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Facilitating Change in Health And Social Care

Introduction

Due to the development of technology and changing needs of individuals, there has to be some consideration regarding safety of the people in any health and social care organisation in UK (Hayes, 2014). Due to this change these organisations must enhance their skills and strategies into a positive output so that they are able to deliver quality care to their service users and are also able to maintain the quality standards of their organisation which will their growth and development.

Task 1: Key points that influences change in health and social care organisations

1.1 Describing the key factors behind the changes in health and social care

As per Harris and White (2009), modernisation agenda in health and social care implies to the fact that the UK government had initially planned for upgrading the services and strategies of all health and social care organisations by promoting independence of the service users, understanding the specific needs of the individual patients and maintaining the consistency of quality care in these organisations and it is still working on these issues for modernising social and health care services. The National Health Service (NHS) modernisation agenda has planners who hold huge opportunities to get involve in these sectors for promoting healthy and a sustainable community (Cameronet al 2015). Strategic Health Authorities (SHAs) establishes a key link between the Department of Health and the NHS particularly at regional areas in UK. SHA is closely associated with primary care trusts (PCT) of UK and it work side by side with them. SHA undertake a strategic examination regarding economic condition of the local health. It then provides a prudent leadership, upgrades the workforce and thus it causes organisational development but it doesn’t provide NHS services. It assures the fact that PCT-led health care systems remains efficient in their performance.

In the context of the case study, the Local action For the Disabled can too take the help of SHA to upgrade their workforce which is very necessary for the change that they had undertaken (Alvesson and Sveningsson, 2015). The majority responses from the stakeholders had been negative regarding shifting of the disabled patients to supported living away from their residences, even some of the staffs also find this idea to be scary, so at this point Denise, being the manager of the organisation must take effective measures so that this idea of modernisation can facilitate health promotion of the patients as well as foster growth of the organisation and can also avoid negative publicity.

Along with the modernisation agenda, there are certain legislations which a health and social care sector must abide by. These are-

Health Act 2006- this act particularly emphasizes on strict restriction of smoking in certain public areas, premises and vehicles. It also strictly amended that tobacco product is to be sold to the person after attaining a minimum age and also there must be strict management regarding use of controlled drugs(Alvesson and Sveningsson, 2015). This legislation is solely intended to safeguard the public health by controlling health related infection and thus it is aimed to improve the functions of NHS in UK by strict monitoring of NHS activities and taking stringent actions if any deceiving act is found by NHS.

NHS and Community Care Act 1990- as per this act any adult of 18 years and above are eligible for accessing services from the Local Health Authority and he has full right to get his needs assessed so that he can expect his required services which will meet his criteria. The local authority is responsible to arrange for a Case Manager who will look after the assessment and care planning of the individual seeking services from a health and social care organisation (Cameronet al 2015). The general patients have to pay for the services but disabled and the mental patients are exempted from paying for the services and those have poor income they too get various benefits from this law.

Health and Social Care Act 2012- this act totally reorganised the structure of NHS of England in UK. This is a complicated legislation which totally abolished the Secretary of State, a legal foundation of NHS previously responsible for providing health service to NHS and instead it was replaced by a more comprehensive health care approach (Smitheret al., 2016). It also removed the responsibility of governing NHS by central government and passed this to NHS England which is a non-governmental body but has the full power to completely remodify the structure of NHS. It also established Clinical Commissioning groups (CCG) by abolishing PCTs. Initially CCG were only responsible with community services but recently they are acting on a joint basis with NHS England for commissioning primary health care facilities as well (Grant, 2014).

Care Act 2014- this law aims in protecting adults from neglect and abuse and it also made provisions for maintaining care standards with integrated and coordinated care services in health and social care organisations (Grant, 2014). It promotes well-being of the individuals through proper health care education and quality care services.

UK government has facilitated NHS patients to choose their General Physician or the hospital as per they will be referred to. Moreover due to ascertaining personal budgets, it has become easier for the people to have more choices and control regarding their health and social care.

The UK government has made the local authority responsible to care for the funding issues of the service users of these organisations (Smitheret al., 2016). Some people have to pay for their services while some have to pay a little amount for their requirements or in some cases people may not pay at all and their whole cost will be undertaken by the government only. These funding issues depends on the assessment criteria of a service user, his economic condition and after assessing his required services (Gould, 2009). The local authority in cases which are really deprived economically and still it requires various services, can meet up their expenses and can arrange the funds with which the poor patients can go through health and social care services.

In the context of the case study, the Local Action for the Disabled (LAD) has taken a tough initiative to provide supported living away from the residencies of the disabled patients. The organisation has failed twice in this attempt before as majority of the responses were negative(Gould, 2009). Even at this time, they are not getting any positive responses, Denise being the manager of the organisation had to convince the management board so that they are successful in their attempt in the third time. They must abide by the legislations that have been mentioned above in order to safeguard the disabled people and deliver them the quality care which will benefit them and promote independent living (Boonstra, 2008). They also must follow government guidance and must inform the local authority about the patients who are economically deprived so that their funds can be arranged and they can have the infrastructure of a supported living.

Other factors that Denise need to manipulate are demographic and cultural factors like she has to consider ageing population and their specific need of supported living. They are the group who need a very delicate care and they have to be treated with patience and care (Cameronand Green, 2015). The fact that maximum stakeholders including the families of the patients were against this decision of supported living, Denise must ensure that proper care arrangements have been made before they are shifted away from their residences. She has to consider the minority ethnic groups so that no sort of discrimination occurs with them and that they are not disrespected and misguided by the workers. She must arrange for training schedules so that the workers can be trained thoroughly and that they develop a better understanding of the individual needs of the patients (Leeuwis. and Aarts, 2011). The lifestyle of a person varies from one another; they must consider this while making care plan for them so that they are able to deliver quality care as per the needs of the patients benefitting them with supported living. Moreover the organisation has undertaken a daring approach in shifting these patients to support community based living and to promote independent living of the learning disabled patients. Inspite of maximum negative approaches, they still continued with this shifting process so, naturally there will be an increased chance of negative publicity and media awareness as people consider this approach of supported living of disabled patients to be really scary and unfit(Leeuwis. and Aarts, 2011). So to tackle all these issues Denise has to be really cautious to implement strategies in such an orderly manner so that the result turns out to be positive.

Technological factors are another issues which Denise must consider. As LAD is going to provide disabled people with supported living so there will be arrangements of infrastructure that can provide supported living (Cameronand Green, 2015). These needs technological knowhow in these aspects for Denise now has to arrange assistive devices for the patients and that the records of the patients must be stored in a digital format so that it can be accessed anytime by the medical experts. It is hassle free and time saving. Various modes of electronic communication must be introduced in the organisation like patients can talk to their family members with the help of mobile phones, video calls or through Skype (Furstand Cable, 2008). Social and health care experts can also be trained with the mode of electronic communication.

1.2 Challenges that above mentioned factors can bring in a health and social care organisation

To bring a change in an organisation various challenges are posed to the authorities. They have to tackle these issues calmly so that the implementation of the strategies can be successful and that all the staffs find it easier and comprehensible to get accommodated with the new changes (Furstand Cable, 2008). Denise being the manger of LAD has to be concerned with the issues that can result from the key factors of changes that have been mentioned above.

The first challenge that she would face is funding issue. To promote independent living, it requires a large amount of financial resources so that she can provide necessary and modern infrastructure to her patients(Leeuwis. and Aarts, 2011). The second challenge is that she has to maintain a good and efficient workforce who are very much skilful to assist patients in independent living. For this, she must arrange for trainings so that her existing workers can be trained thoroughly or otherwise she has to recruit candidates who are efficient in this line. The third and one of the most daring challenge that she would face is that majority of the stakeholders will refuse to get accommodated with this new change and it has been mentioned in the case study too. So to reduce this apathy and negativity, she must convince the stakeholders in a tactful way and must make them realise that this step is going to profit the patients and that they can have independence in their life (Busheand Marshak, 2009). The fourth challenge is that she has to maintain the quality care with all modern ways of treatment to the patients otherwise their organisation can run into a severe bad public repute, the fact that they had initiated this step without any positive response from the stakeholders remains a threat to them. She has to keep on monitoring the changes in her organisation in order to decide for the new strategies in future so that it can foster growth and good public image of the organisation(Boonstra, 2008).

Task 2: Evaluating recent changes in a health and social care organisation

2.1 Devising a strategy and criteria to measure recent changes in a health and social care organisation

To devise a strategy for betterment of a health and social care organisation, it needs to have some criteria based on which a strategy can be decided and implemented. The first criteria is to meet national objective i.e. UK government wants to have the assurance that the patients will receive high quality care every time they visit a health and social care organisation or every time they get admitted to a hospital(Busheand Marshak, 2009). They also want to have an assurance that transparency is prevailed between the service users and the service providers and that the service must be patient centred so that it can benefit their health in an overall manner. The second criteria is that whatever changes has been made in the organisation, they must be assessed so that it becomes easier to perceive that how much benefit the patients will have from these changes and how much profit the organisation can have from the changes. If greater efficiency is required in skilful performance of the employees, then the organisation may have to join partnership with relevant organisation which can help them in better performance of serving the patients(Boonstra, 2008). This partnership can supply continuous efficient human resources and thus recruitment process becomes more improved. The staffs also become very skilful and efficient.

Considering the mentioned criteria, various strategies can be implemented. Regulatory inspections of the performances of the staffs is very essential to determine whether they are able to provide quality care to the patients and if patients are getting benefitted from the updated service (Marshak and Grant, 2008). This can be done in the form of audit also. Quality of the care must be assured by the staffs so that it can result in profit in both the cases of organisational development as well as patient’s positive health outcome. Feedbacks can be taken from the patients in order to know how much the staffs are able to deliver quality care to them and how much they are benefitted from the services. Based on the feedback, the staffs can be trained for further improvement in their service and to enhance their knowledge. The third strategy is self-evaluation which is also an effective process. In this method the organisational authorities themselves evaluate the performances of the staffs so that they can understand how much progress the staffs have made to improve their services towards the service users (Alegreand Chiva, 2008). Based on self-evaluation, a staff can also get appraisal too if he does well to the patients and to the organisation also.

In the context of the case study, LAD had dared to continue with their decision and they were successful in their attempt in the third time as they had implemented strategies very cautiously after pointing the criteria as mentioned above in their organisation(Alegreand Chiva, 2008).

2.2 Measuring the impact of recent changes

After implementing the strategies, Denise was able to measure the impact of the recent changes in their organisation. With regulatory inspection and self-evaluation, it has become easier to track the performances of the care givers in the organisation(Marshak and Grant, 2008). If they make any mistakes, they are made to understand of how to improve their services. Frequent trainings are also arranged for the care givers so that they can improve their care services to support independent living as per the development of the technology. Staffs now share a good mode of communication among them so that the whole care service can be a coordinated one(Alegreand Chiva, 2008). Based on the feedbacks the staffs are improvising their techniques in order to ensure a quality care service to their service users.

2.3 Evaluating the overall impact

After the changes had been made and its impact had been observed in the LAD, its evaluation was done in order to determine how far the success level of the organisation has reached. As per the Health and Social Care Act 2012, various modification of structures has occurred in NHS which solely aims to provide quality care to the service users (Munnet al., 2013). NICE or National Institute for Health and Care Excellence is an independent body established by UK government which aims to

  • provide new treatments and drugs to the hospitals as soon as they can be accessed
  • provide guidance on how a treatment should be carried out in an organisation with evidence based examples
  • provide guidance how social care and public health are interrelated and how they can provide best support to the patients
  • Also provides important data to those who are responsible for managing and providing various care facilities to the patients in an organisation.

With the necessary guidelines from NICE, LAD was able to deliver their patients with quality care by focusing on their specific needs and choices(Munnet al., 2013). It also helped the organisation to upgrade their treatment facilities by arranging latest technology and updated medical information. Apart from this, there was a great focus in inter professional working. The staffs coordinate with each other. There was no sort of discrimination and dispute among them. They were able to carry out their services with diligence and patience. All these influenced promotion of choices like the staffs due to their skilful and tactful efficiency towards their work expected to get direct payments from the organisation (Anderson and Anderson, 2010). They were more encouraged towards community care rather than residential care which had once become really tough to accept. Due to positive response from the patients, the stakeholders now supported this community care approach. There was also a common inspection framework where everyone’s performance would be equally scrutinised and if any faults were found they would be equally made understood of their defects so that they don’t repeat their mistakes.

2.4 Proposing appropriate service responses in respect to changes in health and social care

In order to continue with this community support to the disabled patients, LAD needs to have certain service responses which can take the organisation to a much higher level and also it can create a good public image of the organisation. A good leadership will facilitate the organisation by defining and determining the goal and it can also influence the other employees to work unitedly to achieve the goal(Anderson and Anderson, 2010). With the legislations and updated policies and procedures of the government and the organisation, strategies must be revised and implemented. With the upgradation of the services and policies, the staffs of the organisation must be made aware of all these (Hayes, 2014). Employees of the organisation must participate in the strategy making of the organisation so that various ideas can be shared in a single platform and better communication develops between employees and the mangers as well as the higher authorities. There must be a transparency in every care planning of the service users with the service providers i.e. the service users must be involved while a care plan is made for them, they must be aware of the things that their care manager is planning for them so that they doesn’t think that anything is imposed on them without their knowledge. In this way the service users can be happy with the services and the organisation will also able to support community living with positive responses from the stakeholders(Hayes, 2014).

Task 3: Principles of change management

3.2 Explaining the planning of changes in a health and social care

There has to be efficient consultation with the managers, supervisors and other authorities regarding a change in a health and social care organisation (Doppelt, 2009). The authorities and the senior managers must communicate with every employees of the organisation in order to analyse the problems and the drawbacks that are existing in the organisation and those areas which need to be upgraded for better facility provision to both the employees as well as the service users (Swayneet al., 2012). Communication must sustain in the organisation in a top-down or bottom-up process so that views of every organisational member are taken including the service users also as it would provide a realistic situation to impart a necessary change in the organisation. Informal social system is also an important consideration in planning a change i.e. coordination among different levels of the employees as well as the care givers must be observed in order to analyse how things are get done by their coordinated approach and how well they are connected to each other while serving the patients (Hayes, 2014). To bring a change it also requires changes in infrastructure and use of technology so that the services are updated and modified. Apart from all these, it is very important to have provision for development of staffs because they are the ones who would be responsible for bringing a good public image of the organisation with their devoted and skilful performance. So with the up gradation of the service, it is also important that they get a through training where they can learn new things and can get equipped with modern skills and technological knowhow (Harris and White, 2009). While causing this change to occur effective planning must be made to reduce anxiety of the staffs as well as the service users and their families by making them realise that this change will bring good to all if they all cooperate with each other.

3.3 Monitoring recent changes in health and social care services

After the change gets resulted in a health care organisation, it is really important to monitor the changes on regular basis by means of surveys, feedbacks, questionnaires etc. so that things like satisfaction of the service users, performance up gradation of the care givers, positive response from the stakeholders regarding the change etc. can create awareness in the organisation regarding the extent of success or failure that has resulted from this change(Harris and White, 2009). After surveying the service users and taking feedback from them, the results must be evaluated by the managers or the other high officials who can figure out whether the patients are benefitted from this change process. Similarly feedback and surveys must be arranged for the staffs too so that an estimation regarding the fact that whether the change has resulted in satisfaction of the staff can be made out. Another important thing is that the change will result in huge expense for providing modern infrastructures both to the staffs as well as the patients so, it become really necessary to see whether these infrastructures are benefitting them and are resulting in cost benefit (Hayes, 2014). Time taken for completing a case is also an important consideration and it plays an important role in estimating that how long the patient has to wait to avail the necessary service of his want.

Conclusion:

This assignment has helped us to understand that how things must be considered to bring a gradual change in the organisation (Hayes, 2014). It is very necessary to have a good workforce and management who can coordinate the change in the organisation in an apprehensible format. The organisation which undergoes a change must abide by the legislations and government policies and must evaluate and analyse the impacts of changes to make any further improvements.

References:

Cameron, E. and Green, M., (2015). Making sense of change management: a complete guide to the models, tools and techniques of organizational change. Kogan Page Publishers.

Alvesson, M. and Sveningsson, S., (2015). Changing organizational culture: Cultural change work in progress. Routledge.

Smither, R., Houston, J. and McIntire, S., (2016). Organization development: Strategies for changing environments. Routledge.

Grant, A.M., (2014). The efficacy of executive coaching in times of organisational change. Journal of Change Management, 14(2), pp.258-280.

Gould, J.M., (2009). Understanding organizations as learning systems. Strategic learning in a knowledge economy, pp.119-140.

Boonstra, J. ed., (2008). Dynamics of organizational change and learning. John Wiley & Sons.

Cameron, E. and Green, M., (2015). Making sense of change management: a complete guide to the models, tools and techniques of organizational change. Kogan Page Publishers.

Leeuwis, C. and Aarts, N., (2011). Rethinking communication in innovation processes: creating space for change in complex systems. Journal of agricultural education and extension, 17(1), pp.21-36.

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Marshak, R.J. and Grant, D., (2008). Organizational discourse and new organization development practices. British Journal of Management, 19(s1), pp.S7-S19.

Alegre, J. and Chiva, R., (2008). Assessing the impact of organizational learning capability on product innovation performance: An empirical test. Technovation, 28(6), pp.315-326.

Munn-Giddings, C. and Winter, R., (2013). A handbook for action research in health and social care. Routledge.

Medley, B.C. and Akan, O.H., (2008). Creating positive change in community organizations: A case for rediscovering Lewin. Nonprofit Management and Leadership, 18(4), pp.485-496.

Carter, E., (2008). Successful change requires more than change management. The Journal for Quality and participation, 31(1), p.20.

Agboola, A.A. and Salawu, R.O., (2011). Managing deviant behavior and resistance to change. International Journal of Business and Management, 6(1), p.235.

Anderson, D. and Anderson, L.A., (2010). Beyond change management: How to achieve breakthrough results through conscious change leadership. John Wiley & Sons.

Hayes, J., (2014). The theory and practice of change management. Palgrave Macmillan.

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Doppelt, B., (2009). Leading Change Toward Sustainability-: A Change-Management Guide for Business, Government and Civil Society. Greenleaf Publishing.

Swayne, L.E., Duncan, W.J. and Ginter, P.M., (2012). Strategic management of health care organizations. John Wiley & Sons.

Hayes, J., (2014). The theory and practice of change management. Palgrave Macmillan

Harris, J. and White, V., (2009). Modernising social work: Critical considerations. Policy Press.

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