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FACILITATING CHANGE IN HEALTH AND SOCIAL CARE

Introduction
Change can be claimed as a critical component within the contemporary organisational ethos.
According to the critics sustainability of the business in terms of future success will
significantly rely on the ability of the business organisations to undertake change
management initiatives and adapt to the changing requirements of the environment. The
report has being developed to address the key issues arising in terms of the St. Anns Hospital
care quality inspection report.
To begin with the author will first identify and analyse the key drivers of change that is
driving the required change management initiatives and this will be carried out in terms of a
PEST, SWOT and force field analysis. Secondly the author will assess and analyse the impact
of the change initiatives on the social care industry and other respective industries. Moving
on the author will explain the key principles of change management along with how to
monitor recent changes within the health and social care services.

1.1 explain the key factors that drive change in health and social care services
Bardgett and Wardle (2010) clarify that change initiatives within the business organisations
will initiate with the process of identifying the changing drivers of the business. According to
them change initiatives could be resultant as a consequence of internal triggers as well as
external triggers that are manifesting the requirement for change. Furthermore it has being
outlined that the business will realise the requirements for change internally as well as
externally Christensen et al (2006). Based on the empirical evidence the author argues that
the assessment of the external factors that would drive change the practices within health and
social care will be addressed by using SWOT analysis and PEST analysis for the service
provider.
Table 1: PEST analysis
PEST Factors

Challenges/ Impacts

Actions/ Priorities

CQC (2014) outlines that when managing

Political factors

the hospital the service provides need to

Standing on the regulations that is

adhere to the requirements such as

guiding the health and social care

legislations underpinning.

industry it can be advocated that

For example : Health and social care act

service provider need to take

2008

proactive initiatives in terms of

Mental Health care act 1983 (Mental

complying with the rules and

Health Care, 2014)

regulations laid by the governments

This will enable the service provider


to develop a robust service to the
patients who are getting treated within
BBC (2014) indicates that the economic

the hospital with enhanced service

conditions are growing within United

quality which will secure a higher

Economical

Kingdom which will enable the business

quality of service that is being

factors

to grow the business conditions

provided to the patients.


The resulting consequence might
cause social factors to be moved to the

Social factors

Mental Health Statistics (2011) articulate

increased demand for services offered

that the unemployment, child poverty,

by the St Annes Hospital which need

debt and low income has resulted in

to be taken in to account by the

causing a lot of problems such as mental

service provider as it will have a

disorders

significant impact on the business.


The service provider Annes hospital
need to take precautions in
provisioning the same level of drugs
as others use in terms of serving the
patience. Further it is also important

Drug Scope (2012) accentuate that the

to note that service provider himself

service providers in terms of mental

needs to take initiatives in terms of

health care are continuously focussing on

conducting research and development

introducing new initiatives in terms of

initiatives to fund the required new

Technological

developments to the drugs used to treat

developments in terms of the drugs

factors

the patience

provided to the patience.

1.2 assess the challenges that key factors of change brings to health and social care services
As per the illustration within figure 1, St. Annes Hospital can utilise force field analysis in
terms of assessing and evaluating the change drivers of the business. According Hou and Han
(2005) change drivers will have a higher commitment in driving the change process within
the organisation and as opposed to this the resisting forces will have a higher force in terms
of the driving change initiatives of the business.

Driving forces

Resisting forces

People having a sense that they have

being treated with poor level of quality of


service This has being outlined as a minor
issue within the report however this might
trigger in to a consequence where the
significant impact might cause. It has being
identified that people within the St Annes
hospital was not treated properly where they
fail to meet the needs of the customers and
facilitate with proper care for the patience
(CQC Report, 2014)

Individual needs of the patients were


not met (CQC Report, 2014)

Planned activities in for the patients


not getting properly organised and
initiations are not taken to accommodate
them.

Failing to meet the changes required


by the June CQC Report that has being
given for the service provider

CQC (2014) outlines that they are

planning to initiate enforcement actions

Individual employees have failed to

against change which will require the

understand the duties and responsibilities

company to undertake relevant change

properly

initiatives

High reluctance to change

2.1 devise a strategy and criteria for measuring recent changes in health and social care
Considering the importance of change for the service provider in terms of the current issues
faced by the organisation it is critical for the hospital to implement a system which will
address the issues relative to the change initiatives of the hospital. CSIP (2008) reporting has
highlighted that a robust approach or a strategy which will enable the service providers to

measure the change initiatives again the planned change process is to adopt a balanced score
card approach which will address the following key questions and the criterions.
Benefits for people
Benefits for partnerships
Benefits for organisations
Benefits for systems
According to the above strategic dimensions the service provider can assess the change
initiatives within the service provider. Furthermore it has also being outlines by CSIP (2008)
those key principles that would underpin the above strategic dimensions as follows.
The benefits that has being outlined could be in terms of one individual or one stakeholder or
based on a group of individuals or stakeholder
A benefit is considered as benefit only when the respective recipient admit it
Benefits are considered as retrospective that is benefits will come into play afterwards that
they have being planned
Benefits that is realised for each group of stakeholders need to be in realisable terms that is
they need to be measurable and observable
Realising benefits have being outlined as: doing something new, doing things better and
ceasing to do something.
2.2 measure the impact of recent changes on health and social care services against set
criteria
CSIP (2008) has claimed that the eventual changes that are occurring within the social care
and health care services are of two fold, one which will consider as the major change
initiatives and the other change initiatives are minor change initiatives. However it has being
articulated that major change initiatives have the potential of having significant impact on the
overall organisations and further this will embrace the facts that change initiatives will
eventually have an impact across the health and social care industry. According to CSIP
(2008) the themes that has driven the change to the date has being emphasised where the key
themes can be clarified as the major change that has taken place within the recent past.
Table 3: Recent changes within the health and social care industry
Involvement

Benefits for people

Improving the facilities provided to the staff

This will enable the participants to gain a

in terms of the training and development in

significant level of confidence. Moreover

order to ensure enhances service for the

this will enable them to have more control

over the lives of the individuals. Also this


will contribute towards effective quality
improvements as well.
Benefits for partnerships
This will increase the eventual collaboration
among each other. Further this will also
allow the organisation to share the benefits
of the business as well. At the same time the
partners will be given and directed towards
accomplishing a common objective along
with sharing of good practices within the
business.
Benefits for organisation
This will ensure that the services are
appropriately targeted; further this will
improve the commitment from the
partnership within the service users as well
users.

along with coping with cultural changes.

Further allowing the users of the services to

Benefits for systems

be involved with the eventual planning and

This will ensure improved information

recruitment of the staff and empowering

systems along with the streamlined business

them in identifying the changing areas

practices. Further this will allow the service

within the service providers (CSIP, 2008).

provider to think strategically.

Dignity and respect

Benefits for people

This will allow the staff involved with the

This will allow the service users to feel that

service provision to developed personalised

they are treated with personalised attention

plans for the service users

and care along with respect.


Benefits for partnerships
This approach will ensure that service
providers will work in the intention of
providing excellent service to the users and
all the service that is focussed towards the
users
Benefits for organisation
This will enable the service provider to be

resourced with skilled group of individuals.


Also the service provider will be recognised
as an organisation which provides higher
level of service.
Benefits for systems
This will enable the business to be secured
with significant level of procedures and
policies to be followed.

Benefits for people


This will enable the business organisation to
maintain the independence and also
economic well being of the users and service
providers will also enhanced.
Benefits for partnerships
This will enable the service provider to
share the cost and furthermore the eventual
trust will also be increased.
Benefits for organisation
This will reduce the pressure for services
and also will improve the performance
assessment as well.
Meeting fundamental needs

Benefits for the systems

This is where changing the fundamentals of

This has the capacity of improving the

the organisation in order to enhance the

service levels of the organisation thus

quality of life and well being of the service

eventually enhancing the efficiency and also

users.

streamlined processes.

2.3 evaluate the overall impact of recent changes in health and social care
Pasmore et al eds. (2009) and Cummings & Worley (2008) have noted that every change
should have positive outcome through the organizations. The overall impact of changes in an
organization can be the efficiency of the employees, cost-benefit, case completion, referral
rates, waiting and response times etc.

Efficiency of an organization: Efficiency of an organization means how effective an


organization is to achieve its goals (Daft, 2009). Every organization should be more effective
after making any changes whatever it structural change, change in referral system or
relocation of services. Organisational efficiency mainly relates to the use of resources to
achieve best possible outcome which refers to the amount of resources an organization uses
in order to produce a unit of output. An organisation that maximises its resources in
production without waste is an efficient organization. For example, NHS and GP surgeries are
now becoming more efficient in terms of service delivery. Now if a patient changes their
appointment time more frequently, their registration may be cancelled. They need to pay for
re-registration. As a result, both clients and service providers are keen to maintain their
schedule strictly. So, the NHS authority may not have to pay extra to the GPs and doctors for
their unproductive works. As a result, NHS ranked first place among the countries in terms of
service delivery to the patients.
Cost-benefit: according to Dompere (2004), this is an idea that tries to fix if a project
worthwhile economically. The overall benefits should be greater than the costs. NHS as an
example is concerned about the patients in terms of how they can be treated and the success
rate of surgeries can be hundred percent. The NHS authority is also concerned about the
hospital and surgery procedures, how doctors, surgeons, nurses and other clinicians perform
with the skills and abilities. It is a government organization. So, profit does not take into
account but it needs to take into account that how many and what kinds of patients they have
served and what is the outcome based on the cost. Though the intension of NHS is not to
make profit but they should balance the cost with service outcome to be a cost effective
organization.
Referral rates: Baker et al (2006) have stated that, referral system in health care means having
a relationship between a primary health care provider and a higher-level hospital during the
transfer and discharge of a patient. In the UK, General Practioners (GPs) are responsible to
see and for the primary diagnose of disease of a patient. If they fail to diagnose or give a
solution to the patient, then the patients are sent to higher level hospital where they are
treated by the specialist doctors. The effectiveness of a GP can be measured by the referral
rates, well-being of the patients, number of cured patients etc. Once it was a time, the referral
rates of the GPs were very high as sometimes they did not try their level best to serve a
patient. In that time the GPs had no rewards in terms of service delivery. But now NHS has
been re-structured and GPs who have high referral rates are marked as non-effective. So, they
have to take compulsory training to increase their service outcome. Now, the overall referral
rates are falling gradually and patients are getting good service because of these changes.
Waiting and response time: Anon (n.d.) has shown that waiting and response time of the
patient is still significantly high though the department of health has been re-structured. But
the overall waiting and response time is falling day by day as the NHS is trying to digitalize
the whole organization. Also, they have planned to work along with the private hospitals to
give the fastest and best possible care to the patients.

2.4 propose appropriate service responses to recent changes in health and social care
services

3.1 explain the key principles of change management


Paton and McCalman (2008) accentuate that change is the process of improving the
organisational current performance and transforming the current organisational processes to
be in line with the future business conditions. Further they argue change management will
facilitate eventual enhancement and effectiveness in processes in terms of the performance
improvement for the business organisation. However in contrary Oakland and Tanner (2007)
state that change management is the process of an emotional bond where the change leaders
need to take the buy in from all the change implementers in order to ensure the success of
change management. Therefore the author concludes that change management is the process
of transforming the organisation from one state to another through effective leadership
approaches while ensuring the creation of a friendly environment for the change to occur
(Nickols, 2010).
Despite of the fact that change management need effective leadership and management
approaches it has being emphasised by the scholars that people or the change implementers
within the organisation are lacking the respective motive in terms of implementing the change
process (Kramer and Magee, 2007). The management of the resistance has being emphasised
as a critical component within the change management process (Kotter, 2008). Based on
these grounds Kotter (2008) proposes a model to be used in ensuring effective change
management and managing the eventual resistance from the subsequent users who ate
engaged within the change management process (Moran and Brightman, 2001).
Table 4: Kotters Model overview

Suggestions for the social and health care


Steps within the process

organisation
This process would involve evaluation and
assessment of the market forces and
respective competitive initiatives.
Furthermore this would also involve
initiatives in terms of developing future
direction for the business organisation along
with assessing the evidence to emphasise the

Creation of a sense of urgency

requirement of change.

Developing the leading team

This step will require developing people

from different department to accomplish the


change objectives. Furthermore this process
will also involve encouraging the team work
among the members to work in collaboration
as a team.
This will involve developing a vision that
will enable the successful change process
and also the service organisation will be in a
position to develop strategies to accomplish
Developing a vision

the eventual vision of the business


This is where company need to seek
building up engagement and commitment of
the employees through stories and the
communication need to be precise and

Communication for buy in

simple
This is where the organisation need to take
initiatives to remove the obstacles for the
change and also change structure and vision
need to be aligned with the vision of the

Empowering action

change strategy
This is where the short term wins are created
and the rewards need to be granted for the

Creating short term wins

participants
Further it is important to create performance
improvements and recognise and rewards

Do not let up

personnel involved in the improvements


Need to articulate the connection between

Make change stick

new behaviours and the corporate success

Burnes (2004) claims that Kurt Lewin has emphasised the importance of understanding the
change drivers and resisting forces (Macadam, 2006) and based on these grounds he has
developed a force field analysis to assess the forces that would support for the change
management within the organisation. According to Golber and Lewin (2004) the success of
the change management programme will significantly rely on the strength and possibility or
the higher level of driving forces and it has being identified that driving forces need to be

more than the resisting forces in order to ensure successful transformation of the change
process.
According to Lewins change model it can be claimed that it is important to first unfreeze the
current status of the business. This will involve business organisations emphasising the
positive attributes that is likely to be realised as a consequence of the change process will
take initiatives in order to promote the driving forces of change of the business. Moving on
the change phase would involve managing the change within the business in such a way
where the resistance to change is minimised. Similarly the refreeze phase would involve
establishing the new policies and procedures of the business and also this will require
recognition and appreciation in terms of the new change approaches that is being taken by the
business as well.
3.2 explain how changes in health and social care are planned
Change initiatives within the social care are planned once a quality inspection report has
being released with relevant to the particular social care service organisation. This is because
this will highlight and emphasise the quality issues that are revolving around the organisation
and the service provider will have to amend and adjust the required changes in order to be
outperforming within the industry. Furthermore based on the changing business practices that
are based on the needs of quality enhancement requirements and external regulatory
requirements the business will undertake change initiatives in order to be in line with the
changing business practices and regulations.
3.3 assess how to monitor recent changes in health and social care services.
To monitor the recent changes in health and social care services it can be advisable that
business or the service provider can undertake a PEST analysis whereby the each factor
within the PEST factors might have caused the changes for the service (Armstrong, 2009).
Furthermore it is also important to understand the eventual quality change requirements
within the business as well in order to facilitate change within the social and health care
service. At the same time based on the regulations within the industry it is essential to
develop processes and policies to implement and this will lead the need for change for the
organisation.
Conclusion
This report has being developed to assess the importance of change management practices in
social and health care services. Overall report has being developed to address the issues that
is underpinning within St Annes hospital in terms of the CQC report which has being
recently prepared. The report reveals that the business or the service provider currently facing
many issues in terms of the quality issues that is prevalent within the business organisation.
Further it has being appraised that within the social and health care industries undertaking
change is critical as it will have a significant impact on the service users as well as the service
providers. Further it has being emphasised that the change management is critical for the
service organisation, this is because the change is the process of transforming the service

from one state to another and this has being assessed in terms of the social and health care
industry. Further the relevance and procedures undertaken to monitor the health and social
care change management initiatives also have being emphasised within the report content.
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