Public Services in Contemporary Society: A Research Project

Desklib provides solved assignments and past papers to help students succeed.

Research Project: Public Services in Contempoary Society and the
influence of digital technology
0

Executive Summary
The assignment studies the overall development of public services with special emphasis on the
organization of London Ambulance Services, an organization that operates under the NHS Trust.
Various contemporary practises and organization structures of public sector organizations have
also been discussed in a detailed manner along with their funding, impacts and roles within the
society in general.
1

Table of Contents
Introduction......................................................................................................................................3
LO1..................................................................................................................................................4
Development of public services.......................................................................................................4
Development of London Ambulance Services................................................................................5
Ways in which contemporary practice sits within a tradition of historical practice........................6
LO2..................................................................................................................................................8
Operational structure of London ambulance Services.....................................................................8
Structure of London Ambulance Services with reference to responsibilities................................10
LO3................................................................................................................................................12
Types of sources of funding available to the public sector...........................................................12
Allocation of funding to different public sector organisations......................................................14
Impact of funding from different sources and its allocation within the public sector...................15
LO4................................................................................................................................................17
Define the strategy, structure and role of public sector organisations...........................................17
Impact of proposed changes upon the society in which public sector organisations serve...........18
Conclusion.....................................................................................................................................19
References......................................................................................................................................20
2

Introduction
The public services sector within the territories of UK is one of the largest employers and has
over 5.2 million individuals working as professionals. The public sector is fundamentally tasked
with the provision all the essential public services within the UK and includes a variety of
aspects ranging from emergency services like fire, police and healthcare to education, social
security, child development and so on. The services are broadly categorized based on the
governmental nature, and includes local governmental services and central governmental
services. Public services are crucial in the development of the society and improvement of the
living standards, and have been a key contributing factor towards the excellent living conditions
within the UK.
3

LO1
Development of public services
Public services and administration have undergone a vast number of changes when analyzed
from a modern perspective and compared to the provisions even a few decades back. These
changes have mostly been driven by the rampant growth of globalization and the fact that most
of the service provisions have pluralized inherently and have been increasingly more complex
and varied (Kaur et al., 2019). Governments around the world now focus on improving the core
structure and enhancing the level of efficiency among organizations in a manner where the
services provided reach a majority of the consensus and in an optimized fashion (Furber, 2016).
The concept of decentralization, improved pay scales, working conditions and basic employment
modifications have been the core concepts in public service provisions in today’s times, and
governments around the world including that of the UK follow a bottoms up approach to tackle
the increasingly complex nature of challenges that the public sector inherently entails. The
influence of digital technology has also been a major focus with regards to public services, and
improving information and communication systems within the agencies has significantly
improved the quality of the services provided (Dunn et al., 2016). In the context of public
services within the UK, personal motives, vested interests and bureaucracy had proved to be
major limiting factors in the efficient provision of public services initially. However, a
wholesome reform within the governmental approach largely witnessed a transformation within
the public services sector that focused on removing the concept of bureaucracy by relying upon
performance-based yardstick and ensuring that the recruitment and selection process was solely
4

done on the basis of merit and personal competencies instead of recommendations and
hierarchical beneficiary suggestions (Antony et al., 2016). The pluralisation of services further
involved a number of agencies in the delivery of one service and this ensured that a multitude of
actors were associated with the provision of the service. This focus towards decentralizing the
management and control of power was a massive change in terms of the quality of the services
provided, and has been a significant alteration within the UK in the context of how the
government regulates the public sector, and how the individuals involved with the public sector
undertake their allocated tasks.
Development of London Ambulance Services
The organization of London Ambulance Services has been chosen in the context of the scenario,
with the objective of discussing the influence of digital improvements and how technology and
significantly enhanced the efficiency with which the organization can undertake its
responsibilities and duties. The London Ambulance Service as an organization was initiated in
1965 and was incorporated under the NHS Trust in April 1996. The body was started with
almost 1,000 operative vehicles, most of which were made by Daimler automotive and comprise
of approximately 2,500 healthcare professionals. The first station that was equipped in a
comprehensive manner was that of Deptford, and completed 138 years in 2018. The organization
has developed significantly since the post war era, and now has over 5,000 modern vehicles
equipped with state of the art equipment. There are several units as well, including mobile cycle
units, emergency ambulances, air ambulance services, ambulance boats and so on. The agency is
run completely by the NHS Trust and is governed locally by the South West Thames Regional
Health Authority. The agency has further focused on the improvement of the technology
involved, especially in the case of paramedics and emergency respondents. The agency has
5

benefitted significantly from the use of digital technologies in their services, and the most
pronounced has been the digitization of patient and health records. This focus on digitizing
previous records has proved to be beneficial both for the patients as well as the nurses and
paramedics attending to the patients. The standardization has significantly improved the quality
of the health care services and emergency responses, including increasing the speed with which
London ambulance Services can respond to a situation and potentially prevent an untimely death
or serious injury.
Figure 1: Core structure of the NHS trust
(Source: London Ambulance Service NHS Trust., 2019)
Ways in which contemporary practice sits within a tradition of historical practice
There are several ways in which contemporary practices sit in conjunction with the traditional
practices, especially in the context of healthcare and emergency services within the UK. The
most pronounced example can be seen in the hierarchical nature of the emergency services sector
6

that is mostly due to the conventional nature of the sector and its history that extends to periods
even before the First World War. Contemporary practices have largely been focused towards the
decentralization of the various functionalities involved, while the flow of command is largely
hierarchical. The tasks are delegated using a top to bottom traditionally conventional approach,
but the problems that these tasks address are targeted using the bottoms up approach with the
objective of including every class and strata and hitting the problem at its root (Jones et al.,
2017). This is a significant factor with regards to the large scale development that has taken
place within the UK public health services and has significantly improves the general standard of
living. The influence of digital technology in communication and record maintenance is another
factor that uses contemporary practices within traditional and historical practices. Medical
records have been maintained right from the 1700’s, and a majority was done on paper using
physical means (Shaikh, 2016). However, information discovery was a major problem, and the
rapid digitization has largely eliminated this, and emergency responders can pull out patient
records with the press of a single button. Communication between the various agencies involved
with the delivery of healthcare and emergency services are also largely digitized in the context of
contemporary practises, and this reduces the use of paper required for daily correspondence, a
system that was again present from pre World War periods. Most of the functions that exist in
the provision of health care services today have existed since a long time; but the approach has
largely been changed and adapted to accommodate the increased amounts of complexities that
modern problems have posed (Johnson et al., 2019).
7

LO2
Operational structure of London ambulance Services
The National Health Service which operates in England serves by giving ambulance services in a
geographical area in UK or some specialized function. These trusts were formed under National
Health Service and Community Care Act 1990. These trusts actually do not hold any legal
meaning regarding the word “trusts”. In a very crowded place like London, NHS gives service in
public sectors. They are specialized in serving in paramedics. There are more than 2200 workers
who work for 4700 organizations under NHS (Shaw et al., 2016). London Ambulance Service is
one of them and gives ambulance services and in emergency cases they respond to common
questions made by the general public. They give response to calls that are made to 999 and 111
and give appropriate suggestions. There are 12 board members that work for LAS which consists
of a non-executive chairman, five to six executive directors and six non-executive directors.
There are seven directorates that deal with different category of work. They are:
Accident and emergency operations: these are special cases when a sudden accident is happened
in any part of the country and the effected or the people around the effected need paramedical
services as soon as possible. Therefore, they call the emergency numbers so that they can receive
some useful information based on the condition and in cases, an ambulance reach to the accident
spot to take the effected person under their service
Information Management and Technology: Through the help of information and technology,
LAS connects with the victim and reach to the spot using different devices like GPS
Finance: This part of the operation is very important. This handles all the finance related matter
and cash flow to keep the service going.
8

People and Organizational Development: This section deals with the theories and practices for
the organization to develop new strategies for future. They suggest practical ways through which
this knowledge could be applied to do good for the victims.
Medical: This section deals about the medical relief of the patient. How scientifically a health
related issue can be solved through medicine or other paramedical practices.
Patient transport services (PTS): This section identifies and reaches to the location of the patient
and with the help of ambulance services they take the patient under their treatment facilities and
transport the patient to the nearby hospital with utmost care and responsibility.
These above mentioned operations for LAS are done using two control rooms one of which is
located in central London and another is located in East London (Mahmood et al., 2017). In
cases when required each or both of them has the ability to take over the control over the whole
situation. In case of special needs or special events, the Service's event control room which is
situated in East London coordinates the whole operation.
In case of any unfortunate mass causality, the services of LAS is divides its command structure
into four levels based on the service types. These are named as platinum, gold, silver and bronze
command.
Platinum command: This offers government level command
Gold Command: Emergency Operations Centre manage this situations ensuring normal service
function
Silver Command: This is done directly from the control room
Bronze Command: At the place of incident, on site personnel handle this situation.
9

Structure of London Ambulance Services with reference to responsibilities
The organizational structure of London Ambulance Services with reference to the various
responsibilities involved is based on the specialization of teams and services. The primary
department within the organization is the Resilience and Special Operations department, which is
tasked with responding to emergency situations in hazardous areas that include the likes of high
altitudes, under the sea, urban areas relating to search and rescue missions and so on. The city of
London is fundamentally divided between two Hazardous Area Response teams, one responsible
for the east of London and one for the west (Moffett and Walker, 2015). The response units
primarily comprise of highly trained and specialized paramedics who are meant to assist victims
and hostages in hot zones of active shooting areas and zones of terrorism within the city. The
Hazardous Area Response teams also have a fleet of helicopters that comprise the Air
Ambulance teams.
The Control Services department is another important segment within London Ambulance
Services, and are primarily responsible for logistics and responding to calls behind the scenes.
The Control Services department is also responsible for maintaining an effective communication
channel and network within the city in coordination with the various bodies and governmental
agencies to ensure a foolproof system of security and emergency response. They also include the
clinical hub, which comprise of clinical advisors and staff members who are primarily tasked
with providing assistance to the frontline members that respond to emergency situations and help
them maintain a relatively high degree of efficiency (Barry and Dent, 2017).
The Medical Directorate is another important segment of the London Ambulance Services, and is
primarily tasked with the duties of responding to highly critical patients who have a serious
threat to their life (Nwanekezie et al., 2016). These comprise of advanced paramedics who are
10

also highly trained and specialized, and provide additional services such as mechanical
ventilation, critical life support, emergency on-field surgeries, sedation and anaesthetics and so
on. The Medical Directorate also takes care of patients in residential conditions with the
objective of reducing operational expenses for the organization and providing their services to
the highest number of patients possible.
The Accident and Emergency Operations department is possibly the most important department
within London Ambulance Services, and includes a host of healthcare professionals ranging
from doctors, nurses, paramedics, healthcare technicians, ambulance assistants, transport crew
and so on. The department operates on a 24/7 basis and fundamentally forms the core unit of
London Ambulance Services (Barrett, 2015). The A&E Operations department has divided their
functional units into emergency and non-emergency teams, with the emergency teams forming
the majority owing to the high risk of action within London due to the city being a major
financial city globally. The Air Ambulance fleet is also an integral part of the A&E Operations
team and provides services that are beyond the jurisdiction of the London Ambulance Services.
They also assist third sector organizations in efficiently providing their services and fulfilling
responsibilities and work with doctors and nurses who are recruited both from within British
hospitals and beyond (Weir, 2019).
11