Nhs

The NHS:

The spin stops here!

Jeremy Harris

November 2007

Organizational Behavior

Table of Contents

* . Introduction

* Aim and Objectives

* Methodology

* Follow The Leader.

* A Charismatic Leader to Change Culture?

* Managing the Changes

* Cultural Importance

* Conclusion

* Bibliography

Introduction

The National Health Service (NHS) is currently in a state of emergency and in dire need of reformation within the organisation. Malpractices, unnecessary deaths, and poor customer service has put the world's third largest employer under the microscope of government and public alike. The outcry for change has not only been an external plea from the public, but from within the organisation as well. Many of Britain's physicians are opting for the private sector, which has left the NHS to look abroad for doctors. A blurry sense of leadership within the NHS has undoubtedly led to confusion internally, causing friction between staff and management. The ancient methods used in the NHS have made it difficult for the organisation to implement new strategies and maintain a sustained competitive advantage over their competitors. A clear vision seems to be obsolete within the leadership which has led to uncertainty within the organization. "The NHS seems rapidly to be turning into the National Health Business' with an ethos and methods which feel alien to many of the staff expected to live with them." (Upton and Brooks 1995 p.xi). With ministers having the duty of reporting to parliament the desire to direct is an underlying problem within the leadership structure. With David Nicholson as the new chief executive of the NHS, the "song of rapid reformation" is being sung again. The NHS seems to be on the verge of turning a new chapter in its history. Mr Nicholson has conveyed hope within the organisation with his promise for a more advanced and reformed NHS.

Aim and Objectives

The aim of this report is to examine management changes needed within the organization to achieve success, and will endeavour to explore the behavioural and cultural obstacles faced by the organisation. An analysis of the leadership approach used within the organisation will be used to identify the cause and effects of the approach used. The main components of the NHS's competitive strategies will be discussed along with new initiatives introduced by the organisation to maintain sustainability. Finally the culture of the organisation will be discussed and methods used to motivate staff.

Methodology

The research for the report was carried out mainly through primary and secondary research. Personal observation and reviewing past interviews of NHS employees proved also to be relevant to the discussion on the subject of change. Being an American living in Britain I was able to compare and contrast the service of the NHS as a non-paying patient, and an insurance paying patient in the States. A various styles of leadership are used within the report to give the reader and synopsis of other styles used in a range of companies.

Follow The Leader.

Management and leadership in health care involve an individual's efforts to influence the behaviour of others' in providing direct, individualised, professional care. (La Monica 1994 p.xi). The aspect of leadership within the NHS has proved to be the most difficult challenge of the organisation. The NHS has failed in establishing a clear and sustained vision, due to the inability to retain a figurehead to lead the organisation. Robbins and Judge define leadership as the ability to influence a group toward the achievement of a vision or set of goals, which requires there be a vision in place before the leader can influence the organisation. Critic's see the three-tier leadership model of the NHS as ineffectual and does not give the organisation a clear leader and vision; on the other hand it creates an atmosphere of confusion in the organisation. As the NHS seeks to implement change this problem must be dealt with in order to proceed to the further steps. Influencing activities must become central in order for effective change to flow throughout the organisation; strong leadership will enhance this process. The current leadership structure has proved to be a failure internally and externally. Alan Johnson's idea to invite private companies to manage the NHS services proved to be an unsuccessful venture, and caused division within the organisation. The Adair leadership style was put in place by the health Secretary to improve services, and evaluate health needs of local people. Unison, the public service union, argued the private sector did not have the skills needed to commission healthcare for the vulnerable groups. In the concept of the managerial role, the main priority is the accomplishment of the organisational goals. The private companies had little if any familiarity with the goals of the NHS, and as a result were not able to spearhead the services in a patient focused direction. Although technical skills were evident, the private sector lacked human and conceptual skills which are crucial in being able to rationally process and interpret information.

The NHS utilizes elements of multiple leadership styles, which many has cited to its inability to uphold and implement strategies. Professor Aidan Halligan, a former joint senior responsible officer (SRO) for the National Programme for IT, has said "The NHS was suffering from a leadership void which had caused the service to lose its way....lack of leadership as a reason for the failure to take advantage of smart processes and enabling technology to deliver the quality of care that doctors wanted to see." The NHS approach to leading the organization has been seen as a tri-partite situational style. On the political front Prime Minister Gordon Brown has made implications of implementing new measures in the way funding is distributed within the NHS, whilst the health Secretary Alan Johnson expresses concern of the under funding of the NHS and seeks more money from the government