Facilitating Change in Health and Social Care

PART 1

Key factors driving change in health and social care services

Change is inherent and necessary in every sector and the evolution of the practices in the sector from its traditional ways to the newer ways have always been beneficial for the organizations. However, this transition of leaving the older practice and moving to the newer practices is not a natural process and involves lot of obstacles. The decision to establish and implement a legal framework termed as the Care Act, 2014; has been presented due to a number of drivers in the health and social care services sector that demanded that a comprehensive legal system be implemented in UK that will govern all the healthcare institutes.

Economic Criteria: There were variety of funding reforms that were proposed under the Care Act, 2014 such as a cap on the care costs etc. that ensured that the people were covered or were given the financial assistance that they required but only when they met the criteria set. The act also proposed that the patients that will be given free treatment are allowed only when they are found to be in need of such free primary care (Bearak and et.al.,  2016). The previous law lacked any of such funding reforms and the financial assistance was being given even to those who did not require it or could bear the financial expenses that were incurred.

Redundancy of the legislation in existing healthcare system: The current healthcare system that was being used or implemented in UK was 60 years old and there were many aspects where it lagged behind such as lack of any fool proof legislation that did not govern the activities of the healthcare providers adequately and lacked a substantial eligibility criteria.

Demographic Eligibility Criteria: The Care Act, 2014; rather than leaving it on to the local healthcare providers in deciding what were the criteria that patient required to meet before being given the treatments were standardized by the care act where they specified he eligibility criteria that the patient were required to meet in order to be eligible to receive treatment for the healthcare providers (Han and et.al.,  2018)).

Society Factors: The carers i.e. the care takers in such healthcare facilities did not have a legal framework covering up their right and duties and this Care Act, 2014 was necessary to address those aspects as well. The act specified the roles and responsibilities of the carers as well as the local councils so that the rights of both could be effectively protected. The act also helped in developing a care funding for the carers who were living in the healthcare facilities on a permanent basis.

Sectoral Factors: Another major driver for change was the fact that there was a loot of redundancy in the existing principles that were applicable in the health and social care (Shartzer, Long, and Anderson, 2016). The need for specialized services was increasing and the composition of the workforce in this sector also needed to be modified and additionally, the need to develop systems based on ICT was also rising. All these requirements for change led to the pavement of the way for need of the Care Act, 2014 which covered all these aspects effectively.

Challenges associated with key drivers of change

The implementation of the change that has been ascertained involves many challenges that are to be overcome before it can be successfully implemented:

• Resistance and Apathy: Whenever a change is proposed, the professional working in healthcare sector, the patients, workers etc. all tend to revolt or resist the changes that have been proposed and therefore by making them understandable to the workers, this barrier can be effectively addressed.
• Importance of CPD and ICT integration: The continuous professional development is a necessary aspect in implementing the change that has been proposed effectively and therefore even if the workers or employees might not understand or fully acknowledge the change that has been proposed, it is necessary to implement the changes that have been proposed (Chen and et.al., 2016). When ICT is integrated in the organization, it is necessary to give adequate training to employees so that they can use it effectively and this might not be possible due to the heavy workloads.
• Maintaining quality care: The change that has ben proposed through the Care Act, 2014, will definitely improve the current status of the quality of care that is given in healthcare settings. Therefore, ensuring that the policy is correctly implemented in a manner that ill add on to the current quality level in the healthcare sector is a very crucial aspect.
• Matching efficiency and economy: The change that have been proposed through the Care Act, 2014 is most likely to bring a gap between the cost incurred in implementing the proposed changes and the efficiency in the services that will be added in the healthcare services (Ginossar and et.al., 2019). For instance, the carers are given multiple rights and assistance under the care act and this can be beneficial for a certain time but the increased financial strain on the management might lead to difficulties in accepting the change that has been proposed.
• Human and Financial Resources: The human and financial resources are already well funded and managed in the healthcare service institutes in UK but this can pose additional challenges because the care act might give higher priority to the one sector of employees and thus this might not be able to be implemented in the manner it was intended (Imran and et.al., 2016).

Therefore, there are many challenges in implementing the challenges that have been proposed under the implementation of the Care Act, 2014 in the health and social care services in UK.

PART 2

There have been many recent changes in the healthcare sector of UK such as the Health and Social Care Act implementation in 2012, increased role of the NICE and its guidelines, increased integration with IT programmes, enhanced security and inspection measures etc. and all these have affected the existing manner in which the healthcare sector used to operate in UK.

Strategies and criteria to measure recent changes in health and social care

There are various strategies that can be recommended in order to monitor and evaluate the recent changes that have been proposed:

Regulatory Inspections: The healthcare institutes should try to conduct regular inspections after the change has been implemented i.e. in the current case, after the implementation of the Care Act, 2014, the organizations need to evaluate the efficiency with which the changes under this Act have been implemented and whether the purpose with which these changes were proposed have been fulfilled or not (Hernandez-Boussard and et.al., 2016). These ensure that the compliance to the Act is proper and the regulatory inspections also ensure that all the aspects are being implemented properly.

Organizational system for Quality Assurance: The quality assurance helps in evaluating that whether the implementation of the proposed changes have enhanced the quality or not. The care that is being given must meet all the quality standards and criteria i.e. in context of the quality of services given by carers, the adeptness of the medical professionals etc. and the Care Act must be evaluated in these terms to ensure its efficient applicability.

Feedback: Feedback is another strategy where the management of the healthcare facilities can take regular comments and feedbacks from their employees i.e. that applicability of the Act is done adequately or not, whether all the aspects have been covered or if some improvements need to be incorporated etc. these help in identifying what are those areas where implementation of strategies has not been proper (Guiette and Vandenbempt, 2017).

Similarly, there are various criteria that can be set in order to ensure that the adherence to the intended changes is met satisfactorily:

• Meeting National Objectives where the healthcare services given across entire UK gets improved and integrated.
• Improving the quality of life and the mental well- being of the targeted audience for whom the change has been developed.
• Criteria for organization such as increased efficiency, better understanding, increase in the skills of the workforce, giving specialized or targeted services are some evaluating criteria that can help in judging whether the change has benefited on an organizational level or not.

Measuring the impact of recent changes against the criteria set

When evaluating the implementation of the Care Act, 2014 in the health and social care organizations as against the criteria that were identified above, it can be stated that the issues collectively have been met adequately (Davidoff and et.al., 2018).

• The implementation of Care Act for the organizations have been beneficial because the number of patients that are now enrolling under the Care Act, 2014 have increased thus showing that people are satisfied from the services that they are receiving now.
• The carers have been provided with increased facilities and therefore their dedication level towards giving the services to the patients has increased thus increasing the quality of the services that are being provided now.
• The improved access to healthcare benefits have led to an overall improvement in the national health demographics of the country and therefore it can be said that the Care Act has succeeded under the health and social care services in UK.
• Benefits to the users and the associated parties: The Care act has ensures that the quality of care that will be given to the patients has improved because of the standardized care guidelines that have been proposed in the Act (Taube-Schiff and et.al., 2017). This has increased the satisfaction level of the friends and family as well.
• Delivery and referral rates: The referral rates especially in government healthcare services has increased because only when the patients will be satisfied of the care and treatment that he received, he will recommend it to someone else.
• Waiting time and response times: Because of the development of the eligibility criteria, the number of patients that can be qualified for receiving treatment has reduced and therefore the waiting time has automatically declined. This decline in waiting time has received a great degree of approval amongst the patients or people of UK.
• Cost- Benefits: The cost benefits have been profitable because of the decreased number of patients that are receiving free treatment care and the benefits for carers have been increased thus increasing the quality of care being provided giving double benefits.

Evaluating the overall impact

Proposed responses to the changes

Updated procedures and policies: After the Care Act has been implemented, it can be proposed that the policies and procedures of the organization are made more employee friendly and flexible so that they can adapt to the changes that have been implemented more flexibly.

Leadership facilitating change: When the changes will be implemented, people i.e. employees often tend to resist it and this is mainly due to lack of appropriate leadership (Han and et.al.,  2018). When the employees will be assisted in the changes that they are implementing by their leaders, then the ease will increase automatically.

Employee Participation: This is the most important key in increasing the flexibility in the implementation of the proposed changes and this is because when adequate feedback will be taken from the employees that are actually implementing the changes, then their understanding will increase along with the more effective change implementation.

PART 3

Key principles of change management

Change management can be facilitated by using and implementing change models such as:

• Lewin Change Model: There are three steps under this model where the existing system is changed and modified i.e. at the Unfreezing stage, where the redundancy and inadequateness of the current situation is highlighted before the employees making them understand the requirement for change (Lewis, 2019). Then, at the next stage, i.e. Changing, the proposed change is implemented and organizations transition from earlier state to the desired state and last is the Refreezing stage where after the change has ben implemented and people have become familiar with the implemented change, the process stops.
• Kotter's 8 Step Model is another approach where there are 8 steps that basically consolidates back into the three step change procedure that was proposed by Lewin. Create Urgency, Develop a coalition, create vision for change and communicate the developed vision are first 4 steps which basically refers to Unfreezing (Kumar and et.al., 2016). Then, Removing Obstacles, Creating short goals for win and building on the change are the next three steps referring to the changing step and lastly the eight step i.e. Anchoring the change in Corporate Culture is the step that is similar to refreezing where the changes are integrated to become a part of the organization.

Additionally, there are other principles of ensuring change implementation and management:

• Clarity in term of clearly designated goals, proper segregation of duties and responsibilities and correct identification of the value addition so that the concept of shared vision can be made understood and managing the change that is being proposed in the organization (Guiette and Vandenbempt, 2017). Care Act involves modification of some major policies that have been established since a long period and therefore it is necessary to make them understand that what exactly will be changed.
• The communication lines should be clear and well designated so that the employees know whom to address when the glitch arises while implementing or accepting the proposed changes.
• Employee Engagement and regular feedback are also the major factors that assist in ensuring that the intended change is being clearly understood by the employees, and they are ready to implement the changes that have been proposed. This helps the employees in understanding and facilitating the change process by doing what is expected of them and the organizations are bale to take regular feedbacks or reviews regarding which sections need to be improved and how it is to be done.

Planning of changes in health and social care

Planning is a detailed process where every aspect is taken into consideration before implementing the change that is necessary or the change that has already been implemented:

• The first step is to identify that whether the intended change is necessary or not however, here the implementation of the Care Act is mandatory and therefore the organizations need to integrate their goals now according the propositions of the care Act.
• After this, the changes that have been planned must match the goals that were set according to the Care Act, 2014 (Bearak and et.al.,  2016). Here, different action points can be developed so as to evaluate that the progress is being made in the right direction and take corrective actions to ensures movement in correct direction.
• Additionally, there needs to be a proper plan for the strategies that are required to implement the proposed changes so that the entire procedure becomes simplified and the changes are implemented correctly. Here the financial and human aspects i.e. resources of the organization is integrated with the change implementation.
• Lastly, the planning for change is incomplete if there are no evaluation and monitoring techniques that are developed in order to consider the impact. This can be done by evaluating the financial success or the potential success factors after the Care Act has been implemented in all the organizations.

Monitoring the recent changes

The changes, after they have been implemented must be regularly monitored until the organization has become completely comfortable or familiar with the changes that have been implemented. For this:

• Formal as well as Informal methods of Feedback: This is the most important strategy where the employees need to be regularly incorporated in the feedback mechanism. For instance, here if the Care Act involves higher number of criteria for the eligibility of the patient, then this must be consulted with the employees or the carers so that they can point which are the criteria that are redundant (Bhanja and et.al., 2017).
• Data Analysis: This is another technique that can be used where the managerial team of the healthcare institutes can conduct surveys or other test that will help them in evaluating that whether their aims and objectives have been achieved and the results are compared with the goals set so that necessary modifications can be achieved.

These are some of the effective techniques that can be used and apart from this, there are additional techniques that can be used such as evaluating the care plan of the carers, checking the compliance for the rules that were proposed under the Care Act, checking the financial aid mechanisms and also evaluation of the continuous policies that have been adopted in order to implement the changes proposed under Care Act, 2014.

CONCLUSION

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