Factors Driving Change in UK Health and Social Care

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Contents
INTRODUCTION.....................................................................................................................................1
LO1........................................................................................................................................................2
1.1......................................................................................................................................................2
1.2......................................................................................................................................................4
LO2........................................................................................................................................................5
2.1......................................................................................................................................................5
2.2......................................................................................................................................................6
2.3......................................................................................................................................................6
2.4......................................................................................................................................................7
LO3........................................................................................................................................................8
3.1......................................................................................................................................................8
3.3......................................................................................................................................................9
CONCLUSION.......................................................................................................................................10
REFERENCES........................................................................................................................................11
INTRODUCTION
1

It is marked that health and social care sector is the one which works appropriately only by
accepting variety of changes throughout its course. Change is considered as the action taken
to implement some new reforms and difference in working in health and social care system.
Facilitating change refers to the ways and factors by which the desired changes are facilitated
in the system to improve the current services and outcomes. Different legislation and
regulations are created in order to facilitate these changes in health and social care system.
This assignment deals with discussion of the factors that drive change in health and social
care, along with discussing recent changes in health and social care as well as understanding
the principles of change management that can improve the process of change implementation.
The assignment will mainly focus on how the changes in health and social care are being
facilitated to promote better and improved services as well the support of government,
authorities and legislation to implement these changes will be marked. The aim of changes in
health and social care is attainment of better service quality and better standards of care.
LO1
1.1
2

Changes in health and social care are remarkably implemented on regular basis with aim to
achieve better service delivery and better patient outcomes. In the UK health and social care
system is highly approaching and flourishing field which requires adequate monitoring and
regulations to be on the high standards of care as it is (Nolan., 2005). There are several
factors that either positively or negatively influence the implementation and working of
changes in health and social care. The analysis of these factors can be done by using a proper
analytic tool example PEST. PEST stands for (political, economic, social and technological).
This tool is highly specific in analyzing the macro environmental factors that influence
changes in health and social care.
(Online source https://expertprogrammanagement.com/2018/05/pest-analysis/)
Political factors include the government policies, regulations and laws that are introduced
with aim of betterment of the nation and services. In health and social care as seen the
introduction of Care Act (2014), has brought some specific changes in the current system and
aimed at enhancing the quality of care provided in the UK (NHS Uk., 2014). These
regulations are responsible for the better delivery of services and also are major cause of high
3

grade services in this sector. The agencies’ that are associated with these governmental
legislative tasks like CQC are also considered as one of the factors in political aspect that
helps driving change. For instance of the agency like CQC introduces need for change it
becomes a law for the organization to implement those changes (Reamer., 2006).
The economic factors include funding, wages, taxes, human resources, resource utilization
and economic status of the organization. As seen in given case the labor and human resources
are not adequate and it is estimated that there will be severe lack of human resource staff in
health and social care till 2037 in the UK (Mizrahi and Larry., 2008). This is due to common
factors that influence it including low wages and unsatisfactory jobs for the staff that turn
them over the work and cause lack of workers. The funding in many organizations is also
considered as one of the factor that derives it to failure. The changes are influenced by these
consequences and factors.
Social factors include incidence and prevalence of diseases, cultural practices, demographic
aspects, and health behavior of the population in the region. These factors are closely
associated to implementation and facilitation of changes in health and social care. High
prevalence of disease enhances changes in the treatment and way of service delivery
(Monnie., 2005). Cultural factors and the health behavior induce the authorities to adapt
strategies that will help reduce the prevalence of disease and promote health.
Technological factors include the advancements in technology and helps in enhancement of
the services in the system. The advancing technology has created various easy methods and
provided alternatives for the services, delivery of services and management of care which
were not present in previous era. With advancing medicine and health care it is also
advocated that technological aids and advancements should be used (Lankshear et al., 2005).
This will provide the organizations and health care staff new promoting factors for changes.
Example use of digital diagnostic aids and sensory equipment helps in better delivery of
services for the mentally sick patient and helps in point diagnosis of the conditions. This
factor also enhances the management of health and social care as well as provides positive
results for patient as well as service provider.
1.2
4

The factors as discussed present various opportunities for the implementation and
introduction of changes in health and social care but along with it they also present various
challenges. The challenges or barriers can be in any form including from the inadequate
funding, retaliating from the changes applied, lack of staff and resources, lack of facilities,
etc. These challenges not only restrict the factors to attain change in health and social care but
present as barriers to reduce the quality and standards of services in health and social care
organizations. The factors discussed are interrelated that influence the changes and helps the
implementation of quality services (Pelzang., 2010). If the demands of the population is to be
delivered properly the resources has to be adequate and the facilities have to be enough. The
challenges may be against political, social, economic or technological factors as discussed
above. For instance as the less quantity of staff will increase the work load on the current
workers that will directly influence their skills and quality of services that they deliver
(Eldredge et al., 2016).
Similarly the improper implementation of the legislations like the Care Act will provide
barriers in proper submission of care and lead to failure of services that are prepared based on
these policies. The challenges can also include the inadequate funding that will lead to
reduced equipment, lack of resources, lack of technology and advanced aids. The improper
funds will result in low wages and improper management of the organization that will again
lead to turn over of the staff members. Elderly health care is one of the most vulnerable fields
that has to accept changes in order to be adequate standards. As seen the elder care in the UK
is mostly associated with less funds and low amount of funding granted from overall
healthcare budget that makes the services of low quality (Jon., 2003). Social factors may
resent the challenges from the patient’s side where their cultural belief and values may not
allow them to participate in the health and social care activities or may hinder their
accessibility towards the services. The prevalence of disease again presents various
challenges in front of the health and social car system which has to be addressed properly
using proper change management in the organization.
As working in the Borough of Enfield, London the government introduced a policy to
implement new changes in the health and wellbeing of the region. To overcome the
challenges present the JSNA strategy that stated that the agencies like NHS and local
authorities and boards will work in partnership to avoid these challenges (Strategy, P. R. E.
V. E. N. T., 2011). Some of the policies like the “Marmount Review” (2010), and the NHS
policies include the delivery of services by introducing new changes which are easy to
5

implement and last longer. The policies provided evidence based strategies to overcome these
challenges of low resources, funding, staff and other factors (Holland and Hogg., 2001). Also
it was justified by the efforts of the government in the region that the factors driving change
were properly assessed and the challenges were identified and reduced.
LO2
2.1
6

Measuring change is an important aspect and is as essential in health and social care as the
implementation of change is. There are various strategies and methods to implement and
measure changes in health and social care. Measuring change is important in order to
promote longevity of changes introduced (Fisher., 2005). One of the crucial steps in
measurement of change is the collection of data, the data for the introduction of change,
practice before the change was implemented and the practice after the implementation of
change; all should be recorded and reported properly. These collected data can be observed
and compared for before and after outcomes of the practices. The successful outcomes can
denote proper working of changes implemented and can be useful in measuring the change.
A feedback is another common method used to measure change. Feedbacks from the service
user are very important tool to know whether the services provided by the organization are
satisfactory or not (Riekert et al., 2013). Feedback in form of a written or verbal
questionnaire or discharge interview from the client or his family members is advised. It is a
practice commonly followed in the North Middlesex University Hospital, Enfield. Here the
staff members are trained adequately to retrieve and a measure the efficacy of services and
change implemented by means of patient feedback. Feedbacks make it easier for the service
provider to know whether the changes are being implemented properly and working
efficiently or not.
Another way of measuring changes in health and social care includes the third party audit or
third agency audit. Audits are usually part of the system in UK health and social care where
the agencies like CQC are authorized to audit and inspect the organizations for the proper
implementation of the changes and how effective the changes are working in order to
improve the services of the region (Ferlie & Shortell., 2001). These strategies help the
organizations to know whether the new changes are working appropriately in right direction
or not.
2.2
The measurement of changes in health and social care allows the organization to identify the
loops where the services are lacking and needs improvement and how good the changes
implemented are for the organization. The recent changes that are implemented in health and
social care for instance the introduction of “Care Act” has made some new reform sweep in
the system. The act is mainly focused at equal distribution of services and equal treatment for
every service seeker (Clarke., 2000). The resources, staff, facilities and other factors that help
7

in implementation of this legislation are lacking that is directing it towards the unsuccessful
attempt to change. Without adequate staff members and funding how is it possible for the
health and social care system to deliver quality services. Similarly the introduction of this
legislation is indirectly being influenced by these factors and challenges presented by them.
Thus the Care Act has made it possible to introduce new system in health and social care
regarding the services and safety of the vulnerable adults and age groups in health care
(Makai et al., 2014). The act made it mandatory for every carer to follow the regulations that
will safeguard the service seeker. Since 2014 the introduction of this legislation it is noted
that there is reduced cases of adult abuse as well as enhanced medical insurance and facilities
for the people are undertaken.
2.3
The measurement of the changes in health and social care is an important aspect but the next
step comprises of the evaluation of the strategies that are working in order to evaluate its
impact on overall service delivery in the system (Kotter., 2012). Evaluation of the new
strategies can be easily done by observation, inspection or documentation of the changes
viewed in the outcomes of the services after implementation of change. Improvement in the
patient outcomes can be linked to better working of the changes being implemented and can
be evaluated as good for the organization, employees, and patients (Moorhead et al., 2013).
Positive patient feedbacks denote that the services presented are of good quality and this
helps in evaluation of the changes introduced. Employee review is another way of evaluating
the new strategies as the working pattern of the employee and how well the employee has
adapted to the changes is to be observed and measured for evaluating overall change efficacy.
The behavior of the employee towards service user and the changes implemented determines
the success ratio of the change implemented (Grol et al., 2013). The training to the employees
is a necessary element to make them more competent with new strategies and the more they
get comfortable to new changes the success ratio increases. The overall profit or the services
that the organization present if measured will help in evaluation of the impact of change on
the organization. As in North Middlesex University Hospital it is a common practice to
evaluate the changes implemented on a regular basis. The impact of recent changes that were
introduction of some new technology in the diagnostic arena of the health and social care was
proved to be highly beneficial for the hospital as well as the service user. Also it helped the
service provider by reducing their work load.
8

2.4
Recent changes in health and social care as demarcated the working together of four agencies
including NHS, Kings Trust, and Nuffield trust has proved to be a good strategy in enhancing
the quality of services in health and social care (Buchanan, Fitzgerald & Ketley., 2006). The
service responses of the employees, patients and the organization all determines the success
of changes being facilitated. The employees are less in number as stated by different agencies
and organizations due to lack of funding and low wages they turn over on their job profiles.
This is a major problem being suffered by all the organizations in UK. The response of the
service provider or the staff members is not always friendly to new changes. The changes if
welcomed properly can yield better outcomes. The staff members should be provided proper
training and skill enhancement session to make sure that they get well acquainted with the
changes implemented and provide proper response to the changes introduced (Kotter and
Cohen., 2012). Patient and service users response to the changes are also important as at
times the patients are not ready to adapt to change that makes it difficult for the health and
social care organizations to provide quality services using new strtagies (Care Quality
Commission., 2012).
LO3
3.1
Change management is referred to as a process of implementing changes and managing and
planning it in a systemic manner to achieve effective outcomes (Parkin., 2009). Change is
9

inevitable but following the change as per desired guidelines is not an easy task but a well-
planned and managed change can help in brining better and healthier outcomes in health and
social care. Different models of change management are used by different organizations to
facilitate and manage changes in health and social care. Some of the change management
models widely used is Kubler Ross five stages model, ADKAR model, Nudge theory, Kurt
Lewin change model and Bridges’ transition management model (Moorhead et al., 2013).
Discussing one of these models the light on how change management is beneficial in health
and social care can be focused. Kurt Lewin change management model is one of the oldest
and widely accepted three staged model for change management in an organization
(Manchester et al., 2014). This model focuses on how the changes can be incorporated into
any system by using three step, these includes unfreeze, change, and refreeze. The
organizations when follow these three steps for managing the changes in health and social
care can easily surpass the refraining factors and direct towards achievement of the new
behaviors and goals. The first step mainly concerns with unfreezing of the frozen or set
thought of the individual, the staff members, workers, management and organization has to
first identify the need for change and why change is important for them (Manchester et al.,
2014). As the thoughts of an individual become flexible it is the moment to implement and
introduce changes in the system. These changes when properly interpreted and introduced in
the system have to be freeze or locked for longevity. Refreezing is an essential step as it
allows the changes to be set and stay for longer duration with presenting better outcomes.
During this process communicating the need for change and enhancing the understanding for
change is essential among the organizations workers.
3.2
Planning of any system ensures better outcomes and proper pathway to follow the
implemented ways. Planning of change and managing it as per the proper demands of the
organization and service is important in health and social care (Boshoff., 2005). Different
approaches are applied in order to plan the changes required in health and social care.
Leadership planning and management is an important aspect and in current times where the
staff quantity and lack of services resources is one of the leading factors of failures the
leadership is an important aspect to be managed and planned to implement changes. The
managers of the agencies and organizations as enumerated in the case study should be able to
identify the exact requirement of change and the cause of failure to improve the services
10

(Levasseur., 2001). Elderly services are usually not adequate and this age group is vulnerable
to harm in health and social care, the implementation of the Care Act, 2014 also promotes
safety this age group. To ensure better practices and services for the elder population it is
necessary to plan the changes being implement according to their need and requirements.
Some of the steps are followed by the North Middlesex University Hospital under guidance
of local and international policies for change planning. These steps includes demonstration of
urgency of change, define the scope of change, stakeholders support, creating a change
management team, developing an approach with the management, drawing up a change plan,
communicate the plan and track resistance.
The implementation of changes in health and social care anywhere else in the organization
presents various challenges and a lot of barriers that will hinder the process of change
implementation. To avoid these resisting factors the change planning is an essential step that
allows the organization to enable simple and smooth implementation off change and this
theory may not always be successful but will ensure better outcomes (Barnett et al., 1996).
3.3
Monitoring is the process of reviewing and rechecking he implemented changes for
appropriate working in the system. Monitoring of the changes is essential part in health and
social care as it helps in better lasting of changes and ensures positive outcomes. Changes can
be monitored by observing the results it brings and this can be done by different approaches.
Monitoring of changes includes the evaluation of change as well as proper reviewing of the
results that the changes are brining. The changes as defined in previous discussions for
implementation of the legislation and acts that support the mentally sick patient as well as
elder adults in the UK are to be monitored for better outcomes. The implementation of this
legislation is done but monitoring the effects of this legislation on the overall wellbeing of the
population and health and social care sector is essential. Monitoring can also be done by
routine inspection, employee feedback peer reviews and audits (Jones., 2007).
Close inspection of the employees and their working criterions can be done to ensure that the
changes introduced are being followed by them to the desired standards (Malone., 2004). The
ways that the employees use from years cannot be changed in some days by implementing
changes and old ways can easily sweep in and fail the plan for change. Monitoring of change
ensures that these old ways do not sweep in and allows the organization to have better
11

outcomes from the new changes introduced. Audits and inspections by the agencies once in
six months like CQQC is essential to overrule any mishappening and misconduct in the
services in the organization. The routine monitoring by these agencies enables the
organization to improve the services in a better manner and achieve success (Cameron &
Green., 2015). The feedbacks from the patients and peer reviews by the employees for one
anther also helps in inducing better monitoring process and allows the organization to
measure the effect of changes that will help in monitoring the current scenario and help in
revising the reforms as per the demands.
CONCLUSION
Change is considered as the action taken to implement some new reforms and difference in
working in health and social care system. Facilitating change refers to the ways and factors
by which the desired changes are facilitated in the system to improve the current services and
outcomes. In the UK health and social care system is highly approaching and flourishing field
which requires adequate monitoring and regulations to be on the high standards of care as it
12