Facilitating Change in Health and Social Care - Coursework Example

Facilitating Change in Health and Social Care There are many factors that affect health and social care services. The sector is highly affected by changes in the political systems, the population, legal issues which include the health acts that are put in place to enhance health management, organizational management, cultural and technological factors. Every day new ideas are incorporated in the health sector in the bid to try and make the services better and also adjust to the upcoming issues in form of technology, culture, legal among others. These changes have a direct or indirect impact on the staff and those who offer the services and so calls for an in-depth analysis to evaluate how the change should be implemented to ensure that the best results are achieved. For effects of change to be felt and ensure better results, it needs to be managed well. Naturally people are resistant to change and so when implementing it the best strategies needs to be laid down so that the stress and resistance that comes with it is eliminated. This therefore calls for the learning on how to manage the change effectively and also help others in process so as to improve on effective service delivery. Introduction The health and social care sector is an everyday changing sector that is affected by many factors within and outside it. In order to understand these factors it is important to evaluate the changes that have taken part in the health sector in the recent years. Second it is important to understand the principles of managing change. As highlighted earlier, among the changing factors in health and social care management include, demographic changes which include the population increase, increasing aging people where there has been a 2% increase in the number of people above 65 years, a value that is expected to rise to 23% within five years. Also this includes the public awareness programs which are meant to sensitize the population and ensure that they are aware of the procedures followed in health and social care management. The political and legal factors include the health acts that have been passed in the recent years and which will have a direct impact on the administration of heath care in the country. The acts include the 1999 Health Act, the NHS and Community Care Act of 1990 and the Health and Social Care Act of 2001. These Acts will have an impact in the health and social management as will be discussed later. The modernisation agenda has also come with its impact in the health sector and bound to change it significantly. The change in government and change in funding of the programs introduced in the health sector are other factors that should be considered when discussing the factors that impact change in the health and social sector. Technological factors that should be considered and that have come to change the sector amicably include electronic record keeping where in the current times everything has been simplified. Electronic communication has made administration of the services much easier and therefore affecting the services offered to more people. It is also important to note the impact of technology on the administration of health services. Currently there are new machines which have simplified tasks that in the past proved almost impossible. These have really changed the sector. All these changes in the administration of health and social services have brought an impact in one way or another. Impact of Change on an Organization Introduction of a change in an organization can change it to be better or to start performing poorly. The impact of the change is felt by the staff, the recipient of the services and other involved parties. In this chapter we look at how the change should be made welcome in an organization so as to receive minimal resistance. The change proposed should have a positive impact on the delivery of services to the society. The impact of change in the society can determine whether the people affected will embrace it or resist it. This calls for strategies that will ensure that the affected individuals own up the change and become part of it. They should be informed on the goals and the challenges expected. The management style will determine whether the people will embrace it or resist it. For example in a democratic style, the involved parties feel they are part of the change. This way they enhance the success of the change and the goals are achieved as planned. The change being proposed should have measurable parameters or methods of assessing whether it has achieved the expected results. There are many parties involved in the implementation of change. They should be updated frequently and be made to carry the responsibility of ensuring that the goals set are achieved. This can only be made possible by first ensuring that they feel they are part of the project. Once they own up the project then the desired results can be achieved more easily. The progress and the challenges should be addressed without wrangles to avoid falling out of the involved parties and prompting resistance henceforth. If a change is opposed ruthlessly then it would be wise to first pause the advances and address the issues that the individuals involved are having. This can be made in phases with the ultimate goal being to have them on board as the change is being executed. Giving people different responsibilities helps in ensuring that they feel they have the mandate to ensure the project succeeds. This is better than when the involved parties are not included in the execution of the plans. How to Make Change Effective There are a number of factors that need to be observed by any organization to ensure that the change in health service and social care management is effective. The responsibility of ensuring that the change is effective should be carried by many people. This includes the front line staff and the people who receive the services. The leaders involved would ensure that all the people know what is going on to make them feel they are part of the project. Throughout the time the change is being executed the hopes of all the involved people should be kept alive. This will help in reducing the resistance that would be caused if they felt that there was no future after the changes have been implemented. It is wise to let them raise their concerns and address them appropriately as the progress in change is being monitored. The people involved should be kept fully informed. The certainty of misery is better than the misery of uncertainty. It is better to share bad news with all the parties to ensure that they are not confused which can lead to agitation and resistance. It is their right to know what is happening, why it is happening and the next steps and actions that will follow. If the information is not shared well on time the probability that rumours will erupt will be higher and the damage they could cause is incomprehensible. The arising of ridiculous stories can affect the motivation of health and social workers and therefore affect their administration of services. Telling the truth and the only truth helps in winning the confidence and trust of the people who one is interacting with. This is important when the change is being administered as one will easily get the support of the parties involved. It is also important to teach the health workers and recipients of the services how to handle change. This will eliminate the possibility of a gap being formed when they are moving from the old system to the new one. During the time the change is being executed t is important to constantly reassure the people involved of the goals sets and how they will be achieved. This renews their hopes even if they are facing tough times. When the seniors spend time with the juniors they get the rare chance to hear and address the issues that the juniors could be having but have the fear to submit them to the seniors for fear of victimization. Many junior health and social care workers fear they could be victimized if they resisted a change. The addressing of the issuing that could be retarding the change will make it more effective and the goals that have been set will be achieved in the timeframe specified or even faster. Lastly it is wise to cut and simplify the work. One person or a small group of people may find it hard to execute change. However if more people are involved the tasks will be simplified and everyone will handle a smaller task than when the number was less. Role of the Government in the Health and Social Care System The government of UK is responsible for ensuring that the population is healthy and practicing the right health practices. The changes in the delivery system have been made with greater emphasis on;- preventing illnesses that have been troubling many people in the country and curbing risk factors such as obesity that have been a nuisance in the country. This enhances a healthy nation (Chris, Anna & Beatrice p. vii) The government also has been aiming at providing high standards of primary care in all practices to enable more services to be delivered in primary care where it is available. This aims at ensuring that all the parties involved in ensuring the society is healthy (Chris, Anna & Beatrice p. vii). The government has also benefited by making the changes by ensuring that there is more effective use of community health services and related social care. It has also ensured that the services are available for twenty four hours in a day. Lastly it has been the government’s achievement in integrating health and social care around the needs of the people. There have been calls to make drastic changes in the health and social care delivery in the UK. According to Marmot 2010, the variations in health outcomes between social groups persist and in some cases even widening. This has been calling for changes that can address the issues that make the administration of the services to be retarded. Second, the study that was done by Nolte and McKee in 2011 show that United Kingdom ranks second in having the second highest rate of mortality amenable to healthcare in a study done on 16 high income ladies. However there has been a notable drop in the death rates in the nation. The other thing that called for the changes is the diabetes related deaths which according to the study done by the National Audit Office in 2011 are 24 000 annually. Among the significant changes that have been implemented in the health and social care is the Health and Social Care Act 2012. It is an act of parliament by the parliament of the United Kingdom. It is an act that was aimed at changing or reorganising the structure of the National Health Service in England. This was to be done by abolishing NHS primary care trusts (PCTs) and Strategic Health Authorities (SHAs). The new plan started on 1st April 2013. The bill was aimed at making the General Practitioners the direct overseers of the NHS funds which they did not have in the past. Those funds were being channelled through neighbourhood and regional primary care trusts. Workers in the health and social care sector have had benefits following the changes in the system. First due to the Health and Social Care Act 2012, general practitioners (GPs) were bestowed with the mandate of managing the funds that were initially being handled by the neighbourhood and regional primary care trusts. This will enhance their working conditions and they will have more power in their work. This also translates that due to this change and others aimed at improving the Health and Social care system, the overall beneficiary will be the citizen. With improved health systems there will be reduced mortality rates and with the rising numbers of ageing people, then it will mean that it will be simpler handling them. Principles of Change Management It is important to address the principles that govern successful change and ensure that the results and the goals set are achieved in the time frame allocated. John P. Kotter a professor at the Harvard school of business describes the principles of change of change management that will ensure the results are realized. Kotter’s Steps to Successful Change To ensure that change is successful and one encounters minimal resistance in the process the following principles are important to follow. First it is important to create a sense of urgency. Creating a sense of urgency makes the parties involved to feel the urgency needed to make the change and to ensure that things are working in the desired manner. Many leaders ignore this step when it comes to implementing change and the results result is that there is more resistance from the people involved as most of the times change is not welcome. Understanding this concept will ensure that the health workers in this context and the stake holders in the health and social care delivery understands why the change is important and why it should be implemented at this given time. In creating urgency it is important to engage the involved parties and hear their views on the change that is to be implemented. In facilitating change in health and social care it is important to note that the issue of health is very important and introducing changes would mean that the results and the goals set should not be short of the already set levels. The government being the mandated organ that can implement changes mainly through acts of parliament should be on the front run to evaluate the integrity of the changes that are to be put into place and establish whether they are important or not. For example in the Health and Social Care Act 2012 where the management of funds was to be delegated to the General Practitioners from the previous primary care trusts it faced much resistance as there was limited time to let the involved parties understand why it was important to implement the change at this given moment. The second principle in ensuring that change is successful is creating the guiding Coalition. This is a complex step which involves a number of activities. The leaders must develop the right vision that will let others see the expected results and the clear goals in the health care system after the change. To do this there is the call for the right effort to be put to be put to know exactly how the change will be put in place. Many changes that are put in place fail because of a number of reasons (Robert p. 25). First they do not invest enough to know whether the change will be successful and the challenges they should expect. They do not involve all the stakeholders when facilitating the change and so they encounter much resistance and so the change fails. The need to communicate the change to many people should not be over looked. With many people knowing the exact concept of the change that is to be put in place, then one can be sure that they will see the reason for implementing the change and why it is urgent to do so. In preparation to implement the change, it is also important to address all the concerns of the people involved as that could lead to obstacles when the change is being put into place. Eliminate all the obstacles if the goals set are to be achieved. The qualities of an effective guiding coalition are;- Enough players should be put on board. The larger the number of people you include in your team, the more ideas you will welcome (Robert p. 29). Second, all relevant points that need to be addressed to ensure the change is successful should be put forward as this will enhance making of intelligent decisions. Decisions should be made prior to the initiation of the change and help in addressing the obstacles that could spring as the change takes its course. The people implementing the change or playing the key roles should exhibit credibility so that they can win the trust of the people. A credible group will encounter less resistance and this will make the implementation of the change much easier. However, if there are issues being hidden and cooked up, then the resistance to the change should be expected. It should be noted that the more the resistance to the change the harder it will be to get achieve the desired goals. Lastly the group initiating the change should have transparent and well proven leaders who can be able to lead change. No matter what strategies have been put in place, if the leaders are not accountable, the desired results may not be achieved. The third principle to observe in ensuring that the set goals are achieved in healthcare management is to develop a change vision. The vision should be clear to effectively bring out the expected results if the change is successful. A clear vision will simplify the decisions made and help more people to come on board and embrace the change. It also acts to motivate people as they have more hope of achieving the set goals at the end of the whole exercise. It will also be used to coordinate the actions of people as they will have the backbone to the change. The vision that has been set will include the strategies that have been set, plans that will be followed and the budget. With a clear vision the other procedures become simplified and the goals seem closer to achieve. The characteristics of effective visions are; - they should be imaginable. This will make sure that the people understand them easily and so they become part of the larger picture and the system implementing the change. The visions should also be desirable. They should have appealing short term and long term results which will determine whether the change is effective or not. They should have realistic goals. If the goals set are unattainable then frustrations will peep in and the whole system will fail. They should be focused and not derailed by the obstacles that will be found on the way. Lastly the vision should be communicable so that many people can get to understand it and be part of it. Fourth, to ensure that more people support the change, it is important to communicate the vision in a way that is attractive and appealing. The method used should be simple to understand, it should also help to create a picture of the end results or the goals that are expected. The ideas should be given to the maximum number of people as this will enhance buy in (Robert p. 28) Fifth Kotter explains the need to remove as many barriers as possible in ensuring that the change achieves the expected or set goals. Barriers associated with the internal structure such as resistance from some influential people is harder to get by than when the barriers are external. Troublesome supervisors can also make the expected goals not to be achieved. Their habits inhibit change or block new ideas which would have helped to make the change achievable. The clearing of these problems takes time and so the time frame set to attain the goals may prove unpractical. However, it is always important to try and address such problems in the initial stages as that will save the agony of stalling the change when the goals were already in view. Some of the methods used to deal with such people is convincing them or dropping them from board. Generating short term wins will help to quench the long term goal wait. It is very risky to run a change program without taking into concern the short term wins. The short term wins are important as they help in completing the whole transformation. Change is not a destination, once you achieve one thing you will look further to implement more and more change. This will ensure that you are not overrun by the times as there are new inventions daily and new ideas that need to be addressed or incorporated in the already running system. Do not let up. Always look further to explore and to evaluate new needs that the end consumers in our case the beneficiaries of the health and social care need and through that one can know the changes that need to be incorporated. At this point some of the goals will have been achieved and so more people will be put on board. There will be consistency show of proof for the results from the change and so initiating another change will be easy. Lastly Kotter advices that to ensure that the change sticks it should be planted firm in a culture which is composed of norms of behaviours and also many shared values. This will help to ensure the change does not die (Robert p. 32). In the UK the health and Social care sector is identified by;- The fragmentation of the health services where there are dividing lines between health specialists. These include General Practitioners, Hospital Based Specialists, Hospital and Community based healthcare providers and mental and physical health specialists. This shows that each of these groups is working in a different environment instead of merging and offering their services in one accord. Second, the models of care that are used in the UK appear to be outdated in this era where changes in the health sector have been experienced in many countries. Technology and the society are evolving quickly and this calls for changes that should be aimed at ensuring that the models used are updated enough and running hand in hand with the current technology. These changes have really changed the way the patients who are the end users of the services provided interact with the service providers a situation that calls for measures to be put to address the issue. Third Health and Social Care in the UK still relies heavily on the individuals who have trained in the various professions. In the current times, patients want to participate more in their care and treatment programs and so measures need to be put in place to incorporate the users into the system and thereby allow them to feel as part of the system. These factors are some of the reasons that have called for the changes that have been made into the delivery of health services and many more changes are expected as the sector is being streamlined to incorporate the current trends and issues. There has been the problem of getting quality health care in the public hospitals in comparison to the service offered in the private hospitals. This has raised the question of dedication and determination of the workers in the health sector. The NHS should be held accountable for the fall in the standards of health care services that are found in those hospitals. This was one of the reasons that led to the Health and Social Care Act 2012. In the act the GPs will be responsible and accountable to the money that previously being handled by Primary Care Trusts in managing the health services in the country. This led to the closing of 153 HTCs across UK. There Act led to a loud uproar mainly due the fact that the change was not well illustrated and it seems not self sustaining. Those resisting the move claimed that both parties that is the GPs and the HTCs need to work in harmony to ensure that the customers get the best health and social care available. The law has however been implemented since last year and the resistance is dropping as more people get to understand the concept of the change. Levitt’s Model of Change Levitt broke down the working of an organization into four components to elaborate how organizational change can be made effective. We shall look at his approach as a model that can be used in implementing change in the health and Social care sector. The components are people, structure, technology and the task. In his model he advises that in an organization, it is not wise to look at people just as employees but rather it is good to look at their skills, knowledge and productivity in evaluating their strengths. To implement change in the running organization it means that one is either, changing the tasks that the employee (s) were doing, changing the structure of the organization or changing the technology and equipment that was being used. There is need to introduce and address the change so that the resistance from the workers is minimized. Change in tasks requires intensive training to ensure that the new roles that the employees will be doing are done effectively. This will make them ready to take up the new roles and work efficiently. Change in structure would often mean that the job roles are being switched or changed. The employee will find it important to learn and understand the new job description to ensure that the new roles are taken effectively. If the change is in the tasks that one has been doing, it could mean that there are added tasks or change in the tasks done. The goals set determine the tasks that are done to achieve them. The change should be announced early as it is bound to affect the other components. If there is need for training then it should be done in the appropriate time. Change in structure includes the change in the relationships, communication patterns and the coordination between the interacting and existing management levels and the employees in the organization. Change of people in the organization brings change in structure. If maybe the employees are being changed the new employees may need more or less supervision considering their experience and qualifications. Technology aids people to perform their tasks. In case the equipment and the machines that were being used are being changed then the employees need to be educated on how to handle them. Change of technology is important when one wants to change the employees and hire ones from a specific profession. Management The style of management often affects the results obtained while implementing change. There are a number of management styles. In an autocratic system, the manager makes the decisions alone and consultations are limited. It is also termed to as dictatorial and it limits the progress change due to the limited ideas that are put into practise. It is highly discouraged as it kills the motivation of the workers and so the output is limited too. In a democratic system the leader or manager allows the ideas of the stakeholders and the employees’ before the final decision is made. The decisions are made by evaluating the decisions of many people and coming up with a conclusive and wise ways to execute change. Change should be monitored to know whether the goals set are being realized. This is done by taking surveys and looking at the short term and long term goals’ achievement. Customer and staff satisfaction is always a good indication of the situation on the ground. Conclusion To ensure that change is effective and the goals have been achieved in improving health and social care delivery it is important to research well. The management and the leaders should take their time to learn the needs of the people and from that point they can be able to address them well. Involving the stakeholders in decision making will add value to the process and the resistance expected will be minimized. To manage anxiety and excitement that is always brought by the change, they should set short term goals which will be used to motivate the employees and give hope to the people as they look forward to the long term goals. The long term goals in delivering health services are attaining a healthy nation. To achieve that goal it calls for the critical evaluation of the available options and managing the current health issues such the increasing numbers of ageing people and the number of obesity cases. This will then lead to incorporation of laws, profession and technology to implement changes that will ensure that the goals are achieved. The demographic factors always affect the changes that need to be put in place. For example in looking at the changes that should be, it is important to establish the doctor: patient ratio to know the number of people that a doctor is supposed to tend to. The new laws that are made and incorporated into the health system should be aimed at improving it and to ensure that they are effective, consultations should be made wisely to establish the needs of the population and the prevailing conditions that affect the delivery of health services. Cited Work Robert, James, Campbell. Change Management in Healthcare: The Healthcare Manager. (27) 1 (2008): pp. 23-39. Print. Read More