The Healthcare Components - Essay Example

The Healthcare Components Health care delivery system is one of vital component of NHS of the government. The healthcare components like accessibility to good medical care, quality and cost are increasingly moving beyond the grasp of general public. NHS is also affected by the rising cost which is affecting its overall performance in the core area of its activities. The NHS facing multi pronged problems needs to introduce some radical organizational changes to improve the health delivery systems. 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. We would be looking at the strategies and policies that NHS has introduced in East Neasden to improve its overall performance in health delivery system. According to the study, the committee that undertook the study 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. Therefore, the committee recommended radical reforms in the management process which was designed to influence and improve the overall performance of NHS. The introduction of new set of management structure, compromising of various levels of managerial staff are supposed to streamline the process of ‘command and control’ the organizational performance so as to effectively achieve organizational aims and objectives. The other issues that were the main concern of the authorities were the increasing cost and the low quality of health delivery system. The hospitals and healthcare centres were group into ‘units’ that was headed by a general manager. The individual units would be managed by managers and departmental heads. The unit manager would have the authority to allocate and utilize the budget as per the requirements and would also introduce short term objectives and target based practice with reward system. The general manager would be able to control the overall performance by effective control mechanism through line management relationship with unit managers and departmental heads. The administrative help of medical professionals would be confined to being that of ‘advisor’ to the management. The overall restructuring of management is assumed to promote more efficient health delivery system To facilitate better resource utilization, computers were also introduced and computerised data base was developed to help the management and the medical professionals to increase their efficiency with regard to accessibility of information of patients as well as that of goods and services. The non core activities like cleaning etc were given to private organization to better management the overall performance of NHS. These changes were implemented in East Neasden and brought about mixed reactions from the administration and various interest groups within the units. Department, looking after diabetes and eating disorder is one of the most important departments that diagnoses and provides dietary guideline to in-patients but its out-patients services also offers treatment and advice to local patients. Three major changes were observed in Neasden. First was that the units became more cost effective and the high rate of attrition was the second major change that became quite evident. Thirdly, there was gradual decrease in the team spirit. They were other changes and issues that developed over time and which would be discussed later on. The introduction of computers and forms greatly increased the efficiency of management information system and streamlined the in-house records of the patients. The redecoration and uniform for the receptionists also promoted a more professional look to NHS. The segregation of jobs within the medical professionals, in the units, helped to discipline the process of patient care and resulted in increase of number of patients that were offered medical services of different kinds. The patients are registered and passed on to the clinical staff that diagnoses them and then sends them to the dietician for diet details and then the patient is released. The management changes, that were brought about in East Neasden was not a huge success despite the fact that the overall cost per patient, visibly came down. The main reason that may be attributed could be the attrition rate of staff, especially nursing staff, some of whom were replaced by the part time nurses provided by the employment agencies. The unit saved the cost through these temporary nursing staffs who were employed part time. The new management did not see the attrition of employees as a concern and made no efforts to look into the deeper problems of the employees. In fact, the management turned it into a cost effective measures by employee part-time temporary staff from outside agencies. Implementing levels of patient care via clinical staff, dietician etc. made the overall delivery system more efficient. It was also the main reason for the increased number of patients that was looked after by the unit or the hospital. Segregation of job activities is very important for the effective implementation of core activities of the organization and for meeting the challenges of the organizational aims and objectives. But it is equally important that medical professionals must be given freedom to decide the needs of the patients. The management policy of curtailing and controlling the time, the medical professional spends with his or her patients not only interferes with the delivery of efficient services by the medical professionals but the such acts and policies of the management turn healthcare services into business proposals that are solely into profit making and disregard basic human interaction and sensitivity that is intrinsic part of health industry. Organizational changes are part of meeting the challenges of the changing times. But inn the case of implementing changes in the East Neasden, employees and other staff were not taken into confidence and the new management with new strategy was literally thrust on them. According to Marrow ‘the changes required by the welfare of the business become everybody's business and get made’ (Marrow, 1957, p. 66). Therefore, the management must make efforts to develop consensus through proper dissemination of information. It is important for the leaders and management of the organizations to promote empowerment of its staff through well designed process of problem solving and self learning through mutual cooperation and innovative management approach. In this particular case, the management believed in issuing ‘instructions’ and expected compliance which resulted in increasing absenteeism, both on the hospital and also in the monthly meetings of the staff by the management. The management lacked effective communication that encourages discussions and doubts clearing sessions and leaders must adapt such techniques to overcome resistance and create congenial atmosphere in the organization. Another issue that has considerable influence in the healthcare is that of cleanliness and hygiene. The management policy of outsourcing the cleaning department and making it a centralised strategy without any effective local control mechanism and accountability factors, was not only detrimental to patients’ healthcare but may become one of the major causes for unforeseen epidemic of diseases. One can conclude by saying that the increasing cost of living has wide ranging implications for one and all. The NHS too needs to implement changes for cost effective measures but it is important that it being a premier public institution designed to cater to the healthcare needs of its people, it must take into considerations the various factors that significantly affect the overall aims and objectives of the organization. It is also important that the changes must be accompanied through effective team work that make valuable contribution to the organization promoting a sense of togetherness and collective responsibility that reflects in the increased output and improved performance of the organization. Reference Marlow, Nigel. East Neasden: Efficiency in a unit of a district health authority. University of North London. Marrow, A. J. (1957). Making Management Human. New York: Mc-Graw-Hill Book Company. Read More