Chipton NHS Hospital Trust or foundation hospital is one of the many cutting edges of government commitment to decentralize public health service. The hospital devolve decision making from the central government, hence efficiently meeting wishes and needs of the local communities. It acquired its trust status about fifteen years ago operating within a medium sized town having thriving local business community. In addition to offering hospital services to the large local hospitals, the trust also provides doctors to the entire location. A number of other health provider are in the location thanks to the government polices and recent economic recession threatens the budgetary allocation to the trust, thereby hindering the activities and services to be offered.
Government expects to see an increase in number of patients, high service quality, increased usefulness and competence. The trust has employed out sourcing to counter money problems a well as offering internal contracts. The Trust employs close to one thousand people in the operational support department. The services of the department range from security, estate maintenance, car park management, catering, cleaning and pasturage (Berry, 2006).
Employees belong to various unions such as Unison, GMB and TGWU, this stands at 60% the relationship being fairly good having meeting between the union and management in an interval of two months. This improved communication and subsequently other relevant areas. As a result employee turn over has been relatively low. Despite these efforts to create good employee relation, there were still feelings with employees that things were not right, for instance, they claim that decisions were being forced down their throat instead of collective decision making which will be acceptable by all (Baugher, 2004). Other concerned noted were related to delegation, team building, communication, as well as employee empowering. All these need to be addressed.
According to Answers, (2010) Human Resources (HR) has been defined as people or individuals who encompass labor force of a given business institution or an organization, the term has also been used to define a section or department in a given organization that is bestowed with the responsibility of putting in place policies, strategies and measures that will supervise organizations’ workforce. Due to the responsibilities bestowed to human resource department, it’s then the main arm in any organization to help curb internal as well as external factors that may impact on the employees and eventually to the whole organization.
Current internal situation
Currently, Chipton NHS hospital trust employees have membership in a number of trade unions for instance, Unison, GMB and TGWU. This is an avenue from where they get opportunities to communicate to the management. They do hold meetings after every two months with the management in a multi-union forum yielding fairly good relationship between them. The hospital management team encourages communication policies leading to improvements notably staff showing confidence in the top management especially from the medical staff (Siguaw & Enz, 2000). The management seeks to provide staff with relevant information for instance those regarding forthcoming changes rooting from the government policies.
Staff turnover has been relatively low and stable, according to 2005/06 report; it stood at 11.8% this is the lowest ever recorded falling from 17.1% in 1995/96. This was attributed to the implementation of Agenda for change brought about by the government. This has made the trust to have close to 60% of its employees having an average length of eight years in service. The rate of sickness absence slightly fell from 4.8% in 2004/05 to 4.6% in 2005/06 as a result of better understanding of managing absenteeism.
Currently, the trust embraces the culture of team work amongst its staff as there are groups of between four to six persons assigned on a given department, the number of the group members is largely determined by their roles. The duty allocation is on permanent basis, but the staff undergo routine rotation shift pattern, this is under operation for most of the groups. Each group is a assigned a supervisor. It has been noted that in the operation department, ambiguity and high degree of inconsistency are evident due to how supervisors run their duties. There were tendency of supervisors abdicating certain people management responsibilities as they belief such individuals are not well trained or are either not paid enough to execute the issue at hand (Sloat & Doane, 2005). This subsequently led to partial implementation of operational procedures. How supervision was done made employees raise concerns on issues of delegation, communication, team building and employee empowering particularly within the middle to lower grades of the workers-thus being an issue of heated discussion between management and the union.
The groups worked independently from each other and often from the organization level just above them, with little evidence of effective management control and they have developed highly demarcated and differentiated tradition with their union representative reluctant to agree should change (Ahmet, (1993). There is existence of highly rigid job boundaries established along with multi structured differentiated bonus system introduced thirty years ago has been deemed to be responsible for inflexibility in working practices. Currently there is a situation whereby intra groups’ co-operation has been severely constrained with ‘ a silo mentality’.
Due to financial quagmire as a result of recent economic recession, the trust has resorted to out sourcing for services as well as offering contacts internally. These came with a number of shortcomings although value of money was realized.
On the side of customers and clients, there is a group centered culture that seem to prevalent over customer needs. Human relation is presently controlled from a central human resource department, with some areas of the Chipton NHS Hospital Trust’s people management practices for instance employee selection, grievances, communication and discipline being delegated to line management within the group structure. Currently, issues that need to be quickly addressed include job insecurity, low staff morale, role ambiguity, poor reporting structures as well as weak communication lines that have roots from ill defined limits of authority and accountability (American Camping Association, 2000).
The present department management structure in a descending order is as follows; Operational support manager - Operations Support Business Manager - Head of Services - Security Manager - Estates Manager - Portering Manager - Catering Manager. Supervisors of the all sectors these are; security, estate maintenance, car park management, catering, cleaning and portarage are answerable to their respective managers. Finally, in the current structure, we have the staff team constituting the base of the ladder.
Past and present external and internal factors
Scholars have noted with concerns that internal and external factors do play vital role on how an organization is and will be successfully run. These factors interfere with the four main aspects of management which include, planning, organizing, budgeting and coordinating of activities within an organization. Internal factors generally refer to those issues arising within a given organization originating from the top management and or from employees and nature of work, these factors can be easily controlled compared to external factors which have roots outside any given organization, they are in most cases very difficult and challenging to handle (Berry, 2006). Examples of internal factors include, low staff morale, age of the organization, management competence, laid down management strategies, experience of the firm, role ambiguity, poor communication channel among others while examples of external factors may include such issues as customer demands, government policies, rules and regulations, competition just but to mention a few.
Two main notable external factors affecting Employees Relations at Chipton NHS Hospital Trust are government policies and group-centered culture that appears to have gained prevalence over customer needs. The government policy dubbed agenda for change thought it helped in bringing down the high rate of employee turn over in the trust as it made employees opted to remain in the organization with an anticipation that the new pay system my be of benefit, but many viewed it as if it was an outcome arrived at by only few individual (employees didn’t participated in arriving at the decision) ‘pushed down their throats’ and since it was a government policy, no one dared openly oppose it.
The agenda for change was a single pay system which applies to all employees directly employed by NHS but exempted doctors, senior managers and densists. Three elements to be implemented were job evaluation, knowledge and skill framework of employees as well as harmonized terms and conditions. The agenda for change as mentioned earlier simplified process of designing new ways of working and led to creation of an extended role hence trying to make job more flexible (ArticleClick, 2010). It also provides the organization with tools that will help them deliver the required change within the employees for successful implementation of other policies. It’s worth noting that the agreement for agenda for change was reached with trade unions representing NHS workers.
Another factor which is external and would probably impact on Chipton NHS Hospital trust is the constant change on demand of services rendered to them by the health facility within their locality. Competition from other health offering facilities with the locality in which Chipton operates will definitely impact on how successful it will be in future.
Internal factors that will impact and did impact on the organization are the following; out sourcing of services is a situation where by instead of having employees in-house, organizations simply solicit for such services outside at a fee which is only payable when the service has been provided. This system is usually very good when any organization is facing a period of financial difficulties and when carefully used, value for money is realized. The problem with this approach is that, an organization will not have at its disposal skilled personnel to do regular duties and responsibilities, it can also be an expensive venture.
Style of leadership and management exhibited by supervisors in Chipton does have negative implications as it leads to low productivity and partial implementation of policies. As noted, the supervisors abdicate role on the grounds that the staff is not qualified in carrying out such duties or are not paid enough to execute a given responsibility, duty or task- this in turn lowers the morale of the workforce, if not addressed, it will jeopardize service delivery. It also raises issues related to delegation of duties, communication, and team building as well as employee empowerment (Jackson & Mathis, 2007).
Third internal factor is on the basis of how the human relation department is run. As indicated, the system is centralized, in that there is only one office where most if not all things are handled, including recruitment, selection of employees plus all those staff pertaining an organization’s workforce. Centralization is good but it has huge negative implications for instance, decision making is very first but in most cases it’s doesn’t meet expected needs of employees as they were not involved in making such decision, and since such decision are unpopular there is high chances of them being rejected and if forced to accept, the trust to top management will definitely not be there, thus having negative implication on service delivery (Nina & Danielle, 2007).
Other internal factors in this organization include low morale, anxiety of job security (due to financial problems leading to outsourcing), role ambiguity, poor communication (slack reporting structures), and poor motivation structures especially in operation department. All these are issues that do not operate in isolation as one problem leads or triggers an upsurge of another. These factors did arise from ill defined limits of authority.
Future expected factors
Frequent changes and advancement in technology is one of the main factors that I anticipate to pose a great threat to this organization. It’s very widely accepted that if one will not embrace technology then their future survival in this dynamic could be doomed. Due to the fact that, the organization doesn’t have sufficient money, then there is definitely a big problem as technology is costly in terms of installation and training of employees.
Constant customer changing demands on services offered will threaten the organization if it will not prepare it self adequately to address the issue.
Future financial crisis in the economy in England and the entire world might make the government further reduce the amount of money allocated to NHS trust.
Stiff competition in terms of service delivery from the various local facilities, as well as offering very attractive packages from such organization could make employees from Chipton to go get jobs elsewhere hence increased rates of employee turnover. Maintaining qualified and competent staff will be at risk due to such competition.
Finally I fore see a situation whereby employees may not be willing to accepting change, especially if they were not actively involved in arriving at the decision, as they will see as if the changes are being force down their throats.
For Chipton to be successful in ensuring efficient, effective health service delivery to the local community, there are a number of recommendation are worth to be given serious thoughts; modernize the way work is done and maximize the contribution of the workforce in trying to improve care efficiently. The organization opts to establish an education and training center where employees will be offered opportunity for training vital for promotion among other things. Thirdly, communication channel between employees and top management should be liberal and employees views be incorporated if not substantial reasons opt to be given (partnership). Continually carry out employee opinion survey to gauge their attitude and commit resources to address issues raised by them (Wales, 2010). The human resource should also address issues that lower staff morale eventually leading to psychosocial problems. These include poor communication between employees and employer, vagueness concerning the job responsibilities, lack of support for work-family balance, lack of supervisor support, lack of control of how work should be done, harassment, bullying or even discrimination the later can be through age, sex, religion, nationality among other form of discrimination, lack of respect for workers by those in authority, lack of adequate and appropriate rewards and appreciation for the efforts done by employees. Finally, there is need to put in place a special team of experts made up of top management and employees representatives who will be bestowed with the responsibility of communicating any proposed change in advance, this will help reduce resistance to changes. Employee need to be given duties based on their qualification with minimal supervision, this will empower them.
In any organization, it does encounter internal as well as external factors which bring both positive and negative implication. Since the implications mainly affect, workforce of that given organization, it’s thus the responsibility of human resource department to help address any negative impact and capitalize on the positive implication of either factor. External factors mainly originate from government policies, rules and regulation as well as changing customer demands on health service required. Internal factors facing Chipton include, challenges in communication, low staff morale, style of leadership and management of human resource department, delegation and employee empowerment.