The NHS has grown and flourished to become the worlds largest publicly funded health service. Since its establishment in 1948, NHS is being funded centrally from national taxation, which explains the organisation’s accountability to the Parliament. The following is a report to the Managing Director, which makes comprehensive analyses of organisational behaviour in the NHS, in order to examine the effectiveness of NHS concept- Quality improvement and patient safety, is everyone’s business. This report will study the organisational structure of the NHS and identify the leadership styles mirrored in this organisation. This report will also discuss the application of motivational theory in the NHS and will examine the steps taken for innovation in the NHS. This report will study the concept and importance of team working and discuss the risk management process. Finally it will examine the role and responsibilities of the organisation in brief.
The primary aims of the NHS are promoting health are preventing ill health, diagnosing and treating injury and disease ……caring for those with long term illness and disability. The organisational structure of NHS broadly consists of activities such as task allocation, coordination, and supervision, which are directed towards the achievement of organisational aims. The NHS consists of several branches, departments and workgroups. In a wide spectrum, NHS can be viewed as encompassing two dimensions of healthcare: the Primary care and the Secondary Care. The Department of Health (DH) is responsible for funding, directing and supporting the NHS. The Primary Care Trusts assess local needs and commission care. Strategic Health Authorities (SHAS) adopt the responsibility for managing, monitoring and improving local health services.
Basic four types of organisational cultures can be identified in organisations. They are: collaborate, create, control and complete. The organisational structure of the NHS can be perceived as a cultural web, as proposed by Johnson (1995), comprising of intertwined elements of rituals such as ward rounds, shroud waving, infantilising patients; symbols or names/logos, big institutions…… and so on; power of doctors, professional bodies, prima donnas, OB networks; structure which is hierarchical, mechanistic and following a system of peaking order; incentives like private practice, merit awards and other professional recognitions; common myths like viewing change agents as ‘fools’; and communication through consultation episodes, financial reporting and waiting lists.
The cultural and structural impact of NHS has numerous effects. It provides a well organised structure for nationwide health service. It ensures satisfactory healthcare treatments to the patients and follow up their feedbacks. It also helps to identify serious cases of patients in terms of their condition of diseases and prioritise health service on emergency basis. It helps to maintain good communication between sectors and makes sure that the performance of NHS in every aspect is desirable to the demands of the nation as a whole.
It is evident that any improvement in the quality of care within the NHS requires an organisational change. This in turn calls for the need for effective leadership in the NHS. Leadership is also essential for any change management within the NHS. The ultimate aim of NHS is to ensure patient safety and for this leadership is vital importance. Contingency or situational leadership, which is contingent upon factors of situation, people, task, organisation and environmental variables, can be observed in NHS. Understanding this science of leadership, correlating the quality of outcomes, recognising the strength of distributive leadership a cross the clinical spectrum, positive role modelling, along with a supportive infrastructure and providing clear incentives can be identified as the enable to leadership development within the NHS.
Motivation can be described as the process of inspiring and encouraging employees to perform and stay with the company. This is an essential aspect for the proper functioning of the NHS. Theoretically, motivation is associated with needs, drives, goals and incentives. The concept of Maslow’s hierarchy can be applied to organisations, especially NHS, where the base of the hierarchy refers to sustaining legal requirements which gives the licence to operate. As one moves up the hierarchy health and well-being increases. The next level of the hierarchy is concerned with reacting to minimum targets in order to satisfy investors. One investors’ demands are met, one can move up the hierarchy to the next level which focuses on market leadership. Here the organisation sets its own destiny. The highest level of this hierarchy is concerned with making market, whereby the organisation realises and uses its potential to shape the destiny of others. Herzberg’s two factor theory of motivation in the context of NHS illustrates a broader perspective defined by hygiene factors and motivators. Salary and benefits, working conditions, company policy, status, job security, supervision and autonomy, office life and personal life constitute hygiene factors. On the other hand motivators comprises of achievement, recognition, job interest, responsibility and advancement.
Another element which is essential for the functioning and development of NHS is innovation. This generates flow of ideas and change so that the organisation itself can survive and develop overtime. It includes creativity, collaboration, spread and diffusion of ideas. With adequate funding from NHS and the Department of Trade and Industry move emphasis is now being placed on the adoption of healthcare technologies. NHS has now innovated two learning methods, which are E-learning and Interpersonal learning. E-learning is a means of learning using technology to enhance the traditional approach to learning, whereas interpersonal learning is when professionals learn from and about each other to improve collaboration and quality of care.
In the NHS, team working is of paramount importance, since the quality of performance, meetings, communication and integration processes in health care teams contributors to the introduction of new and improved ways of healthcare. It has to be borne in mind that clear leadership facilitates effective team processes, high quality patient care and innovation. In primary healthcare teams especially, a wide range of professional groups working together, can be witnessed and this is associated with higher levels of innovation in patient care.
Risk management is a process which, according to Burrows (2002), involves planning, organisation and direction of a programme that will identify, assess and ultimately control risks. This enhances the quality of treatment and care services through providing safer environment for staff, improving staff morale and productivity, preventing future incidents and reducing costs of replacement, repair and claims. Risk management process in the NHS involves the establishment of the context, identification of risks, analysis of the risks, evaluation of the risks and the actions to overcome risks. These require frequent communication, monitoring and review.
The NHS thus has the responsibility to establish policies and procedures. It must organise for risk management and encourage training and education of the staff and the public. NHS has to gather and share information as well as mange incidents manage claims and complaints. NHS must make it appoint to learn from these incidents and should take adequate measures to prevent future adverse incidents. NHS was born out of a long held ideal that good healthcare should be available to all regardless of health. This principle still remain at its core. It can be concluded this majestic organisation in England is the biggest part of the system in healthcare by far catering to a population of 52 million people and employing more than 1.4 million people. Strong team work and innovation are the key elements for ensuring quality improvement and patient safety in an organisation like the NHS. It is critical that, as an organization, it has the right people in place, people who can rise to new challenges, find innovative ways of working and motivate others to do the same, while never losing sight of values that underpin the foundation of the organisation. The NHS is growing and changing faster now than at any time in our history. The NHS is striving to deliver the highest levels of human knowledge and skill to save lives and improve health. It is the responsibility of the NHS to bring together a diverse work force that serves the diverse communities equally and shares the cultural values essential to provide the best services possible. The NHS must work continuously to improve quality and safety while making the most effective and sustainable use of resources. It is evident that NHS has a duty towards every patients it serves and must respect their rights. At the same time, it has a wider social duty to promote equality through the services it provides and to pay particular attention to groups or sections of society were improvements in health and life expectancy are not keeping pace with rest of the population. Thus NHS is an integrated system of organisations and services bound by principle and values.