Funding and Performance of Healthcare Services at NHS
Relevance of conducting labor market analysis to organizations related to NHS
The case study indicates that NHS is facing some significant issues related to funding and consequently, the quality of healthcare services is being deteriorated. Due to lack of fund, the organizational body of NHS is not able to pay wages properly even to nurses of the setting. Therefore, it is necessary to learn about the factors that caused financial shortage at NHS. In addition, labor market analysis helps to learn about the HRM elements, which would help NHS to regain its performance. OECD (Organization for Economic Cooperation and Development) data reveals that the nurse to population ratio in United Kingdom is nearly 8.2% nurses per 1000 population, which is slightly lower than the OECD average of 9.1% (Allen 2013).
The case study indicates that UK nursing labor market has been characterized by cyclical pattern of nursing shortage. Inadequate long-term workforce planning indicates that nursing supply and demand in United Kingdom has barely been under coordination. In this context, Buchan and Black (2011) there have been periods when active. The National Statistic indicates that there are almost 690,000 qualified as well as midwives registered with nursing and Midwifery councils. In this context, Cooper et al. (2011) commented that UK nursing labor market is typified by cyclical patterns of nursing shortage. The significant issue of a lack of long-term as well as strategic workforce planning indicates that nursing supply and demand in UK has rarely been coordinated. Barr, Bambra and Whitehead (2014) pointed out there are some situations where international recruitment has become “policy program” for the organizational body of NHS in UK.
The major issue is that present challenge to NHS is the aging nursing workforce, Particularly, it is found that proportion of nursing workforce over the age of 45 is near 45%, which is almost one third of nurses presently working in mental health over the age 50 (Bosak et al. 2017). On the other side, the economic downturn occurred in 2008 and its aftermath consequence also created the constraints of funding as well as stiff immigration policy formed in 2006 came as the barrier before the growth of nursing workforce in the recent time. However, simultaneously, the healthcare demands were also increasing rapidly. However, the case study provides the evidence that the demand of nursing is outdoing the supply. More particularly, one more evidence is that the “Francis report” and the successive guidelines over employment have become a significant driver of nursing demand since 2014. In this context, McGuire et al. (2016) commented that even though the supply of nurses has increased since 2008, this has not particularly offset the growing demand for nurses. This happens as there is a significant amount of decline in the category of EEA-nurses entering UK over the same period.
Factors affecting nurse workforce planning
Consequently, organizational bodies of NHS have maximized the use of agency staff to fill the vacant positions by driving up the cost of agency. Eventually, it can be ascertained that the labor market of nurses in UK suffers from a significant financial crisis caused by economic downturn and stiff immigration policies despite the growing demands. It is also found in the case study that NHS organizational body suffered from a significant shortage of finance and workforce. Thus, the relevance of labor market analysis lies on the fact that the findings of the case study and the states of labor market of nursing workforce appears to be similar. Due to lack of funding the entire NHS body has suffered and the industry observed a significant decline in the workforce population rate.
This analysis is highly relevant and the outcome of this analysis would help to create an effective plan. Based on the issues found, the solutions can be developed through the plan. The above-presented analysis indicates that NHS lacks proper planning to implement the initiatives. Oliver (2016) opined that healthcare sector in UK has been dynamic in nature with the significant unknown market challenges. Thus, to deal with those challenges, an organization should always have both short and long-term planning. The short-term planning helps to protect organization from recent challenges, while the long-term planning remains as the back-up to deal with the future challenges.
Moreover, the analysis presented above, particularly the issues like the percentage of decline in workforce and amount of budget helps to learn what the organization exactly needs to do. While making the plan, the statistical data helps to realize current situations and provides ways to turn the situation. Without a proper labor market analysis, it is not possible to identify the external factors or the forces in the market, which might appear as the challenge. Thereby, the analysis provides clear image about the areas such as vacancies of nursing posts, continuous recession and slow growth of economy that should be considered in the planning
Importance of short-term planning in the decision-making
In order to increase the rate of nursing workforce, the organizations in the healthcare sector should decide on providing intangible benefits on short-term basis (Cooper et al. 2011). This means within a limited budget, the organization can recruit and retain nurse with low wages but high intangible benefits such as regular training and development programs, which would help to enhance the skills of employees. In order to enhance employees’ experience, the organization can assign their nurses in serious health issues of patients; this would certainly increase nurses’ experience. On the other side, the long-term planning of retaining employees also lies on the intangible benefits such as providing employees and their family members with free medical coverage (Farndale, Hope-Hailey and Kelliher 2011). Again, as the short-term planning in decision-making, the organization needs to motivate its employees in the crisis situation by sharing issues that organizations face. The organizations also need to ask opinion of their employees about the issues; this increases a sense of belief among the employees that their employers value their skills and knowledge.
Short and Long-term Planning for Retention and Performance Management
One transparent factor is that NHS will not experience a speedy growth of economy in the recent time, where its financial crisis would be resolved. So, within the existing limited budget, which is the final funding of £6.3bn, NHS needs to develop its performance management and retention strategies. In order to retain employees and improve quality of service within a limited budget, the firm needs to pay attention to motivation and retention by meeting employee needs with intangible benefits and making employees understand the about the value of work they do. This can be done by implementing following steps.
According to behavioral scientist, Herzberge, job factors can be divided into two categories such as hygiene factor and motivation factor. The hygiene factor include Pay, administration policies, physical work conduction, fringe benefits and status, while the motivation factor recognition, growth and promotional opportunities and responsibility (Dartey-Baah and Amoako 2011).
Hygiene factor-
Pay- NHS needs to develop a suitable pay or salary structure and it should be equal and competitive to those in the industry
Organizational policies- The organizational policies should not be stiff; rather they should be fair and clear.
Fringe benefits: NHS should provide its employees with medication plan and free medical coverage for employees and their family members.
Status- It is important to have certain employee familiar and retained status within the hierarchical structure of NHS.
Motivation factor:
Recognition- The nurses of NHS should be praised as well as recognized for their achievements by the senior practitioners.
Growth and promotional opportunities: NHS should provide growth and advancement opportunities such as training and development programs and assign them to large healthcare related service.
Reflecting on my experience of conducting job interview exercise
Job interview is a vital aspect that recruitment strategy. I as an interviewer have to consider certain elements such as the skills and knowledge of the candidates, organizational budget, discussion on the wages and market demand of the workforce. I realize that especially, when an organization has a limited budget but the firm needs the candidates, it becomes very difficult for the interviewers to manage. In addition, being an interviewer, I also have to think of NHS’ goals such as the improvement of services, providing a comprehensive service to all and aspiring to the highest standards of excellence as well as professionalism. Thus, being an interviewer, I had to consider both the organizational goals, the goals of candidates and industry principle of hiring nurses.
My strategies serving the strategic goals of NHS
The strategies presented above in the report help to motivate the employees under any crisis situation and when the employees are motivated, they understand the value of work and they increase their engagement in their job responsibilities. Consequently, the performance starts improving. In addition to this, strategy of providing intangible benefits to nurses, as the approach of meeting employee needs is effective because a study on human resource management conducted by Farndale, Hope-Hailey and Kelliher (2011) reveals that when employee needs are met, they start giving the inputs to their job. Similarly, Guest (2011) also mentioned that motivation yield positive satisfaction and these elements are inherent to work and they motivate employees for an enhanced performance. Thereby, Brunetto, Farr-Wharton and Shacklock (2012) referred these elements as “satisfiers”. So, when the workers find these elements rewarding, motivational elements such as recognition indicates the psychological needs that were conceived as an additional benefit. Therefore, even if the organization is running out of budget, by this strategy, the performance can be improved, as the employees are motivated in another sense.
I have conducted a labor market analysis with the support of some existing research papers in human resource management, where I found that most of scholars and market analysts mention that it is very important for any organization to pay attention to employee needs. A study conducted on performance management by Farndale, Hope-Hailey and Kelliher (2011) implies that employee turnover goes high for certain factors such as employee lack motivation, inappropriate organizational culture and leadership, difficult human resource practices and others. So, by paying attention to these factors, I found that NHS faces the issue of limited workforce where the nurses are not motivated about the job and they are working under a “wage policy”, which is not appropriate compared to industry standards. Thus, the issue of funding will not have any intense impact on workforce, if the nurses are satisfied with other benefits. The inadequacy in the wages can be covered by providing nurses with additional intangible benefits. When the intangible benefits are provided, eventually, the amount of remuneration remains same.
What did not go well?
NHS did not pay attention to employee needs. The organization only thinks about how funds can be allocated to performance development and the leaders only observed that nurses are working the adequate wages. Leaders did not have an open-talk with the nurses regarding their issues. In addition, the nurses are not provided with any training and development programs where they could brush up their skills.
What I could have done differently to improve the job interview?
As an interviewer, I would have designed the job responsibilities considering both organizational and individual goals. I would assess the skills of the candidates and link how those skills can be utilized to improve performance of the organization. I would have particularly analyzed the skills of knowledge sharing, because knowledge sharing is highly important in nursing job. Most importantly, it is also important to ask why the candidates want to enhance their career in nursing, as there may be some candidates who want to work for monetary benefits. Such candidates do not fit for nursing because in nursing, one has to take care of series of responsibilities.
References and Bibliography
Allen, P., 2013. An economic analysis of the limits of market based reforms in the English NHS. BMC health services research, 13(1), p.S1.
Alshmemri, M., Shahwan-Akl, L. and Maude, P., 2017. Herzberg’s two-factor theory. Life Science Journal, 14(5).
Antonazzo, E., Scott, A., Skatun, D. and Elliott, R., 2003. The labour market for nursing: a review of the labour supply literature. Health Economics, 12(6), pp.465-478.
Barr, B., Bambra, C. and Whitehead, M., 2014. The impact of NHS resource allocation policy on health inequalities in England 2001-11: longitudinal ecological study. BMJ, 348, p.g3231.
Bevan, G. and Skellern, M., 2011. Does competition between hospitals improve clinical quality? A review of evidence from two eras of competition in the English NHS. BMJ: British Medical Journal (Online), 343.
Bosak, J., Dawson, J., Flood, P. and Peccei, R., 2017. Employee involvement climate and climate strength: A study of employee attitudes and organizational effectiveness in UK hospitals. Journal of Organizational Effectiveness: People and Performance, 4(1), pp.18-38.
Brunetto, Y., Farr-Wharton, R. and Shacklock, K., 2012. Communication, training, well-being, and commitment across nurse generations. Nursing outlook, 60(1), pp.7-15.
Buchan, J. and Black, S., 2011. The impact of pay increases on nurses’ labour market: A review of evidence from four OECD countries. OECD Health Working Papers, (57), p.0_1.
Cooper, Z., Gibbons, S., Jones, S. and McGuire, A., 2011. Does hospital competition save lives? Evidence from the English NHS patient choice reforms. The Economic Journal, 121(554).
Dartey-Baah, K. and Amoako, G.K., 2011. Application of Frederick Herzberg’s Two-Factor theory in assessing and understanding employee motivation at work: a Ghanaian Perspective. European Journal of Business and Management, 3(9), pp.1-8.
Farndale, E., Hope-Hailey, V. and Kelliher, C., 2011. High commitment performance management: the roles of justice and trust. Personnel Review, 40(1), pp.5-23.
Guest, D.E., 2011. Human resource management and performance: still searching for some answers. Human resource management journal, 21(1), pp.3-13.
Hyun, S. and Oh, H., 2011. Reexamination of Herzberg’s two-factor theory of motivation in the Korean army foodservice operations. Journal of Foodservice Business Research, 14(2), pp.100-121.
McGuire, C., Rankin, J., Matthews, L., Cerinus, M. and Zaveri, S., 2016. Improving the quality of the NHS workforce through values and competency-based selection. Nursing Management, 23(4), pp.26-33.
Oliver, D., 2016. David Oliver: Wishful thinking won’t save the NHS. BMJ, 354, p.i4544.
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