Nature of Health Service Management - Essay Example

Running head: NHS . Nature of Health Service Management Insert Insert Grade Insert 18 March Nature of Health Service Management Introduction The National Health Service (NHS) was founded on 5 July 1948 in the UK to offer basic and hospital care to the vast majority of the population in the UK (Stephens, 2003, P.1). It was founded to serve three major purposes: to offer uniform healthcare in all parts of the UK; provide free health services to all citizens without discrimination based on medical requirements; and lastly, to offer all-inclusive services covering medical needs. The name NHS refers to three of the four state financed healthcare systems in the UK including the English NHS, NHS Scotland, NHS Wales, and Health and Social Care in Northern Ireland (HSC). The NHS offers all-inclusive health services to all basic and community healthcare, intermediate care and hospital-based care, and provides information services, as well as helping individuals in relation to health promotion, disease prevention, self-care, rehabilitation and after-care (NHS, 2010). The current NHS boasts of a new constitution mandate of the government in enhancing NHS accountability in the provision of a comprehensive health service out of national taxation and support (DH, 2010. P.4). The NHS is under Department of Health that is headed by the secretary of state for health who answers to the prime minister, which also runs England’s 10 Strategic Health Authorities (SHAs) - which manage all NHS activities in England, with each SHA supervising all the NHS trusts in its jurisdiction (NHS, 2010).  The nature of health service management The NHS structure is largely grouped into two sections: primary and secondary care, with the primary care being the initial point of access to free health service for majority of people and offering services provided by general practitioners (GPs), pharmacists, opticians, dentists, and NHS Direct (NHS, 2010). The secondary care offers organized specialist medical services or surgery or emergency services. The NHS also offers health services to non-NHS members and foreigner on commercial basis. The provision of primary and secondary care is administered by NHS trusts, which own and control hospitals and other facilities that were previously controlled by Regional, District or Special Health Authorities (Merrills & Fisher, 2006 P.3). The trusts include structural facilities and other facilities such as medical evacuation services, ambulance services, and consultation services. There are various NHS trusts and authorities overseeing running of NHS, which include acute trusts, primary care trusts, ambulance trusts, care trusts, mental health trusts, foundation trusts, strategic health authorities, and special health authorities. Primary care trusts (PCTs) provide health and social care services for general health needs of local communities. Generally, there are about 151 PCTs in England, controlling 80% of NHS budget (NHS, 2010). Acute trusts oversee running of hospitals, ensuring hospitals offer good health services and meet financial obligations. Ambulance trusts offer emergency link to healthcare through ambulance services. Basically, there are 12 ambulance services in England dealing with emergencies that are categorized into category A emergencies that are life-threatening condition and category B or C emergencies that are not life threatening (NHS, 2010). On the other hand, care trusts are institutions that offer both health and social care services, and currently, there are very few. Mental health trusts offer health and social care services to patients with mental health problems through primary care or specialist care. Moreover, strategic health authorities oversee management of local NHS on behalf of the secretary of state, and they were formed by government in 2002 (NHS, 2010). Lastly, special health authorities are national institution offering health services to entire country and are not restricted to a local community. The NHS is managed by health service managers through a hierarchical structure. At the peak of the management is the Chief Executive Officer (CEO) who oversees coordination of the activities of the entire institution. Since the NHS trusts are corporate institutions, they are managed by a board of directors limited to 11 members with five executive directors, a chair and five non-executive directors who represent the community served by the trust (Talbot-Smith, & Pollock, 2008, P.63). Trust managers (executive directors) manage day to day running of the NHS Trusts; and in between the CEO and Trusts managers, there are many middle managers offering various management roles fitting the needs of the institution (Harris, 2005, P.27). After the Trust manager, there are departmental heads and supervisors who monitor and coordinate the rest of the workforce and activities of each unit of the trust. Each level of management requires requirements in terms of training, skills, specialization, experience, and discipline. Nevertheless, the management serves as the engine propelling the NHS towards fulfilling it principles and mandate in provision of quality health services for the vast majority of the English people. The key challenges faced by managers working within the health service. First, there is job insecurity since health managers work in hierarchical structure, and with change in government or review in health care policies, there are institutional restructuring entailing change of organizational structure, workforce, and abolishing of some of health managerial positions (Harris, 2005, P.27). Secondly, the relationship between the managers and clinicians has always been characterized by controversies, with clinicians having ‘a complex of professional networks with managerial hierarchies imposed on them; professional networks develop around very complex, uncertain work, while hierarchies are best for relatively simple, predictable activity’ (Southon, 2003, Para 1). With this kind of situation, there is always room for conflict as managers are overseeing some services they cannot clearly grasp, while the clinicians feel enough is not being done to aid services in their clinical practice. Thirdly, NHS, being a state funded institution, the NHS managers are charged with a huge responsibility of ensuring services meet the requirement of users, resources are well utilized, governance and public accountability obligations are observed, as this can taint the public opinion from good to worse (Jones, 2007, P.178). Fourthly, there is ambiguity in defining duties of some of staff like midwives and maternity support staff, while criteria for managing staff shortages are not well in place (Chitty, 2007). This puts managers in awkward position in implementing their jobs, as in case of a crisis, there is no responsible party to that particular problem; all they can do is encouraging team work. In addition, as managers tend to progress career wise, there are increments in tensions due to government demands, actualization, and fear of moral corruption, leading to some of top managers leaving NHS before their retirement date (Pattison & Pill, 2004, P.68). Moreover, managers are subjects to risk associated with working in healthcare including ill health and accidents. Conclusion Though faced by many challenges, NHS has continuously provided quality health services to the people of UK since inception. Being the largest employer in health institution globally and having adhered to its principles and mandate, NHS is a model organization in which other countries can borrow a leaf from, in implementation and designing of their healthcare systems. References list Chitty, M., 2007. Management Challenges from the NHS. (Online). Available from: http://progmanager.wordpress.com/2007/05/29/management-challenges-from-the-nhs/ (Accessed on 18 March). NHS. 2009. The NHS in England - About the NHS - NHS core principles. (Online). Available from: http://www.nhs.uk/NHSEngland/aboutnhs/Pages/NHSCorePrinciples.aspx. (Accessed on 18 March 2011). Department of health. 2009. NHS Constitution for England. Department of Health website. (Online). Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_093419 (Accessed on 18 March 2011). Harris, M.G., 2005. Managing health services: concepts and practice. Sydney: Elsevier Publishing. Jones, R., 2007. Key Topics in Healthcare Management: Understanding the Big Picture. Abingdon: Radcliffe Publishing. Merrills, J. & Fisher, J., 2006. Pharmacy law & practice. Sydney: Elsevier. Pattison, S. & Pill, R., 2004. Values in professional practice: lessons for health, social care, and other professionals. Abingdon: Radcliffe Publishing. Southon, G., 2003. Conflict between Clinicians and Managers: A structural problem. A response to the concern about conflict between Doctors and Managers in the NHS. (Online). Available from: http://homepages.paradise.net.nz/southon/Gray/abs1.htm (Accessed on 18 March 2011). Stephens, M., 2003. Hospital pharmacy. London: Pharmaceutical Press. Talbot-Smith, A. & Pollock, A., 2008. The new NHS: a guide. London: Publishing Routledge. Read More