Performance Management: Public Health Sector - Essay Example

Name: Tutors Name: Course: 01\06\2012 Introduction This paper is going to look at performance management with consideration of the NHS. The paper will begin with an insight into good practice and how the method has been used to achieve great results by the NHS. The various reasons through which the NHS has been abler to succeed in the delivery of its services will be considered as well. The role of the stakeholders will also be discussed amongst other performance management tenets. Good Practice Good practice is a method that through study and practice has proven to constantly pilot to excellent results. Good practices are efficient ways used by business or organizations to help them in achieving their goals/objectives. Using good practice helps any organization to learn from and through the experience of others. This is done through benchmarking; it allows one to compare ones business with other successful businesses. As a result, figures out other good practices of working against the competitors and achieve the organization’s product and service quality. In addition, good practice especially in management can be achieved through forecasting, monetary planning, strategic planning and performance monitoring. Good practice entails clear relation of planned organizational objectives and business arrangement processes, business approach between the management, shareholders and employees, attending to any underperformances as quickly as they are detected, timely feedback and clear expectations of good behavior and achievements. Applying good practice helps an organization increase its sales, revenue and penetration into new markets, become more efficient in terms of reduced costs and improved skills of the workforce, more competitive and effective in adapting of new technology, and finally in its improvement, in the quality of products and services. Over the years, the NHS has put endless efforts in trying to improve its performance in rendering quality services. To achieve this, the NHS has relied on innovations that have been got through paying attention and learning from each other and later implementing it. Continuous innovation has played a role in designing a better health care system for the patients, currently and for future purposes. The NHS has worked with and through clinical networks, which has been confirmed as valuable and prolific as it has guaranteed positive learning that has spread widely across the whole system. The chief executive, Sir Nicholson, continues to stress on the need to introduce long-term activities that will help reinforce the multidisciplinary networks in trying to identify the best ways to improve the results of patients. Sir Nicholson finds the whole system of networking as the place where clinicians from different systems come together to improve the service and care quality given to patients (Department of Health, 2009). To ensure that the NHS is able to attain its goals, it regularly communicates with its stakeholders. Regular monitoring and evaluation of the activities carried out in the hospital have made it easy for the management to identify problems, and immediately look for solutions. Performance Management Performance management is the systematic process by which an organization involves all its stakeholders: employees, customers, shareholders and managers/administrators, in improving managerial effectiveness in the execution of the organization’s task and objectives. Performance management is used to develop the team performance, founded on the values of planning, appraisal, action (reacting to the detected problem and rewarding) and monitoring. Effective execution of organizations goals requires advanced planning that is, citing performance prospects and objectives for the teams and persons to conduit their hard work towards attaining the organization’s purpose. To be able to attain the goals employees need to be incorporated in the planning process. They get to understand the organizational goals objectives and what is required of them. Second from planning is the principle of appraisal. The management compares the current achievements and the required achievements hence, getting to identify the shortcomings that need to be attended to immediately. The management is then expected to react on any problem detected in the previous stage; come-up with a plan and execute with an aim of improving the performance of the organization. To shed more light on performance management in the public sector, I will give an example of a public health sector (NHS), which has various stakeholders who include users and payers of the service, politicians, employees, local authorities and other non-governmental and voluntary organizations. The NHS is based on the principles of equal access of service for all, and free services at the point of use founded on the medical want and not on the aptitude to pay. NHS is funded by the government out of the public taxation. In the recent years, healthcare expenditure has been a challenge to the national government. The expenditure levels keep on increasing taking up a substantial percentage of the national income. The public sector motive is not to maximize profits, but rather to meet the publics’ expectations in providing of services. Therefore, there is a need to control the health care costs while paying close attention in the quality of its services and products (Klein, 2007). To achieve this, improving the management practices as a way of increasing both quality and productivity has proven to be inevitable. The NHS has, therefore, laid its objectives of reducing the expenditure cost and providing quality services. Improved management skills such as well managed hospital operations, performance and talent management, has been associated with better clinical outcomes: lower death rates from emergency heart attacks, higher levels of patient satisfaction and well managed budgets. For instance, as a result of better management practices, a six percent fall in the mortality rates from heart attacks has been registered (Klein, 2007). A research carried out showed that strong management practices evident in the health care systems, in the United Kingdom, led to a reduction on the amount spent compared to that in the United States. Strong management techniques in the country, is as a result of an increase in the number of managers with clinical knowledge and the level of autonomy given to them, thus, an improvement in the managerial practice. Talent management has been reached through rewarding of the top employee performers with either monetary or non-monetary rewards, shifting or removing underperformers from the hospital or department, evaluating and holding accountability of the superior staff on the strength of the workforce they build and finally recruiting gifted persons before other opponents(private sector). Public hospitals in the country are able to register strong management scores as compared to the amount of finance directed to them because management roles are occupied by clinicians. McKinsey and Monitor came up with the Service Line Approach (SLM), which is a dependent regulator of the NHS Foundation Trusts, designed to devolve decision making and accountability to the clinicians responsible for patient care. Effective functioning of the service line just like in the private sector has been made possible through allocation of autonomy to the clinicians in each department, by the clinical departments through the SLM; they have greater control over day to day activities as well as the long-term goals. A mature strategic, planning process of an organization lays emphasis on the satisfactory of the employees. The management lets the employees know the mission and objectives of the organization. As a result, they get engaged in their work, that is, they take pride in their work and even go an extra mile in offering their services such as customer care, being innovative and responsive to their respective departments. However, the trust has at some point experienced a shortage of employees (nurses and doctors). The current employees are forced to over work and at some point even fail to meet the demands. As a result, poor service delivery of service has been experienced, an extent that has made 42% of the employees say that they would not like they relatives to be treated from the hospital (Hope J, (2011).. Thus, it is clear that performance management has not been at its best. NHS’s accountability to the local and national government The term accountability gives a reflection of intelligibility and dependability. It calls for just and impartial governance from the leaders or administrators of any organization. There has been a revolution from the conventional secretarial in public administration into an advanced form of public accountability since the late twentieth century. The change from financial accountability to public accountability resulted to the prologue of New Public Management by Thatcher’s government in the United Kingdom and to the Reinventing Government reforms instigated by the Clinton-Gore administration in the United States. The named reforms led to the introduction of various private sector administration techniques and mechanisms into the public sector that is, contract management, employing of performance indicator and standards to monitor and evaluate the success and competence of public organizations (Pollitt & Bouckaert, 2005). In its efforts to demonstrate accountability to the national government, the NHS has a constitution that assigns the government to providing a statement of NHS accountability, which illustrates the system of liability and answerability of taking decisions in the NHS. The document gives a synopsis of the existing arrangement and function of the NHS. The NHS also, provides a clear and up-to-date financial statement per every financial year, which sums up all the activities that the organization has been learning in the given financial year (Department of Health, 2010). The public health sector demonstrates its accountability to the local and national authority by eliminating prejudice and discrimination. The health sector is based on two principles of same handling and opportunity. It delivers services that are delicate, fair and diverse encouraging a society that is improved and more contented (Blackman et al., 2008). As a result, the NHS is hence accountable to the patients it serves. The structural modification within the transformed health service along with well revealed administration failures have heightened attention in the planning for securing open accountability among the public in the health service. In the year 2011, the Health Department published its complete reply to the NHS future forum report, giving its projected amendments to its plans for the transformation of health and public care. Additionally the department of Health printed the NHS Constitution in March 2011. The constitution stipulated the directive doctrines of the NHS and the rights that every patient gets to enjoy (Department of Health, 2010). The rights encompass how every patient gets to access health care services, the quality of care that every patient is entitled to, the information, handling and programs that are available and finally the discretion and right to whine incase things get out of the way. The publishing of the constitution demonstrated one of the ways, in which NHS was accountable to the national government, by stipulating clear guidelines that would enhance NHS achieve its objectives. The NHS involves the local government (primary care trusts) in decision making about their services. The primary care trusts are engaged in setting up of health services, in making suggestions for adjustments in the rendering of services, and choices that will have an effect on the way services function (Department of Health, 2009). The primary care trusts then give the report to the public on how they have tabled their needs and how they are going to be executed. The NHS is also able to give its feedback to the local authorities through regular patient analysis. The NHS also demonstrates its accountability to the local authorities, by making the primary care trusts one of its members. The NHS members play a part in the running of the organization that is, they get to have a right to vote in elections for governors of the NHS foundation trust. The board of governors’ work hand in hand with the board of directors in ensuring that the wellbeing of the members is met in the way that the NHS foundation trust is administered (Department of Health, 2009). Additionally, the NHS listens and responds to the views of the Overview and scrutiny committees of the local authorities. The committees are made of local councilors, supported by the council officials (Department of Health, 2009). In the year 2011, the department of health gave a response report, emphasizing on a smaller number of national targets and more of the targets on the local authorities. Also, the NHS proposed transfer of more sovereignty to the NHS trusts in making administrative and medical decisions (Bruce & McConnell, 1998). Listening and acting on the views of the committees, clearly shows NHS transparency to the local authorities. The government, local authorities, non-governmental and voluntary organization, consumers, the parliament, employees and the media are some of the NHS stakeholders. More often, the stakeholders have the fear that efficient services might not continue for long due to unregistered success. They are interested with NHS accountability as it helps them in the evaluation process of the organization. NHS stakeholders have predetermined goals that they expect the NHS to fulfill. Some of these goals include, improving the quality and increasing the value of services, strengthening, developing and expanding the range of services provided, and finally, enhancing partnership arrangements to deliver a better range of integrated services. To ensure that their interests are met, the NHS is expected to be transparent and in a measurable way (accountable). Through evaluation of the service, the stakeholders are able to increase their control and thus, improve their health (Judd J et al., 2001). Additionally, they are able to realize and address any shortcomings. Nevertheless, the payers of the service (taxpayers) are interested in knowing how their money is used. The parliament funds the NHS through the department of health, thus; they are interested in knowing how well the funds allocated to the department of health are managed. A big portion of funds granted to the Department of health is directly allocated to the local organizations; the primary care trusts. The primary trusts assess the wants of the public and put in place the NHS services to meet those wants. As a result, the local organization is not only accountable to the central government, but also to the society. To ensure that they meet their goals, their interest on the accountability of the NHS is inevitable. The NHS has also well applied the principle of performance management in executing its objective of improving the quality of service delivered to its patients. The approach that the NHS has used to improve its service delivery is, first, defining the outcome objective that takes approximately three months, secondly, test the hypothesis and build in interest to know more, thirdly, test its applicability and identify the leaders. Finally, define the problem, and how it is to be solved and recruit people to carry out the task (Department of Health, 2009). NHS application of good practice and performance management has seen it register the following achievements in the financial year 2010-2011. One million women received cervical cancer screening test results within two weeks at sixteen pilot sites. This removed ten million waiting days, and an amount of 1.6 million pounds was saved (Department of Health, 2009). NHS prior planning enabled it detect that it had a financial shortage that needed immediate attention. To counter the shortage, partnership with the private sector was inevitable (Klein R, 2007). Conclusion NHS has well embraced the technique of performance management and also put good practice in to action. It is through this ways that the NHS has been able to register incredible development in the delivery of services to its patients compared to other countries like the US. Stakeholders play an important role in the execution of the organizations objectives, and the NHS has engaged its stakeholders in a positive way leading to its success. Reference List Blackman T; Wistow G. & Wistow J., (2008). Accountability for health: a scoping paper for the LGA health commission, Journal for Local Government Association, London. Boukaert G. & Pollitt C., (2000). Public Management Reform: A Comparative Analysis, Oxford: Oxford University Press. Bruce A. & McConnell A. (1998).Local Government and the NHS: Accountability in the Hollowed Out State, Journal of Public Policy and Administration, vol. 13, Pp 56-69. Department of Health, (2009).The statement of NHS Accountability for England: Publication policy and guidance. London. Department of Health, (2010). The NHS Constitution for England: Publication policy and guidance, London. Hope J., (2011).We wouldn't want family treated at OUR hospital say a third of NHS staff, Available at: < http://www.dailymail.co.uk/health/article-1366832/One-NHS-workers- NOT-recommend-hospital-treatment.html > [accessed on 1st June 2012] Judd J, Frankish J, & Moulton G., (2001) Setting standards in the evaluation of community- based health promotion programs— a unifying approach: Oxford Journal on Health Promotion International, Vol. 16 (4), Pp 367-380. Klein R., (2007).The new model NHS: performance, perceptions and expectations, Journal of British Medical Bulletin, vol. 81-82, Pp 39-50. Marks L. & Hunter D., (2007). Social Enterprises and the NHS, Changing patterns of Ownership and Accountability. London: UNISON. Scally G & Donaldson L. J., (1998) Clinical governance and the drive for quality improvement in the new NHS in England, British Medical Journal, 317(7150), pp.61-65. Read More