Leadership, Culture, and Healthcare: A UK NHS Case Study Report

This report examines the critical relationship between leadership and organizational culture within the context of healthcare, specifically focusing on the UK's National Health Service (NHS) and the Mid Staffordshire NHS Foundation Trust. The report explores how leadership practices, including communication, accountability, and ethical standards, directly shape the culture of healthcare institutions and influence patient care. The analysis highlights the leadership failures that contributed to the Mid Staffordshire scandal, emphasizing the importance of patient-centric approaches, effective complaint redressal mechanisms, and a positive organizational culture. The report also discusses the influence of findings in delivering greater health services, focusing on forming a positive organizational culture, patient-centric approaches, complaint redressal mechanisms, and enhanced quality standards. The study underscores the need for strong leadership to foster transparency, openness, and ethical conduct, ultimately improving service delivery and patient outcomes. It also highlights the significance of effective communication and performance management in preventing similar failures in the future.

Report

Table of Contents
INTRODUCTION...........................................................................................................................1
Assessment Task 2...........................................................................................................................1
Overview.....................................................................................................................................1
Leadership concerns....................................................................................................................2
Influence of findings in delivering greater health services.........................................................4
Formation of positive organisational culture..........................................................................4
Patient Centric Approach.......................................................................................................5
Complaint redressal mechanism.............................................................................................5
Enhanced quality standards....................................................................................................5
Medical Training and Education............................................................................................6
CONCLUSION................................................................................................................................6
REFERENCES................................................................................................................................7

Topic: “It is a truism that organisational culture is informed by the nature of its leadership”
INTRODUCTION
Leadership is referred to an crucial element in an organisation which is looking to
incorporates safety and healthy practice. Therefore it is essential to conduct an experimentation
and identify approaches which are most suitable to the organisational circumstances (Bercaw,
2016). It aims to direct activities of a group so that target which have been set by the
organisation are fulfilled. This report focuses on the leadership theories and practices which are
carried out in context of National healthcare service, UK. This assignment intents to analyse key
leadership challenges in context of Mid Staffordshire NHS foundation. The influence of young
leaders upon healthcare foundation will be understood as well.
Assessment Task 2
Indeed it is true that leader plays a crucial role in formation of organisational culture. The
manner through which leader influences culture of an organisation is through model behaviour
which has been portrayed. The behaviour which has been depicted by the leaders is often
followed by the supporters as well. The manner through which communication takes place in an
organisation influences culture as well. This feature is also dependent upon the extent to which a
leader encourages within an organisation. The additional feature which determine the culture in
an organisation are accountability and team features. The mentioned elements are also
encouraged by a leader in an institution. All these factors are responsible for shaping of culture
of a healthcare institution.
Overview
The study is based on the report which has been released relating to the Mid Staffordshire
enquiry which have clearly stated that suffering of patients have been caused due to failure on
the part of the trust board. The Mid Staffordshire hospital which was formed in the year 1983
have been part of the NHS foundation trust since February, 2008. This foundation have been
known to deliver primary healthcare services to people. Things have turned around when it was
identified that sub standard care which is delivered by this institution is known to be major cause
of death of people. The institution have claimed approximately 400 to 1200 lives ranging in the
year 2005 to 2008. the reason which have identified in the report is that needs and expectation of
patients were not given any attention due to negative culture which was practised in the
organisation during that period (Mid Staffs hospital scandal: the essential guide, 2013).
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National healthcare service can be termed as one of biggest health care service provider
in the world. This institution is known to deliver quality healthcare access to people and that too
free of cost. There are thousands of people working in this sector which are committed to offer
best of services to patients. The faith and trust that is employees have in this institution is
remarkable. The occurrence of such scandal have disrupted the circumstances of the trust in the
most significant manner. People were not believing in the fact that even after repeated
complaints such circumstances were not dealt and were allowed to persist in the institution.
There were numerous efforts carried out by the central management but all of them failed badly
and could not overcome this situation.
Leadership concerns
The prime failure which lead to origin of such incident is of the leaders or management
which was responsible for running the institution. The complaints of the patients and their
families went unheard and resulted in such as scandal in which approximately 1200 people lost
their life. Therefore it can be said that leaders and manager working with NHS Mid Staffordshire
during that period failed to realise their responsibility of providing ideal healthcare services to
people. It is not only confined to the people who were managing organisation resources there is
an significant contribution from the external sources as well. There have been organisation which
are known to regulate healthcare activities of the institution such as PCT and healthcare
commission. These organisation failed to oversee and scrutinise activities of this institution until
HCC probe. Therefore it can be concluded that governance and code of conduct of such
organisation have failed miserably and which could only be possible with the support and
encouragement of the senior level executives. The method and approach which was employed by
them at conducting investigation is being questioned.
The another challenge which could relate to leadership is that ability to use the resources
and facilities which are provided for the welfare of the people. This institution was supported by
NHS trust board through budgets and financial allocation which are provided so that better
service could be offered. The last recorded data have identified that over 6 million euros of cash
have been thrown away as the money was used on the medication which has been expired.
Therefore it can be concluded that the management have failed to utilise the resources which
were provided to them. The report which published in February 2010 was possessing harrowing
experience of patients which relates to services which have been offered to them. It has been
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identified that there was a lack of basic services and the behaviour of workers were not
acceptable as well.
It can be said that culture of an institution is formed through the behaviour of leader. The
poor leadership which was practised in the organisation directly resulted in the unhealthy culture
(DaCosta, 2012). The culture which of this institution relied on the self-promotion activities
rather than possessing analytical and open approach. The presence of unhealthy work culture
claimed the life of numerous people admitted in the institution. Considering above statement, it
can be said that unhealthy is a direct results of the poor leadership approaches which are carried
out in an organisation. The another major factor which hinders formation of appropriate work
culture in an organisation lies with the size and complexity of institution. The recommended
approach in this segment revolves around making such institution automated so that a consistent
and work oriented culture could be developed. There were numerous changes carried out in form
of leadership and structure but it was not analysed that feature which needs to be modified is
organisational culture. Culture which is practised within an organisation determines the manner
in which operations are carried out (Higgins and et. al., 2014).
Another crucial element which needs to be contributed to circumstances is ineffective
communication. The report have identified that there was a lack of effective communication
within employees or between regulatory and supervisory body on the grounds of patient care and
patient safety. The communication based intervention which are practised in this domain helps in
improving quality of services which has been offered to service users (Doody and Doody, 2012).
The situation of Mid Staffordshire can be eliminated at the initial stages but leaders tend to be
more rigid with their behaviour which fuelled the situation. The communication would have
made sure that there is a proper exchange of information and challenges which would further
assisted in countering the circumstances. The failure of communication within the organisation
suppressed matters which are to voiced out at initial stages of the scandal.
Ethical standards are defined to be code of conduct which justify the manner with which
patients in a healthcare organisation are catered. A healthcare organisation focuses on the
forming of ethical standards which are further maintained by health executives. There are
numerous set of features which revolves around established ethical standards and commitment in
an organisation such as decision making, patient care and research. All such feature make sure
that patients are treated with best possible capacity of an organisation. Therefore it is essential to
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produce leaders with a code of ethics along with a justified culture which further helps in
fulfilling purpose of an organisation (Gopee and Galloway, 2017). The failure of system lacked
on the grounds of performance management as well. There was no evaluation of performance of
individual, teams and organisation which further is the main cause of no improvement of
services in this domain. The performance of employees in the organisation have emerged to be
one of the strongest cause of substandard care which is offered to clients. This instance also
indirectly points towards members of executive board.
Influence of findings in delivering greater health services
The report which has been provided numerous criticism upon the institution and stated
the manner in which existing services delivery could be improved. It is a known statement that
leadership in an organisation possess right influence and tactics to improve the organisational
performance in terms of healthcare delivery. The learning which has been availed from this
project makes sure that service delivery prior to incident will be much greater and will ultimately
assure that patients are able to lead a comfortable and healthy lifestyle.
Formation of positive organisational culture
In this report it could be easily identified that culture stood most crucial and defined the
manner in which operations are carried out within institution. The major segments of
organisational culture which were cause of poor service delivery are lack of openness, no
presence of customer centric approaches and defensiveness. It is essential for leaders in this
contemporary era to focus on construction of right organisational culture so that improved
service could be offered to patients (Howieson and Thiagarajah, 2011). These features cannot be
completely eliminated but their lesser presence assures that right services are catered. To form a
right positive culture in the organisation it is essential to comply with the policies and regulation
undertaken by the authorities. There is a crucial need to embed transparency and openness in the
culture so that right service are catered (Trong Tuan, 2012). The climate can be formed solely
with the help of strong leadership approaches which are more clear and transparent. The various
people working for an institution are to bonded together so that their performance could be
compared and ultimately improved.
Patient Centric Approach
This is another approach which can lead to attainment of efficiency in terms of service
delivery. It is essential for a leader to make sure that needs and expectations of clients are to be
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considered as priority and are to be fulfilled in the best possible manner with the available
organisational resources (Porter-O'Grady and Malloch, 2011). The tool of communication in this
aspect should be clearly emphasized so that there is an enhanced sharing of information and
concerns amongst various stakeholders. The incident helps us in understanding importance
which lies with tool of communication within an institution. In this segment, Transformation
approach is to be utilised which aims to utilise its resources in the best possible capacity with a
sense of mission. The leader in this approach provides guidance to employees which are to be
followed by them so that collective purpose is fulfilled.
Complaint redressal mechanism
Complaints are crucial source through which it can be easily determined how well an
organisation is performing in the market. The complaints are known to identify whether an
organisation is keeping up with healthcare standards which are formed by the central authority
(Ortega and et. al., 2014). It is a major learning from the incident that addressing complaints
rapidly will assures that potential losses to an institution could be eliminated. The complain
which relates to a healthcare institution should be reviewed and implemented nationally. The
leader should make sure that complaining about services and professional should be made easy
so that they could be redressed (Kantabutra, 2011). The leader in this segment should form a
uniform process of complaint handling system so that they could be responded. Under critical
circumstances, it is persuaded to leader to adopt approaches such as situational leadership so that
particular circumstance can be dealt by the leader undertaking right decisions. The complaints
carry the power to enhance our learning but should be utilised only in analytical rather than being
formulaic or insensitive.
Enhanced quality standards
The report helped in identifying the role which has been catered by the quality services
delivery in an organisation. The standards which are formed in terms of quality by CQC ranging
from basic to specialised care. The investigation which are to be conducted by quality institution
should be genuine so that non-compliance could be identified unlike in the case of NHS Mid
Staffordshire (Daly and et. al., 2014). The commissioners are known to form quality standard
which are to selected above minimum standards which are acceptable in this domain. The
contractual standards are known to enhance quality of services which are catered to patients. The
targets should be formulated for the short term by a leader so that they could be practised and
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altered as per the requirements (Spurgeon, Clark and Ham, 2017). The scrutiny which is being
carried out by NHS commission should be transparent and genuine so that such happening could
not be repeated in the near future. The practices of shared leadership is promoted in this segment
which leads to collaborative practices in order to improve quality of services produced. This
leadership style empowers staff to an extent to which they are able to fulfil their roles in an
effective manner along with attainment of job satisfaction. There should be an input of the all the
internal and stakeholders of this institution so that right approach to quality maintenance and
improvement are identified (Currie and Lockett, 2011).
Medical Training and Education
It has been identified that employees play most important role in the service delivery.
There needs to be a right modification in their behaviour so that they are able to serve patients in
the manner that is being desired by them. A leader with use of reinforcement and reward
technique makes sure that employees are performing up to the standard established (Heuston and
Wolf, 2011). It is a form of transactional leadership approach which is much popular in the
contemporary era. Training and education should be catered to medical trainees and best
amongst them should be selected to work with a healthcare organisation.
CONCLUSION
It can be concluded from the above report that leadership in healthcare sector stands
crucial. NHS Mid Staffordshire have been termed as one of worst service care provider in the
country. The credit for the failure of this institution have been given to this leaders and unethical
work culture which was promoted within an organisation. The healthcare commission failed to
identify discrepancies in terms of service deliver even after repeated complaints by patients and
peers. Therefore it can be identified that prospering leaders have to focus on forming a right
organisational culture, complying with health and quality standards, launching a complaint
redressal form and finally provision of training and education to medical training. Undertaking
such initiatives by a leader in healthcare sector will make sure that greter services are offered
patients.
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REFERENCES
Books and Journal
Bercaw, R., 2016. Lean leadership for healthcare: approaches to lean transformation.
Productivity Press.
DaCosta, J., 2012. Leadership models for healthcare improvement. British Journal of Healthcare
Management. 18 (11), pp.575-580.
Doody, O. and Doody, C.M., 2012. Transformational leadership in nursing practice. British
Journal of Nursing. 21(20), pp.1212-1218.
Gopee, N. and Galloway, J., 2017. Leadership and management in healthcare. Sage.
Trong Tuan, L., 2012. Corporate social responsibility, leadership, and brand equity in healthcare
service. Social Responsibility Journal. 8(3), pp.347-362.
Porter-O'Grady, T. and Malloch, K., 2011. Quantum leadership: Advancing innovation,
transforming health care (pp. 249-283). Burlington, MA: Jones & Bartlett Learning.
Kantabutra, S., 2011. Sustainable leadership in a Thai healthcare services provider. International
Journal of Health Care Quality Assurance. 24(1), pp.67-80.
Spurgeon, P., Clark, J. and Ham, C., 2017. Medical leadership: from the dark side to centre
stage. CRC Press.
Currie, G. and Lockett, A., 2011. Distributing leadership in health and social care: concertive,
conjoint or collective?. International Journal of Management Reviews. 13(3), pp.286-
300.
Heuston, M. M. and Wolf, G. A., 2011. Transformational leadership skills of successful nurse
managers. Journal of Nursing Administration. 41(6), pp.248-251.
Daly, J. and et. al., 2014. The importance of clinical leadership in the hospital setting. Journal of
Healthcare Leadership.
Ortega, A. and et. al., 2014. The influence of change-oriented leadership and psychological
safety on team learning in healthcare teams. Journal of Business and Psychology. 29(2),
pp.311-321.
Howieson, B. and Thiagarajah, T., 2011. What is clinical leadership? A journal-based meta-
review. International Journal of Clinical Leadership. 17(1).
Higgins, A. and et. al., 2014. Factors influencing advanced practitioners' ability to enact
leadership: a case study within Irish healthcare. Journal of nursing management. 22(7),
pp.894-905.
Online
Mid Staffs hospital scandal: the essential guide. 2013. [Online]. Available through:
<https://www.theguardian.com/society/2013/feb/06/mid-staffs-hospital-scandal-guide>.
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