Evaluation of Pay Level for Healthcare Workers in the UK - Research Paper Example

Contents Introduction 2 a) ment of the problem 3 b) Purpose of the study 4 c) Significance of the study 5 2. Research questions and hypothesis 5 2(a) Research question 5 2(b) Research hypothesis 6 3. Review of the literature 7 4. Research Plan 10 4(a) Framework of the study 10 4(b) Data collection and sample 11 4(c) Data analysis 11 4(d) Strength and weakness 11 5. Ethical considerations 13 6. Timeframe of the study 14 7. Reference 15 Is NHS implementing job evaluation in order to assist pay equity? 1. Introduction Health care delivery system is one of vital component of public welfare schemes of the government. The healthcare components like accessibility to good medical care, quality and cost are increasingly moving beyond the grasp of general public. The down trend in the important component of the healthcare delivery system of the nation has become a major issue which, if not tackled soon, may boomerang on the government with serious consequences. The needed reforms, therefore, require not only a comprehensive feedback of delivery system as a whole, but a careful consideration to all the various pros and cons of the developing situations in the concerned areas of the public health care, has become the need of the hour. The healthcare organizations are facing multi pronged problems that need to introduce some radical organizational changes to improve the health delivery systems. Human resource in the health organizations of UK has therefore become pivotal in improving and improvising the quality of healthcare delivery. So the question, ‘Is NHS implementing job evaluation in order to assist pay equity?’ becomes highly pertinent. Pay equity broadly defines same wage across people belonging to different gender, race, culture or disability for the same job description. The study is designed to evaluate the job criteria of people employed in the healthcare organization organizations and would make efforts to find if they assist pay equity. 1(a) Statement of the problem National Health Service is the largest healthcare organizations of government of United Kingdom that forms strategic alliances with local authorities to take initiatives in the various healthcare related projects for the welfare of the people at large. A study of East Neasden had found that the main reasons for the problems of NHS was that it was not managed professionally and was guided primarily by the ‘consensus management’ between the different interest groups like administrative, clinical, para-medical, nursing and other such groups that facilitated delivery of healthcare (Study, p1). The deteriorating quality in NHS hospitals has increasing become major concern. In the emerging challenges of the changing business equations, the healthcare industry needs highly skilled persons who are able to work under stressful conditions. There are several business aspects that impel HR strategies to move towards this new work environment in a flexible and versatile approach. 1(b) Purpose of the study The purpose of the study is to gauge the extent of the influence of the job criteria and job skills on the quality of the healthcare services and the safety of the patients in the hospital. The private equity in the hospital seems to have significantly increased the cost of healthcare, without promising quality and safety for the patients. The various constituent of safe measures like right diagnosis of the illness, efficient and timely delivery of healthcare services, clean and hygienic conditions of the hospitals etc. are important criteria of healthcare. It is a fact that the even though the state spends a huge amount on the healthcare system, the complexities that encompass the inter-related processes of the various elements of the system, are seemingly contributing to its falling standard of effective delivery. The hospitals are plagued with increasingly low number of staff presence which is adversely affecting the quality of its health delivery system which resulted in long waiting list and low quality of healthcare services. The study would primarily be evaluating the job description against the existing job profiles of the staff so as to find if pay equity has been implemented across different gender, race and culture and how it reflects in their performance outcome. 1(c) Significance of the study The study would help to understand the various factors which are seriously affecting the quality of the healthcare services in the United Kingdom. The study would help to streamline the processes of HR strategy and evolve a rationalized healthcare system ‘that would be more efficient (and less costly), less cumbersome and perplexing and safer… and development and application of national practice guidelines would simultaneously reduce complexity and variability and improve the quality of care for millions of patients’ (NCHC, p21, 2004). With the advent of technology, the collective production has become more complex. There is a significant paradigm shift in the technical division of labour from direct to indirect model that is focused on regulation, administration, improvement and innovation to meet the challenges of the changing time that is increasing relying on information technology. Human resource being central to the organizational visions and goals, HR leadership initiatives become crucial factor for creating and organizing an effective workforce. 2. Research Questions and Hypothesis 2(a) Research questions 1. Does the NHS implement job evaluation to assist pay equity in its hospitals? 2. Does NHS promote job equity in projects which it forms under public-private partnership? 3. Will job equity improve better working conditions? 2(b) Hypotheses The long waiting list and low quality of healthcare services in the hospitals run under NHS have become major cause of concern. In healthcare area, innovative approach is the key to successfully disseminate information and implement new schemes and better resources that meet the challenges of the time. The methodology of the delivery system of the healthcare and the administrative inputs are important ingredients that make it a success. It is a fact that despite huge spending by the state on the healthcare system, the complexities that encompass the inter-related processes of the various elements of the system, are seemingly contributing to its falling standard of effective delivery. It is imperative that issues and factors, that promote the concept of safest hospital at affordable cost, be addressed urgently to meet the challenges of the deteriorating healthcare services. The study is seen as an effort to gauge the performance outcome of the workforce in NHS through evaluation of their job and looking at factors like pay equity. 3. Review of the literature In US, the healthcare system is increasingly becoming market driven and the various modules, even the essential ones like insurance, accessibility etc are treated like commodities. Anderson’s theory arranges the healthcare system as per the contribution of government and private agencies in the healthcare delivery (Anderson, 1997). It also explains the deteriorating status of healthcare delivery in UK and increasing disparity in care provided to the people, at large. In the market driven health system, consumers or people decide what goods (health module) to buy and at what cost. Therefore, the prices and the level of services become the crucial factor in the exchange of goods or the healthcare services. In the era of globalization, it becomes important that HR leaders look beyond the criteria of race, nationality and colour of their employees. HR leaders need to be aware that the traditional process of labour deployment is undergoing a fast transformation, both in terms of quality and quantity. ‘It is widely acknowledged that over the past decade and a half, radical new forms of production have emerged with the pervasive expansion of information and communication technology (ICT)’(Freeman and Perez 1988, Best 1990). The rapidly changing models of work environment has made it imperative for the employees and the job aspirants alike, to keep themselves updated with the knowledge and use of all the latest gadgets and processes which are increasingly replacing the older model of office efficiencies. According to scholars, the migration of healthcare delivery towards a more market determined system has had major effects on the social and economic outcomes of the society (Nichols, Ginsburg et al., 2004). In the last few decades, UK has seen a marked shift in the healthcare which has moved from public driven policies to market funded paradigms. Healthcare is funded by private agencies and insurers, some of which may have forged partnership with NHS. The NHS has specifically taken initiative in involving the PFI (private finance initiatives) in the ‘non clinical’ support services like portering, catering, laundry etc. Such ancillary services form important part of NHS administration which not only stretch the NHS budget but they are also observed to reduce the efficient execution of core competency of the NHS in emergency and critical hours (Amicus Union Guidelines, pg3). NHS has stressed the need on participation from local bodies as it provides an opportunity “to overhaul an inappropriate system of governance characterized by a high level of centralization and a low level of accountability” (Hughes et al.,p.231). Thus, opting for private participation ensures that high quality of such services are maintained at comparatively low cost and NHS is able to carry on with its main aims and objectives of providing the quality healthcare services to the people. This has led to huge disparity in the quality of services rendered by the so called outsourced agencies, ultimately leading to deteriorating healthcare delivery. Quality healthcare and safest hospital have remained inaccessible and not so safe primarily because of lack of accountability. According to World Bank report ‘social accountability is defined as an approach toward building accountability that relies on civic engagement, i.e., in which it is ordinary citizens and/or civil society organizations that participate directly or indirectly in exacting accountability’ (WB, 2005). Concept of accountability is an extremely important factor in the healthcare industry because of various interacting elements which have significant influence on the overall development processes of the society. Institutions are “often neither responsive nor accountable to the poor” and “not accountable to anyone or accountable only to the rich and powerful” (Narayan et al. 2000, pp.172,177). Singh says, ‘poor people are most reliant on government services and least equipped to hold government officials to account, they have the most to gain from social accountability initiatives’ (Singh & Shah, 2003). Strategies and policies must incorporate the changing nature of the society that is increasingly becoming multicultural. Hence job evaluation becomes imperative part of management to assist pay equity for delivery of quality healthcare services. 4. Research Plan 4(a) Framework of the Study The proposed research study would be qualitative in nature and would involve comprehensive literature review. Qualitative research is a very important tool for evaluating trends and behavioural pattern of the people who are in a position to influence a set of defined parameters or vice versa. It helps to analyse the changing paradigms of the evolving social values and the factors that affect the decisions for adopting the changes. The study would be taking into account the conceptual model as well as the theoretical model. Secondary information sources such as libraries, commercial bibliographic databases for peer review, internet resources and e journals would be used for literature review. The wider conceptual model of the research would be used to analyze the data. 4(b) Data collection and Sample Since qualitative research methodology was adopted focusing on literature reviews, the sampling primarily comprised of reading works of wide ranging authors on the topic concerned who had compared different approaches to the same issue but with different perspectives. 4(c) Data Analysis The ‘typology method’ of data analysis would be adopted. ‘It is a classification system, taken from patterns, themes or other kind of group data’ (Patton, p393, 398) John Lofland & Lyn H. Lofland. In this case, the literature contents would be segmented according to pre-defined criteria of theme, pattern and issues to develop and predict pattern that best reflect the sentiments of the people. 4(d) Strength and Limitations Comprehensive sampling with wide ranging factors which are significantly influencing the quality and cost of healthcare would be identified in the literatures so that the scope of study is large enough to ensure success of the research’s aims and objectives. Another strong point of the study is the wide diversity in the sample selected which would ensure wide scope of accurately measuring the performance index and criteria for quality healthcare. The qualitative research approach is highly relevant as it deals primarily with the feelings of the target subjects and hence requires something more than numbers to evaluate the emotional impact of their feelings on the issues and factors which are under study. The qualitative methods are comprehensive in their understanding of the social relationships and try to evaluate behavioural pattern of the people or target subjects so as to evolve new theories that can correctly interpret the social changes. They are, at the same time, designed to consolidate the perspectives and experiences of the subjects to portray and reflect the behavioural pattern that may determines the aims and objectives of the research. The limitation of the study would be that we would be taking into account only the impact of the evaluation and pay equity on the healthcare delivery within a predefined sample that does not focus on the diversity of the demography. 5. Ethical Considerations The rapid globalization has brought in an era of pluralistic society and increasingly large segment of population comprise of people from different race, colour, culture and nationality. The changing values necessitate development of a new social order which would not only embrace multi cultural values but help forge a universal bond that would transcend race and religious boundaries. Managing diversity, thus, has become a crucial issue with the businesses which needs to be addressed urgently if they want to maintain competitive edge over their rivals. Therefore, one often comes across moral and ethical dilemma while dealing with people with cross cultural values in the healthcare industry. The research study would be particularly looking at the topic from the perspective of the inclusion of people from the diverse background and ensuring that the literature reviewed has diversity issues within its content and scope. 6. Tentative time frame Serial Activity Months 1. Field Work 3 2. Compilation of data 2 3. Data entry and processing 1 4. Data analysis and evaluation 1 5. Writing and printing 2 Reference Anderson, G. and Black, C. (1997). Willingness to pay to shorten waiting time for cataract surgery. Health Affairs, 16(5): 181-190. Amicus union Guidelines. Guide to NHS PFI Schemes and the TUPE Regulations. Available from: [21 March, 2009]. BBC news. (2005-03-07). Labour hails fall in MRSA cases. Available from: [21 March, 2009]. Best, M.(1990). The New Competition: Institutions of Industrial Restructuring. Cambridge. MA: Harvard University Press. Freeman, C. and Perez, C. Chapter Four in Dosi. G et al. (1988). Technical Change and Economic Theory. Pinter. London. pp 38-66. Hughes, J., Knox, C., Murray, M., and Greer, J. (1998). Partnership Governance in Northern Ireland: The Path to Peace, Oak Tree Press. Dublin. Lofland, John & Lofland, Lyn H. (1995). Typological Systems: Analyzing social settings, 3rd ed. Belmont, Cal.: Wadsworth. Narayan, Deepa, Raj Patel, Kai Schafft, Anne Rademacher and Sarah Koch-Schulte (2000). Voices of the Poor: Crying Out for Change. Washington: World Bank. National Coalition on Health Care. 2004. Building a Better Health Care System: specifications for reform. Available from: [21 March, 2009]. NHS. Available: [21 March, 2009]. Nichols, L. M., Ginsburg, P. B. (2004). Are market forces strong enough to deliver efficient health care systems? Confidence is waning. Health Affairs, 23, (2), 8-21. Singh, Janmejay and Parmesh Shah (2003). Making Services Work for the Poor: The Role of Participatory Public Expenditure Management. World Bank, Social Development Note No. 81. World Bank. (2005). World Bank operations and evaluation department report(2005) ‘The Effectiveness of World Bank Support for Community-Based and -Driven Development’ Available: [21 March, 2009]. Read More