Facilitating Change in Health and Social Care

FACILITA FACILITATING TING CHANGE IN HEALT HEA LTH H AND SOCIAL SOCIA L CARE

Introduction

Change can be claimed as a critical component within the contemporary organisational ethos. According to the critics sustainability of the business in terms of future success will significantly rely on the ability of the business organisations to undertake change management initiatives and adapt to the changing requirements of the environment. The report has being developed to address the key issues arising in terms of the St. Ann’s Hospital care quality inspection report. To begin with the author will first identify and analyse the key drivers of change that is driving the required change management initiatives and this will be carried out in terms of a !ST" S#$T and force field analysis. Secondly the author will assess and analyse the impact of the change initiatives on the social care industry and other respective industries. %oving on the author will e&plain the key principles of change management along with how to monitor recent changes within the health and social care services.

'.' e&plain the key factors that drive change in health and social care services (ardgett and #ardle )*+'+, clarify that change initiatives within the business organisations will initiate with the process of identifying the changing drivers of the business. According to them change initiatives could be resultant as a consequence of internal triggers as well as e&ternal triggers that are manifesting the requirement for change. -urthermore it has being outlined that the business will realise the requirements for change internally as well as e&ternally Christensen et al )*++,. (ased on the empirical evidence the author argues that the assessment of the e&ternal factors that would drive change the practices within health and social care will be addressed by using S#$T analysis and !ST analysis for the service  provider. Table '/ !ST analysis !ST -actors

Challenges0 1mpacts

Actions0 riorities

olitical factors

C2C )*+'3, outlines that when managing the hospital the service provides need to adhere to the requirements such as legislations underpinning. -or e&le / Health and social care act *++4 %ental Health care act '546 )%ental Health Care" *+'3,

Standing on the regulations that is guiding the health and social care industry it can be advocated that service provider need to take  proactive initiatives in terms of  complying with the rules and regulations laid by the governments

!conomical factors

Social factors

Technological factors

((C )*+'3, indicates that the economic conditions are growing within 7nited 8ingdom which will enable the business to grow the business conditions

This will enable the service provider  to develop a robust service to the  patients who are getting treated within the hospital with enhanced service quality which will secure a higher  quality of service that is being  provided to the patients.

%ental Health Statistics )*+'', articulate that the unemployment" child poverty" debt and low income has resulted in causing a lot of problems such as mental disorders

The resulting consequence might cause social factors to be moved to the increased demand for services offered  by the St Anne’s Hospital which need to be taken in to account by the service provider as it will have a significant impact on the business.

9rug Scope )*+'*, accentuate that the service providers in terms of mental health care are continuously focussing on introducing new initiatives in terms of  developments to the drugs used to treat the patience

The service provider Anne’s hospital need to take precautions in  provisioning the same level of drugs as others use in terms of serving the  patience. -urther it is also important to note that service provider himself  needs to take initiatives in terms of  conducting research and development initiatives to fund the required new developments in terms of the drugs  provided to the patience.

'.* assess the challenges that key factors of change brings to health and social care services As per the illustration within figure '" St. Anne’s Hospital can utilise force field analysis in terms of assessing and evaluating the change drivers of the business. According Hou and Han )*++:, change drivers will have a higher commitment in driving the change process within the organisation and as opposed to this the resisting forces will have a higher force in terms of the driving change initiatives of the business.

9riving forces

;esisting forces

< eople having a sense that they have  being treated with poor level of quality of  service = This has being outlined as a minor  issue within the report however this might trigger in to a consequence where the significant impact might cause. 1t has being identified that people within the St Anne’s hospital was not treated properly where they fail to meet the needs of the customers and facilitate with proper care for the patience )C2C ;eport" *+'3, < 1ndividual needs of the patients were not met )C2C ;eport" *+'3, < lanned activities in for the patients not getting properly organised and initiations are not taken to accommodate them. < -ailing to meet the changes required  by the >une C2C ;eport that has being given for the service provider  < C2C )*+'3, outlines that they are  planning to initiate enforcement actions 1ndividual employees have failed to against change which will require the understand the duties and responsibilities company to undertake relevant change  properly initiatives < High reluctance to change

*.' devise a strategy and criteria for measuring recent changes in health and social care Considering the importance of change for the service provider in terms of the current issues faced by the organisation it is critical for the hospital to implement a system which will address the issues relative to the change initiatives of the hospital. CS1 )*++4, reporting has highlighted that a robust approach or a strategy which will enable the service providers to

measure the change initiatives again the planned change process is to adopt a balanced score card approach which will address the following key questions and the criterions. (enefits for people (enefits for partnerships (enefits for organisations (enefits for systems According to the above strategic dimensions the service provider can assess the change initiatives within the service provider. -urthermore it has also being outlines by CS1 )*++4, those key principles that would underpin the above strategic dimensions as follows. The benefits that has being outlined could be in terms of one individual or one stakeholder or  based on a group of individuals or stakeholder  A benefit is considered as benefit only when the respective recipient admit it (enefits are considered as retrospective that is benefits will come into play afterwards that they have being planned (enefits that is realised for each group of stakeholders need to be in realisable terms that is they need to be measurable and observable ;ealising benefits have being outlined as/ doing something new" doing things better and ceasing to do something. 2.2 measure the impact o recent chan!es on hea"th and socia" care ser#ices a!ainst set criteria

CS1 )*++4, has claimed that the eventual changes that are occurring within the social care and health care services are of two fold" one which will consider as the ma?or change initiatives and the other change initiatives are minor change initiatives. However it has being articulated that ma?or change initiatives have the potential of having significant impact on the overall organisations and further this will embrace the facts that change initiatives will eventually have an impact across the health and social care industry. According to CS1 )*++4, the themes that has driven the change to the date has being emphasised where the key themes can be clarified as the ma?or change that has taken place within the recent past. Table 6/ ;ecent changes within the health and social care industry 1nvolvement 1mproving the facilities provided to the staff  in terms of the training and development in order to ensure enhances service for the

(enefits for people This will enable the participants to gain a significant level of confidence. %oreover  this will enable them to have more control

users. -urther allowing the users of the services to  be involved with the eventual planning and recruitment of the staff and empowering them in identifying the changing areas within the service providers )CS1" *++4,. 9ignity and respect This will allow the staff involved with the service provision to developed personalised  plans for the service users

over the lives of the individuals. Also this will contribute towards effective quality improvements as well. (enefits for partnerships This will increase the eventual collaboration among each other. -urther this will also allow the organisation to share the benefits of the business as well. At the same time the  partners will be given and directed towards accomplishing a common ob?ective along with sharing of good practices within the  business. (enefits for organisation This will ensure that the services are appropriately targeted@ further this will improve the commitment from the  partnership within the service users as well along with coping with cultural changes. (enefits for systems This will ensure improved information systems along with the streamlined business  practices. -urther this will allow the service  provider to think strategically. (enefits for people This will allow the service users to feel that they are treated with personalised attention and care along with respect. (enefits for partnerships This approach will ensure that service  providers will work in the intention of   providing e&cellent service to the users and all the service that is focussed towards the users (enefits for organisation This will enable the service provider to be

resourced with skilled group of individuals. Also the service provider will be recognised as an organisation which provides higher  level of service. (enefits for systems This will enable the business to be secured with significant level of procedures and  policies to be followed.

%eeting fundamental needs This is where changing the fundamentals of  the organisation in order to enhance the quality of life and well being of the service users.

(enefits for people This will enable the business organisation to maintain the independence and also economic well being of the users and service  providers will also enhanced. (enefits for partnerships This will enable the service provider to share the cost and furthermore the eventual trust will also be increased. (enefits for organisation This will reduce the pressure for services and also will improve the performance assessment as well. (enefits for the systems This has the capacity of improving the service levels of the organisation thus eventually enhancing the efficiency and also streamlined processes.

2.$ e#a"uate the o#era"" impact o recent chan!es in hea"th and socia" care

asmore et al eds. )*++5, and Cummings  #orley )*++4, have noted that every change should have positive outcome through the organiBations. The overall impact of changes in an organiBation can be the efficiency of the employees" costbenefit" case completion" referral rates" waiting and response times etc.

!fficiency of an organiBation/ !fficiency of an organiBation means how effective an organiBation is to achieve its goals )9aft" *++5,. !very organiBation should be more effective after making any changes whatever it structural change" change in referral system or relocation of services. $rganisational efficiency mainly relates to the use of resources to achieve best possible outcome which refers to the amount of resources an organiBation uses in order to produce a unit of output. An organisation that ma&imises its resources in  production without waste is an efficient organiBation. -or e&le" DHS and E surgeries are now becoming more efficient in terms of service delivery. Dow if a patient changes their appointment time more frequently" their registration may be cancelled. They need to pay for reregistration. As a result" both clients and service providers are keen to maintain their schedule strictly. So" the DHS authority may not have to pay e&tra to the Es and doctors for their unproductive works. As a result" DHS ranked first place among the countries in terms of  service delivery to the patients. Costbenefit/ according to 9ompere )*++3," this is an idea that tries to fi& if a pro?ect worthwhile economically. The overall benefits should be greater than the costs. DHS as an e&le is concerned about the patients in terms of how they can be treated and the success rate of surgeries can be hundred percent. The DHS authority is also concerned about the hospital and surgery procedures" how doctors" surgeons" nurses and other clinicians perform with the skills and abilities. 1t is a government organiBation. So" profit does not take into account but it needs to take into account that how many and what kinds of patients they have served and what is the outcome based on the cost. Though the intension of DHS is not to make profit but they should balance the cost with service outcome to be a cost effective organiBation. ;eferral rates/ (aker et al )*++, have stated that" referral system in health care means having a relationshipF between a primary health care provider and a higherlevel hospital during the transfer and discharge of a patient. 1n the 78" Eeneral ractioners )Es, are responsible to see and for the primary diagnose of disease of a patient. 1f they fail to diagnose or give a solution to the patient" then the patients are sent to higher level hospital where they are treated by the specialist doctors. The effectiveness of a E can be measured by the referral rates" wellbeing of the patients" number of cured patients etc. $nce it was a time" the referral rates of the Es were very high as sometimes they did not try their level best to serve a  patient. 1n that time the Es had no rewards in terms of service delivery. (ut now DHS has  been restructured and Es who have high referral rates are marked as noneffective. So" they have to take compulsory training to increase their service outcome. Dow" the overall referral rates are falling gradually and patients are getting good service because of these changes. #aiting and response time/ Anon )n.d., has shown that waiting and response time of the  patient is still significantly high though the department of health has been restructured. (ut the overall waiting and response time is falling day by day as the DHS is trying to digitaliBe the whole organiBation. Also" they have planned to work along with the private hospitals to give the fastest and best possible care to the patients.

2.% propose appropriate ser#ice responses to recent chan!es in hea"th and socia" care ser#ices

$.& e'p"ain the (e) princip"es o chan!e mana!ement

aton and %cCalman )*++4, accentuate that change is the process of improving the organisational current performance and transforming the current organisational processes to  be in line with the future business conditions. -urther they argue change management will facilitate eventual enhancement and effectiveness in processes in terms of the performance improvement for the business organisation. However in contrary $akland and Tanner )*++G, state that change management is the process of an emotional bond where the change leaders need to take the buy in from all the change implementers in order to ensure the success of change management. Therefore the author concludes that change management is the process of transforming the organisation from one state to another through effective leadership approaches while ensuring the creation of a friendly environment for the change to occur )Dickols" *+'+,. 9espite of the fact that change management need effective leadership and management approaches it has being emphasised by the scholars that people or the change implementers within the organisation are lacking the respective motive in terms of implementing the change  process )8ramer and %agee" *++G,. The management of the resistance has being emphasised as a critical component within the change management process )8otter" *++4,. (ased on these grounds 8otter )*++4, proposes a model to be used in ensuring effective change management and managing the eventual resistance from the subsequent users who ate engaged within the change management process )%oran and (rightman" *++',. Table 3/ 8otters %odel overview

Steps within the process

Suggestions for the social and health care organisation

Creation of a sense of urgency

This process would involve evaluation and assessment of the market forces and respective competitive initiatives. -urthermore this would also involve initiatives in terms of developing future direction for the business organisation along with assessing the evidence to emphasise the requirement of change.

9eveloping the leading team

This step will require developing people

from different department to accomplish the change ob?ectives. -urthermore this process will also involve encouraging the team work  among the members to work in collaboration as a team.

9eveloping a vision

This will involve developing a vision that will enable the successful change process and also the service organisation will be in a  position to develop strategies to accomplish the eventual vision of the business

Communication for buy in

This is where company need to seek   building up engagement and commitment of  the employees through stories and the communication need to be precise and simple

!mpowering action

This is where the organisation need to take initiatives to remove the obstacles for the change and also change structure and vision need to be aligned with the vision of the change strategy

Creating short term wins

This is where the short term wins are created and the rewards need to be granted for the  participants

9o not let up

-urther it is important to create performance improvements and recognise and rewards  personnel involved in the improvements

%ake change stick 

 Deed to articulate the connection between new behaviours and the corporate success

(urnes )*++3, claims that 8urt ewin has emphasised the importance of understanding the change drivers and resisting forces )%acadam" *++, and based on these grounds he has developed a force field analysis to assess the forces that would support for the change management within the organisation. According to Eolber and ewin )*++3, the success of the change management programme will significantly rely on the strength and possibility or the higher level of driving forces and it has being identified that driving forces need to be

more than the resisting forces in order to ensure successful transformation of the change  process. According to ewins change model it can be claimed that it is important to first unfreeBe the current status of the business. This will involve business organisations emphasising the  positive attributes that is likely to be realised as a consequence of the change process will take initiatives in order to promote the driving forces of change of the business. %oving on the change phase would involve managing the change within the business in such a way where the resistance to change is minimised. Similarly the refreeBe phase would involve establishing the new policies and procedures of the business and also this will require recognition and appreciation in terms of the new change approaches that is being taken by the  business as well. $.2 e'p"ain ho* chan!es in hea"th and socia" care are p"anned

Change initiatives within the social care are planned once a quality inspection report has  being released with relevant to the particular social care service organisation. This is because this will highlight and emphasise the quality issues that are revolving around the organisation and the service provider will have to amend and ad?ust the required changes in order to be outperforming within the industry. -urthermore based on the changing business practices that are based on the needs of quality enhancement requirements and e&ternal regulatory requirements the business will undertake change initiatives in order to be in line with the changing business practices and regulations. $.$ assess ho* to monitor recent chan!es in hea"th and socia" care ser#ices

.

To monitor the recent changes in health and social care services it can be advisable that  business or the service provider can undertake a !ST analysis whereby the each factor within the !ST factors might have caused the changes for the service )Armstrong" *++5,. -urthermore it is also important to understand the eventual quality change requirements within the business as well in order to facilitate change within the social and health care service. At the same time based on the regulations within the industry it is essential to develop processes and policies to implement and this will lead the need for change for the organisation. Conc"usion

This report has being developed to assess the importance of change management practices in social and health care services. $verall report has being developed to address the issues that is underpinning within St Anne’s hospital in terms of the C2C report which has being recently prepared. The report reveals that the business or the service provider currently facing many issues in terms of the quality issues that is prevalent within the business organisation. -urther it has being appraised that within the social and health care industries undertaking change is critical as it will have a significant impact on the service users as well as the service  providers. -urther it has being emphasised that the change management is critical for the service organisation" this is because the change is the process of transforming the service

from one state to another and this has being assessed in terms of the social and health care industry. -urther the relevance and procedures undertaken to monitor the health and social care change management initiatives also have being emphasised within the report content. Reerences

Armstrong" %. )*++5, Armstrong’s Handbook of %anagement and eadership" *nd edn ondon/ 8ogan age imited (ardgett" ;. 9." and #ardle" 9. A. )*+'+," Abovegroundbelowground linkages/ biotic interactions" ecosystem processes" and global change )pp. '6+'," $&ford/ $&ford 7niversity ress (urnes" (. )*++3," 8urt ewin and the lanned Approach to Change/ A >ournal of management studies" 3')," 5GG'++*

;e ‐appraisal"

Christensen" C. %." (aumann" H." ;uggles" ;." and Sadtler" T. %. )*++," 9isruptive innovation for social change" Harvard business review" 43)'*," 53 Cummings" T. E." and #orley" C. E. )*++5," $rganiBation development and change Cengage earning Eolbert" >." and ewin" 9. ;. )*++3," %odelbased control of fuel cells//)', regulatory control" >ournal of ower Sources" '6:)'," '6:':' Hall" A. )*++4, $vercoming ;esistance to $rganiBational Change 1nitiatives" $% :*' Conflict %anagement and 9ispute ;esolution" Capella 7niversity Hou" I."  Han" C. )*++:," -orce field analysis snake/ an improved parametric active contour  model" attern recognition letters" *):," :'6:* %acadam" C. )*++," Addressing the barriers of managing changes " %anagement 9evelopment ;eview" 5)6,. p. 643+ ‟

%oran" >.#. and (rightman" (.8. )*++', eading organiBational change" Career 9evelopment 1nternational" )*," pp. ''' = ''5  Dickols"-. )*+'+," Change %anagement '+'" 1nternational >ournal of Change %anagement #eb ;eferences C2C )*+'3, Health and social care act )*++4, J$nlineK" Available from/ http/00www.cqc.org.uk0organisationsweregulate0registeredservices0legislation" JAccessed/ *:0+60*+'K CS1" )*++4, The (alanced Score Card" J$nlineK" Available from/ http/00www.dhcarenetworks.org.uk0Llibrary0HighL1mpactLChangesL-orLHealthLand SocialLCare.pdf" JAccessed/ *:0+60*+'K

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