possible and future
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uncertainties can be identified. For example, clinical assessments and audit data are useful
indicators of change (Sprint et al., 2015). Legal indicators can also be used to measure
changes in the HSC organizations. For example, implementation of the Care Act 2014,
which ensures proper right to exercise rights related to care services can, be measured and
seen whether it is fully utilized. The Royal College of Nursing (RCN) policy statement can
be useful criteria. It states that population must be making healthy choices. It is to be
measured whether service users are receiving accurate information and thereby being
empowered to make own decisions regarding own health and wellbeing (Kozlowska et al,
2018).
2.2
Change in an organization is supposed to have positive influence on the service providers as
well as service users (Scott, 2015). Change in the form of structure, overall organization of
tasks or minor administrative changes can be effective always. In the context of case
scenario, it is seen that older people in the society require support however, it has been seen
from research that the services provided by HSC organizations are lagging behind to much
extent and it cannot meet the needs and demands of the service users. In London, the impact
of recent changes has been felt when local boroughs in London developed a partnership and
started a programme by the name “The London Sexual Health Programme”. Since people
often suffered from Sexually Transmitted Diseases (STIs), the services in the programme
includes screening and treatment of STIs (Londoncouncil.gov.uk, 2019). From diagnosis,
HIV testing to contraception use, this service model has been effective in improving health
outcomes of people. So far, the collaborative work has improved the experience and resident
access. In London, this programme has helped in providing integrated care for infectious
diseases. It is a very popular service among the young people as it has major impact over 32
councils in London. It also provides free and confidential online service in order to make the
programme cost effective. This service also possesses the potential to reach out to groups
that usually lose touch or contact.
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2.3
The large influence of recent changes can be felt in an organizational setup when it can
improve motivation levels of the staff, increase productivity in the workplace.
Organizational proficiency can be analysed when the work outcomes of the staff can be
maximized (Borkowski, 2015). For example, the NHS does not allow numerous
appointments or cancellations of services. In the context of the case study, it has been
observed that The King’s Fund and the Nuffield Trust’s Home claimed that higher
competition has been rising in order to find staff who are willing to work in exchange of low
pay. It is also estimated that the social care industry might have to face a worker gap of 1
million care workers by 2037. In London boroughs, the implementation of The Health and
Social Care Act 2012 also had an impact on NHS, England. From April 2013, the changes
have been felt. As in, GPs and various other healthcare experts are given budgets so that
they can purchase care on behalf of their local communities. Recently, responsibilities have
been shifted from Department of health to NHS Commissioning Board (renamed as NHS
England) (England NHS, 2016). The major impacts of changes were on patients in over-seas
who are now charged because they cannot provide free healthcare certificates. The family
members of the service users also felt that they were treated inappropriately. It can be stated
that people from oversees are in dire need of services and might not be able to afford or pay
for it but this should not be a hindrance in accessing any kind of treatment. In the context of
the case study, it can be stated that the social care system is in a critical stage. Since,
organizations are not being able to pay deserving wages to social care providers there could
be a major impact on the organizations in terms of low staff count. There will be a lack of
efficient number of service providers and this will have a negative impact on the service
users.
2.4
Depending on the employees of the organization, changes take place as their approaches and
attitudes pave the way for change (Quirke, 2017). The service responses to improve quality
and make change in the organization might be widening the scope of training and education
facilities. It is necessary to properly analyze diplomas or certificates before hiring staff.
Response to the changes in the organizations is very fundamental. Therefore, training is an
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important way by which staff can develop specialization in particular areas. The entire
healthcare industry has been undergoing change and social care workers has to provide
updated services and must possess updated knowledge regarding recent changes in
government policies or legislations (Ginter et al., 2018). In order to carry out the review
process to measure knowledge of staff, interviews and rating systems must be in place. They
need to acquire the technical knowledge and relevant skills. Through continuous training,
employees can also sharpen their skills. In the areas of government regulations,
interpersonal development, organizational procedures and change management, training can
be given (Sitzmann et al., 2018). With emergence of new technology, the competence level
of staff must also emerge and evolve. For measuring the competence levels, appraisal
techniques can be employed. By reviewing the entire training process, organizations will be
capable of identifying the differences and suggest way of improvement. It is to be identified
by the organizations that whether change has been beneficial for service users as well as
providers. The management structures of the organization go through a change and it is
essential for organizations to sustain long-term strategies and keep on re-inventing and
implementing them to provide quality care. The organization is also accountable for
wrongdoings. In case of the case scenario, it is crucial for HSC organizations to search for
care providers and hire them, as there is increased competition in the market to hire
employees at a low wage. Therefore, employees are not willing to join those organizations.
It is also relevant for organizations to assess the extent to which the Care Act 2014 can be
implemented as according to recent reports this Act is continuously losing its importance.
The sector is also lagging behind meeting the needs of older people at the local or national
level and therefore requires hiring and training staff effectively.
Conclusion
It can be concluded that the strategies and criteria that help in measuring changes in health
and social care organizations has been devised to some extent. The impact of recent changes
on the HSC organizations has been measured. The evaluation process to the recent changes
has been done and finally appropriate services have been proposed for the case scenario.
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Part 3. Essay on principles of change management (Task 3- 3.1, 3.2, 3.3)
Introduction
In the introductory part of the essay, the key principles of change management will be
explained. Kotter’s eight steps change management model and McKinsey’s 7S model are
useful for setting the key foundation of change management. The technique of planning
changes in health and social care organizations will be discussed and lastly the ways to
monitor recent changes in the care services will be assessed.
Discussion
3.1
It is a common scenario that while implementing change, some people usually embrace
change, some might accept while others might completely reject, as it is human nature to
stay comfortably in familiar situations. Change management can only be effective when
people successfully develop learning habits (Drucker, 2016). By doing repetitive tasks on a
daily basis people learn techniques and skills. Change management often fails because
managers in the organization might fail to communicate their vision to the subordinates. It is
necessary to track short-term wins and not allowing the interference of roadblocks into the
vision. It is also crucial to anchor changes in the organizational culture. There are various
change models such as Kubler-Ross five stages transition cycle, Kotter’s eight steps of
change management, Kurt Lewin’s change management model and McKinsey’s 7S
framework. The Kotter’s model has been designed for leaders who are aiming towards
managing change in a strategic manner. The Kotter’s model explains the establishment of
the need for urgency in which the organization need to feel motivated and realize the urgent
need of change (Salman et al., 2017). The principle involves not getting panicked and acting
after proper preparation. It is important to encourage group work for making change. The
vision of the group must be directed towards change as well. Keeping the communication
open will help in employee engagement and coalition behaviour among employees can be
taught as well. The staffs in the organization also have an inherent need to feel empowered
and therefore obstacles need to be removed. Short-term wins need to be planned for visible
performance. Victory should not be declared too soon and ideas are to be kept fresh as well.
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The McKinsey’s 7S highlights the fact that preparing structures does not always mean
organizing everything (Channon et al., 2015). The leaders are aware that change
management requires more than organization of boxes, descriptions or charts. Therefore,
according to them, change means an updated framework. The 7S are –skills, systems,
structure, strategy, shared values, staff and style. All these factors go into making a
successful change management plan. In 7S, Strategy implies a plan that will be made to
allocate resources of the firm like environment, customers etc. The structure denotes
division of work (top-down), centralized system or decentralized system (Ravanfar, 2015).
Systems mean procedures and routine to be followed to do the task. It might include the
financial systems, performance appraisal systems and information systems of the
organization. The skills imply distinct capabilities of employees and staffs denote the
number of personnel working for the organization. The style points towards social cultural
behavioural style of the personnel and managers in the organization. Lastly, shared value
helps in forming interconnection among employees and this can only be similar when the
central belief systems like attitudes or norms are similar in nature. Trust and bond is based
upon similar shared values. In this way, the employees can stand for a vision and make
necessary changes.
3.2
The techniques of planning changes in health and social care organizations includes the
identification of the need for change, identification of the goals of the organization, devising
strategies for implementing change and clear a consultation process with the staff (Eldredge
et al., 2016). In the first step, the HSC organizations need to change because new service
models will eventually improve the quality of life of service users. The digital technologies
play a major role in applying innovative models. Financial challenges are also a reason
behind making change. Moreover, the aging population has been going through a stage
where morbidity levels have increased and due to this factor, their demands for integrated
services have been increasing as well. The NHS Change Model was designed to deliver
services that are sustainable in the end (Hayes, 2018). The values of NHS are centred
towards involving everyone who gets affected by change. Therefore, it must try to revisit
their shared purpose and improve people’s lives. The organizational goals can be identified
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