MOD004054

Healthcare Environment
Structure, Culture and the Healthcare Manager Essay

(Word Count: 3332)

Contents
Introduction:................................................................................................................................................1

1. Role of a Healthcare manager in managing learning disabilities:............................................................2

Importance of Healthcare Management:..................................................................................................2

Roles of a Healthcare Manager................................................................................................................3

2. Impact of Organisational Structure on Organisational Culture................................................................5

Structure of the local hospital..................................................................................................................5

Structure of Age UK................................................................................................................................6

Difference in culture................................................................................................................................6

Impact of change on local hospital’s culture............................................................................................7

Impact of change on Age UK’s culture...................................................................................................7

3. Different Organisational Structures In Business, Health And Social Care Organisations........................8

The health and social care structure.........................................................................................................8

Difference between business and Healthcare structure............................................................................9

Optimal structure for my healthcare institution.....................................................................................11

Conclusion.................................................................................................................................................13

References.................................................................................................................................................14
Introduction:

Healthcare management is one of the most researched topic in the modern medical discipline. Recently

due to covid-19 pandemic, the health and social care sector of the United Kingdom was pushed to it's

limits. There was about 1.738 million Covid-19 cases in 2020. Hospitals and Healthcare facilities were

overwhelmed to provide lifesaving service to such an immense number of critical patients. There was a

nationwide crisis of personal protection equipment, medical equipment, medicines, and health care

personnel. The NHS had to cut down its budget from different projects and reroute those funds to fighting

the pandemic. This catastrophic event gave is a glimpse of how important healthcare management is in a

situation like this. It is the duty of the healthcare manager to utilise the organisational structure of the

healthcare facility to manage and mobilise resources to handle healthcare crisis. This assignment will

focus exactly on the duties and responsibilities of a healthcare manager in determining and utilising the

care structure to provide the best support to those who need it the most.

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1. Role of a Healthcare manager in managing learning disabilities:

Healthcare manager is the person responsible for coordinating and leading the effort to provide optimal

care service to a patient. Care Management is a integrated approach to medical service. A Healthcare

manager mobilises health Care professionals from different backgrounds to provide a care package that

will improve the condition of a complex patient (King, 2000). Healthcare management is a common

practice in the sphere of patients with learning disability. Learning disability is the cognitive inability to

understand and preserve information in the brain (Forrester‐Jones, 2006). Learning disability is mostly

common in young children. This type of impairment hinders the ability of a child to read or learn

anything in the conventional process.

Importance of Healthcare Management:

Using Healthcare management to provide medical service to people with learning disability has become

of utmost importance. Providing Medical and Rehabilitation service is a requirement for all the health

system as stated in the policy “Compassion in Practice “by the Department of Health (2012). In a recent

census it was found that about 1.5 million people in the UK are suffering from some extent of learning

disability. Almost 24 percent of these people are children and minors below the age of 17 (Levy and

Tedstone, 2017). These individuals young and adults alike face living a normal life as a challenge. They

are unable to achieve conventional education, or get employment in wage earning activities. The

Government of UK has decided that the integration of people with learning disability into our society

needs to happen through the coordinated approach of healthcare professionals. To have these people live

a healthy and normal life and give them an opportunity to gain financial independence, the Care Act

(2014) act requires the establishment of specialised education and vocational opportunities. Helping the

patients with their difficulty in learning capacity is another concern of the NHS. Behavioral therapy,

cognitive therapy and occupational therapy specialists must coordinate to provide medical care to these

patients.

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Roles of a Healthcare Manager

It is the duty of the Healthcare manager to determine the best combination of care services to be provided

to a person with learning disability. The combination and management of care services may vary due to

the type of learning disability and the extent to which the patient is affected by it (Forrester‐Jones, 2006).

Regardless of this the broad responsibilities of Healthcare manager in providing service to people with

learning disabilities are discussed below.

One of the significant challenges that a person with learning disability faces is to find a suitable housing

that accommodates the special needs of the patient. Patients with learning disability find it hard to

understand the use of common household objects. So it might become necessity to provide the patient

with specially made household objects. The house needs to be easily accessible and free of complex

mechanisms that are used in day to day life of people. A person with learning disability often find it a

daunting task to operate electronic devices such as the washing machine or the microwave oven. It is the

duty of the Healthcare manager to determine the ability of the patient to use these devices (Baum, 2006).

If the patients exhibit the inability to operate Complex machinery, the Healthcare manager must describe

the use of simplified and specialised version of these machines. There are electronic home appliances in

the market available for people with disabilities.

The Healthcare manager must consult with healthcare experts from different backgrounds to determine

the best course of therapy to be provided to patient with learning disability. Physical therapies along with

occupational therapy have been proven as three times more effective in reinstating learning capacity in

patients (Atkinson, 2015). Particularly in young patients, and prescription of occupational therapy can

lead to normal learning capacity. Show the health care manager must be vigilant in determining the

condition of a young patient. It has been found that learning disability can be caused due to neurological

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damage or abnormality. In such cases occupational therapy along with medication can lead to

improvement of cognitive ability of the patient.

Patients with learning disability need accessibility to Healthcare. Often these types of patients are the

most vulnerable parts of a society. It is the duty of the Healthcare system to provide them accessibility to

health care even if they are not able to afford it (Gibbs, 2009). Learning disability inherited from birth is

required to be kept under constant supervision of pediatric psychotherapy specialist as mentioned in the

Care Act (2014). The help manager must assign growth and learning development inspector for a child

born with learning disability to keep track of the development of the patient's condition. Learning

disability in adults needs to be kept under the supervision of specialised nurse. The community health

care structure will provide these individuals accessibility to cognitive therapy sessions and support

instruments for the maximum amount of 1000 pounds (Levy and Tedstone, 2017). This ensures that no

individual is unable to access Healthcare due to financial problems.

Occupational therapy is a type of rehabilitation practice that focuses on improving the capacity of a

patient to participate in day to day activities and operation of common household instruments to improve

the quality and independence of living in patients with impairments (Mansell, 2008). Atkinson (2015)

concludes that occupational therapy in patients with learning disability along with medication can help

the patient improve cognitive ability by 38%. There is a wide range of occupational therapy is available

for patients with learning disabilities. It is the duty of the help manager to referred the patient to a

psychotherapist who will determine the appropriate educational occupational therapy program in which

the patient needs to be enrolled in. Determining that type of learning disability is a vital precursor to

providing occupational therapy. Proper psychometric evaluation of the patient can help the help manager

determine the best course of action for the betterment of the patient.

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In modern medical science healthcare management serves as the cornerstone for providing beneficial

medical service to a patient. People with learning disabilities often find a difficult to explain the

impairment and problems they are facing. It is the duty of the healthcare manager to assume leadership

role in evaluating, prescribing and managing a coordinated effort to provide medical service to the

patient.

2. Impact of Organisational Structure on Organisational Culture.

Organisational structure is a key ingredient of any profit or nonprofit entity. Turi and Sorooshian (2019)

define organisational structure as a standardised channel for flow of information, responsibilities and

feedback from one point to another point within the organisation. The organisational structure of a

Healthcare facility is different from the organisation of structure of a business entity. The organisational

structure of a health Care facility is also known as care structure. Care structure is defined as the network

established across multi-disciplinary medical backgrounds to facilitate the flow of information and

specialist consultation under broad divisional management (Nierman, 2002).

Structure of the local hospital

One of the most prominent organisational structures in local small Healthcare facilities is based on

hierarchy. Hierarchical organisational structures have levels of Management. Usually in this type of

organisational structure authority resides with the top level management. The top level management takes

decisions regarding the broad aspects of the organisation, while the lower level of management are

responsible for carrying out those decisions (Mathumbu and Dodd, 2013). The hierarchical structure of

the local Hospital constituted the following parties responsible for the management of the organisation.

Firstly the governing board is responsible for making abroad Healthcare and management decisions.

While the executive are responsible for handling the day-to-day business operations of the hospital.

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Department administrators perform daily activities of their respective department and report to the

executives. Patient care Manager manage a small group of Health Care professionals who provide direct

service to the patients. And finally that service providers comprise of all the nurses, doctors, therapists,

and clerks who are involved in direct care giving (Nene and Pillay, 2019).

Structure of Age UK

Age UK is a nationwide charitable Organisation in the United Kingdom that provides Healthcare services

to the elderly population (Lluberas and Gardner, 2013). Age UK has broader field of operation, that's why

they have a totally different organisational structure from that of a local Health Care facility. Age UK is

known to have a divisional organisational structure. The Divisional organisational structure is type of

organisational structure where the organisational functions are grouped into different self-sufficient

divisions. Each division has access to all the necessary resources it needs to function independently of

other divisions (Bennett, 2004).

Difference in culture

The organisational structure is a major indicator for the organisational culture. Organisational culture is a

set of norms values and beliefs that guide the employee workforce towards the achievement of

organisational goal (Nene and Pillay, 2019). Any sudden change in the organisational culture can bring

about resistance from the workforce. It is the duty of a manager to successfully introduce new cultural

elements in the pre existing one.

The organisational culture of a local Hospital is influenced by is hierarchy based organisation structure.

This means the local Hospital depends on the decision making of the top level management and have little

capacity to choose independent course of action. On the other hand the organisational culture of Age UK

is very much influence by the Divisional organisational structure. This means the organisational culture of

Age UK relies on the capacity of the workforce to make educated independent choices. The

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organisational structure requires the workforce to be highly effective and specialised in their own field of

work.

Impact of change on local hospital’s culture

If the local hospital and the Age UK is merged together to provide better Healthcare during this troubling

time of economic crisis, there will be a significant impact on the organisational culture of the small

hospital. In the event of a Merger, the local Hospital Vin come under the jurisdiction of Age UK. The

local Hospital will have to abandon it hierarchy based organisational structure and must Reform itself to

integrate itself into the divisional organisational structure of Age UK. This will result in a major cultural

shock. As the local Hospital is not accustomed to making independent choices, they will find it difficult to

operate freely under Age UK. The workforce of the local Hospital will also have to deal with increased

amount of official paperwork. This will require the hospital to educate Their employees regarding the

forms and formalities of operating under a sophisticated organisation like Age UK. Also the hospital must

facilitate healthcare services primarily for the elderly population. This will impact the organisational

structure of the local general hospital as they will have to educate themselves on providing specialised

care to senior citisens (Nene and Pillay, 2019). The hospital will have to integrate its patient management

structure with the guideline of Age UK.

Impact of change on Age UK’s culture

In the event of the Merger between the local hospital and Age UK, there will be significant impact on the

organisational structure of Age UK. Assuming that Age UK will be taking the leadership role in this

Merger, it will not have to change its organisational structure. Rather Age UK will absorb the

organisational structure of the local Hospital (Nierman, 2002). However Age UK will need to mobilise

resources to first structural support to the local Hospital.

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The organisational structure of a Healthcare facility helps provide better Healthcare service to the

community. These organisational structures are mediators of organisational culture in Healthcare

facilities. Often the structure and culture is reliant on the scope and sise of the Healthcare facility. A small

local hospital might have an organisational culture that is highly centralised while a large health Care

Foundation will often have a decentralised independent organisational structure. Regardless of the current

organisational structure, healthcare facilities must always be ready to adopt a new system to provide

better Healthcare services to the patients (Mathumbu and Dodd, 2013). In the current economic situation,

the merger of different Healthcare institution will become common. This will be done with the aim to

provide better Healthcare services. It is the duty of a Healthcare manager to facilitate such changes with

minimum level of friction.

3. Different Organisational Structures In Business, Health And Social Care

Organisations.

Organisational structure is the skeleton of hay business for Healthcare institution. Organisational structure

determines the flow of decisions responsibilities coordination and communication throughout different

level of management within a organisational entity (Turi and Sorooshian, 2019). The organisation of

structure of a business entity helps it to direct the available resources to achieve profitability and long

term growth. Business organisations perform within the sphere of different types of organisational

structure with a common goal of achieving profitability and competitiveness in market (Kim, 2016).

There are slight differences between the organisational structure of a business and a health and social care

entity.

The health and social care structure

The organisational structure of Health and social care institution does not always focus on maximizing

profit or achieving competitiveness in the market. Rather the main focus of Healthcare organisational

structures is to create a system for providing medical support to patient in the most efficient manner

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(Mathumbu and Dodd, 2013). The organisational structure of a Healthcare facility is also known as care

structure. It is defined as a multidisciplinary network facilitating the flow of information and consultation

to better manage the condition of a patient (Nierman, 2002). Structures are adapted with a view to

improve the quality of service provided by healthcare institutions. The Healthcare manager are

responsible for coordinating the collaboration of medical Specialists from different medical backgrounds.

Difference between business and Healthcare structure

There are different types of organisational structures available in the health and social Care industry.

Which organisational structure is the most optimal is a matter of debate. In recent years the United

Kingdom has experienced adaptation of many experimental organisational structures in the Healthcare

industry. Basically there are three broad types of organisational structure available.

Figure: Broad organisational structure types (King, 2000).

In a hierarchical organisational structure people associated with primary and secondary care are

vertically integrated in the same organisation. Under this organisational structure coordination of

activities is done through a chain of command (Alwazzan, 2018).

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There are some benefits of adopting a hierarchical organisation of structure in a Healthcare facility.

Namely this structure provides a better control over operational and financial functions of the health Care

institution. The functions of the Healthcare institution can be standardised and made efficient under this

system. Organisation can achieve economic of scale by using employment contracts. This helps the

organisation to generate loyalty to the common purpose of the organisation. Also in a hierarchy based

organisational structure decisions are made quickly which can be vital in complex medical issues.

However, this type of chain of command organisational structure provide little to no flexibility. The lack

of flexibility can cause the institution form providing the best service the Specialists can provide

(Alwazzan, 2018).

In contrast to hierarchical organisational structure, the market structure comprised of individual legal

entity with separate attachments operating independently in the market. The nature of healthcare in this

structure is dependent on the supply and demand along with the level of prices (Holmes, 2007).

The market organisational structure keeps Health Care facility free from long-term attachments. This

provides a level of autonomy to the institution that help it to direct its operations towards the betterment

of the patient and the institution. Market organisational structures provide a great deal of flexibility to the

organisation and help it improve its efficiency. However the market structure relies heavily on the mutual

understanding of different Healthcare entities participating in the market. This can be hard to achieve as it

relies heavily on legal contracts. Having this type of legal complexity can we reduce the coordination

capacity of the organisation. This also gives rise to transaction cost of preparing and monitoring legal

contracts. Market competition may lead to market fragmentation (McCourt, Rayment, Rance and Sandall,

2012).

To avoid the rigidity of hierarchy based organisational structure and the risk associated with market

structure a network structure is established. In a network structure healthcare organisations retain their

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Independence and autonomy but maintaining connection like market structure (Steyn, 2020). This type of

organisational structure helps different health and social care institutions to build a relationship based on

trust and risk sharing.

So it is evident that network organisational structure helps the organization to harness the market

understanding among institutions reducing the transactional costs. Network structure is optimal for

Institutions with Complex services. This makes it one of the most suitable structures for a health and

social care institution. It provides the institution with flexibility of market structure without the rigidity of

the hierarchy. However one shortcoming of this structure is that building long term relationship based on

trust and reciprocity is really hard (Hüttl and Nagy, 2017).

Optimal structure for my healthcare institution

Upon being approached by clinical commissioning group (CCG) to establish are Healthcare organisation

for promoting public Health awareness within the borough of Lambeth, I will choose the hierarchical

structure. I chose the more rigid hierarchical structure because it is necessary to have a centralised chain

of command to operate a new organisation. To make a new organisation successful in the highly

competitive market, the need of making quick decisions is necessary (Holmes, 2007). The hierarchical

structure provides the most efficient decision making process. Also a new organisation needs to have

standardised process of operation to survive in the preliminary stages. The hierarchical structure ensure

that functions of the organisation are standardised. The hierarchical structure is also free from

transactional costs. Keeping the cost of the organisation minimum is the key to Survival for a new

organisation (Kim, 2016). That is why I choose the hierarchical organisational structure for my new

Healthcare organisation.

Having a thorough understanding of all the available organisational structure and their mode of functions

has let me choose the hierarchical organisational structure as the optimal structure for my Healthcare

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organisation. It will be my duty as a capable Healthcare manager to introduce necessary changes in the

organisational structure in the future.

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Conclusion

This assignment provided us with a clear understanding of the roles and responsibilities of a Healthcare

manager in providing optimal Health Care Regime for a critical patient. The leadership and management

capacity of the Healthcare manager serves as the main facilitator of coordinated effort toward patient well

being. We also saw how the Healthcare manager can utilise different types of organisational structures to

create a organisational culture of multidisciplinary coordination based on trust and risk sharing. By

evaluating each type of organisational structure available for a Healthcare institution, we found that

different structures have their own unique set of advantage and disadvantages. Depending on these, a

decision was made to choose the hierarchical organisational structure to establish a Health Care facility in

the borough of Lambeth.

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