Re-Designing Services Offered by the UK - Assignment Example

Proposal Report on Re-designing Services Offered by NHS UK Executive Summary NHS UK is a well established organization dedicated to provide free health care services to the residents of UK. The government has put in a lot of money for its expansion and sustenance but NHS is not able to deliver and address the needs of the patients in the region. The organization doesn't have enough capacity and the patients have to wait for long hours to meet a doctor. Also, the NHS facilities don't have the required infrastructure to accommodate all the patients approaching them for care. NHS has to urgently set its priorities and hire more GPs and hospital staff to increase its capacity. The authorities have to establish better performance evaluation systems and ensure that their facilities are delivering world class services like their neighboring countries. Situation Analysis (i)Company Background Established on 5th July 1948, NHS is now one of the largest public health care service in the world (Hawe, 2008). The UK authorities established the NHS to provide the residents with equal access to treatment. NHS aims to provide clinical help to patients regardless of their ability to pay for the medical expenses. The organization is funded through national taxation and this ensures that NHS is able to provide care to people who are not able to afford it with personal means (Dept. of Health Staff, 2004). (ii)SWOT Analysis The public sector in Europe has been characterized by poor quality of service and due to this the people have begun to have low expectations from public facilities (Lffler, 2004). This report will now conduct a SWOT analysis of NHS UK. This analysis is expected to present more clearly the current situation of this organization, show its strengths, weaknesses, opportunities and threats. Strength The government has increased the investment in NHS UK. While the organization only had 33 billion in 1996/1997 to spend, it now has around 67.4 billion in funds for its needs. NHS has also seen an increase in spending on buildings and equipment and now has 3.4 billion for investment in the infrastructure. This surplus has allowed the organization to have more modern equipment and facilities and take better care of its patients. NHS has also decided to have more staff on board and thus it has begun to steadily increase the number of doctors, nurses and attendants (Dept. of Health Staff, 2004). These figures indicate that the organization has the attention of the authorities, and the government is trying to pull it up by putting more money for its sustenance and future growth. The funds available to NHS have increased considerable over the last decade, and the authorities now have the money to improve their infrastructure. By purchasing modern equipment, NHS can dramatically improve its quality of services and gain appreciation from the patients in the UK. In addition, NHS has more staff at its disposal and thus they have more hands to provide services to their community. Weaknesses Even though the authorities are making several efforts to improve the quality and accessibility of NHS, the organization is often accused of low standard in health care. A report indicates that in comparison to other European countries, the patients' survival rates were very low in NHS. This reason for this low rate was due to poor organization of services. NHS has very long outpatient and elective surgery waiting times and need to have more focus on areas such as cancer and heart disease (Scambler, 2003). Apparently NHS is not improving despite the amount of money it is receiving from the government. The residents of UK are not happy with the quality of services and are still complaining about the low standard in health care. The patients are comparing the services available to them with those of health care services provided to residents in other European countries. NHS needs better organization of services where the patients don't have to wait for a very long time for surgeries. Also, NHS has to ensure that serious diseases such as cancer and heart disease are on the priority list of the doctors. These patients must be given immediate attention so that their condition doesn't get worsened with lack of proper care (Scambler, 2003). Opportunities The patients now expect more from medical facilities and there are a number of developments in the healthcare technologies. These have encouraged the government to focus on improving the quality of services (Sines et all, 2005). NHS can leverage the focus of authorities to get the infrastructure to grow and deliver. The management of NHS can use the funds available to them to expand, improve its services, and ensure that the taxpayers' money is utilized judiciously. Threats The people in UK are quite fed up with the long waiting times and they are now turning to the private sector for treatment of their diseases. A large number of people (with and without insurance) are using private facilities for diagnostic work such as X-rays, blood tests, and ultrasounds (Sewell, 2003). Overworked NHS hospitals have also subcontracted hundreds of operations to private hospitals and this may tarnish the reputation of the organization (Sewell, 2003). NHS plays a very important role in the local economy and purchase a number of goods and services from local sellers. If people turn away from this organization it will result in lesser employment opportunities to the local people and affect these sellers (Ward et all, 2006). The poor quality of service has led to loss of confidence in the NHS and a large number of people think that services at NHS will get worse on the coming years. An editorial in 'The Sun', a popular newspaper in the UK, called NHS a dead duck and most of its readers agree with this opinion. A service like the NHS is meant to be used by large numbers in the population and if it is delivering poor service, people will stop trusting the organization. They will believe that NHS is not spending the taxpayers' money (Gooby, 2006). This information clearly shows that people are losing faith in NHS and look towards the private sector to address their health care needs (Sewell, 2003).Even uninsured people don't think much before they use the private services for diagnostic work. The situation is further worsened by the fact that the NHS hospitals don't hesitate to subcontract operations to private hospitals. Seemingly, the loss of reputation for NHS translates into loss of business to local sellers and thus a set back to the economy. The poor performance of the organization has also been caught by the media and they are also criticizing NHS for not keeping up to the expectations of the patients in UK. The media will further deteriorate the image of the organization and this may push more patients towards the private sector (Gooby, 2006). Service Constraints (i) Very Little Capacity Despite the increased investment in the organization, NHS is still offering poorer health service when compared to services in France and Germany. The hospitals still have very long waiting times. For instance, patients in the Royal United Hospital in Bath have to wait for more than six months to see a specialist. Due to this reason the RUH carries a tag of a zero-star hospital, despite being appreciated for its clinical excellence (Sewell, 2003). The experts say that the long waiting time is due to too little capacity. NHS also has a shortage of doctors, nurses and beds. The shortage of GPs is very acute in deprived areas like Hackney. This is surprising as people expect the government to focus their efforts in theses areas to end health inequalities. NHS is still very far away from the goal to give patients an appointment within 48 hours (Sewell, 2003).Seemingly, the NHS is not able to deliver proper health services to the residents in UK due to very little capacity. People needing the urgent attention of the specialists have to wait for a long period of time and suffer from the consequences. The deprived areas are most affected by this shortage and hospitals in these regions urgently require more staff to attend patients. In fact people suffering from general diseases cannot expect to see a GP within 48 hours. All these problems can be addressed if the government decided to quickly fill up the vacant places with qualified doctors and nurses who are immediately available to look after the patients (Sewell, 2003). (ii) No Continuous Evaluation of Performance The NHS Modernisation Board claims that the organization is steadily improving and the services of NHS are slowly getting better. However, analysts say that the improvements are not good enough and they have failed to significantly affect the front-line delivery of services on a large scale. Due to this reason the NHS services are not greatly benefiting the public in UK (Sewell, 2003). Experts say that this failure to deliver is due to the absence of any continuous evaluation of performance against criteria. The NHS authorities don't set any precise management objectives. The management should be asked to make better plans and ensure their effective implementation (Pollock et al, 2005). This information indicates that the absence of any concrete evaluation system of performance at NHS is resulting in the poor front-line delivery of services on a large scale. Low accountability leads to poor performance wherein the doctors and hospital staff is not bothered about his or her performance. A proper evaluation system can help improve the quality of services at NHS UK (Pollock et al, 2005). Service Objectives Scambler (2003) says that the NHS has to work hard to improve its services and must focus on achieving the following objectives- (i) NHS should ensure that the patients don't have to wait for more than 18 months for any inpatient treatment. (ii) If the GP suspects the people to have cancer, they must be able to have the attention of a specialist within 2 weeks of the GP visit. (iii) The patients seeking their first outpatient appointment should not have to wait for several weeks. Currently, a patient has to wait for more than 13 weeks for his first outpatient appointment. (iv) NHS should focus on improving and maintaining the cleanliness of their facilities. (v) The hospitals under NHS must have a very low rate of emergency readmissions. (Scambler, 2003) The NHS UK must aim to reach these objectives diligently and ensure it has the required resources to achieve its goal. In addition to reducing the waiting time, the organization must provide immediate attention of doctors to the patients that are suffering from life threatening diseases. It is indeed a very unfortunate situation that a patient has to wait for more than 13 weeks for his first outpatient appointment. This should be corrected and the focus should also be on improving and maintaining the cleanliness of their facilities. Finally, the authorities must have systems in place to ensure a very low rate of emergency readmissions (Scambler, 2003) Recommended Service Strategy The NHS can improve its services by the following ways:- (i) Increasing the Capacity NHS should attempt to follow the successful systems used by the hospitals in neighboring countries such as France. The French system boasts of excess capacity and the people in that country never have to wait endlessly for an appointment with the specialist (Sewell, 2003). Currently, long-planned operations have to be cancelled if the beds are not available. NHS must arrange for more beds and invest in infrastructure to take care of more patients. The organization must also employ more doctors and nurses to increase its serving capacity (Sewell, 2003). NHS will never be able to offer world class services to the patients if it fails to solve its underlying capacity problem. It is true that the organization has recruited around 50,000 more nurses, and 1,200 more GPs since 1997 but still it lags behind in quality as compared to France and Germany (Sewell, 2003). NHS must have better workforce planning so that they don't have shortage of staff (Rosenthal et al, 2003). NHS UK can copy what other successful countries are doing and deploy their systems in their facilities. They must attempt to find out how France has excess capacity and their people never have to wait for medical care. Proper infrastructure is imperative for deliver of health care and NHS must keep enough number of beds to serve their patients (Sewell, 2003). (ii) Redesigning the System The system for booking appointments and operations has to be redesigned effectively so that the patients get timely care (Sewell, 2003). Obviously, the existing system for NHS is not up to the mark and failed to contribute in the smooth functioning of the organization. The authorities must redesign the system so that the patients get timely care and attention. (iii) Tighter restrictions for the NHS Doctors The NHS must have policies in place that mandates the hospital specialist to work full time in NHS. The organization must have tighter restrictions for the doctors and they should be asked to spend more time in NHS than in private sector (Scambler, 2003). If the doctors have stricter guidelines at NHS they will be driven to focus more attention at NHS and this will ultimately improve the services at this organization. (iv) Deploy smart working practices Sir Derek Wanless advises Gordon Brown on NHS funding needs. He believes that NHS has a chance to deliver world class service with fewer doctors and nurses if it designs and implements smart working practices. But, the authorities have not yet come up with any concrete plans (Sewell, 2003). The policy makers for NHS are also trying to learn from the best practices from other nations (Kvist and Saari, 2007). As discussed above, NHS can search and find out more about the successful practices at countries such as France and Germany. These working practices can be deployed in NHS to make it a world class organization. (v) Setting the priorities for the NHS Despite the attempts of the Labour government to boost the standard of services provided by Britain's National Health Service (NHS), the organization has failed to meet the expectations of the people. The Conservative opposition stresses that there are several inherent failures in NHS such as the lack of a family doctor service and inefficient long-term care services (Luna, 2006). The government has also been accused of not clearly setting the priorities for the NHS (Clarke and Allen, 2004). The organization needs to prioritize its planned activity to become a healthcare provider of repute (Paton and Storet, 2005). Evaluation and Control Successful monitoring and evaluation in health services can be achieved by establishing systems and procedures for auditing compliance with managerial, clinical and professional indicators (Antony et al, 2002). The NHS has attempted to use a command and control system wherein the government sets the performance targets and uses the management to ensure those targets are achieved (Kvist and Saari, 2007). The government has also introduced 'clinical governance,' a framework that mandates the managers of NHS to examine the effectiveness and quality of services in the organization. Clinical audits are also being conducted where the practices of doctors and nurses are compared with the agreed standards and outcomes (Sines et al, 2005). In order to have better control in the organization, NHS must establish clear line of responsibility and accountability. This will ensure overall quality of clinical care (Rosenthal et al, 2003). 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