Strategic People Management

Strategic people management is a key function in every organization. This article seeks to discuss the three strategic people management areas in England’s National Health Service (NHS). Specifically, the paper will analyze leadership and management, talent management, and training and development in the NHS. Finally, the paper will recommend ways forward for the NHS in keeping best practice and improving areas which are more problematic.

The competitive advantage of an organization is based on several things like investing in new technologies, financial management, and effective human resource management. The style in which people are managed in an organization has a critical role in achieving the goals of an organization. Poor management of people can lead to poor performance or to the collapse of the whole organization. To avoid the demerits associated with poor people management, three areas referred to as areas of strategic people management have been devised.

The three areas are leadership and management, talent management, and training and development (Bailey, Mankin, Kelliher, & Garavan 2018). This article seeks to compile a report on England’s National Health Service (NHS) department and highlight the importance of strategic people management.

In 1948, the NHS was established to manage and regulate health services in the United Kingdom. The objectives of establishing the trust were to offer comprehensive health services, free at point delivery, and to centralize the health services. 70 years after its establishment, the trust is yet to achieve some of its objectives. It has been accused of poor health care delivery, failure to cater to the ageing population, long waiting times, over management, and insufficient staff training. The junior staff of the trust have complained of high workloads while the senior management complains of poor funding. A report by King’s fund supported the claim that the trust is poorly funded and refurbished the allegations by the critics that the trust is over-managed (Ham et al., 2011).

Strategic People Management and Leadership

Great Man Theory of leadership suggests that everyone is born with certain leadership traits (Spector 2016). This theory means that if you put together several people to work together in different leadership positions, a great result can be obtained. The NHS in England has tried to employ this theory by having many leaders in each department. Over the last two decades, the trust has increased its number of leaders significantly. In England, there has been an increase of 37% in the number of leaders in the last 19 years. However, many leaders can lead to leadership bureaucracy because no single person can be held responsible for a failure. Managerial positions are entitled to managerial remuneration, therefore, increasing the number of leaders increases the administrative costs for the trust which is already under-funded.

The NHS has been attacked by political parties and other critics of being over managed.  Currently, the trust has over 6000 board member and 700 doctors practicing as directors. The critics accuse the doctors of working as directors in contrary to their calling of treating people. However, positioning doctors as directors only cater for distributed leadership. Experienced doctors should the nurses and other doctors to address the issue of poor care and in implementing clinical processes. It is also easy for doctors to hold clinical officers accountable than other professionals. Health care is a complex service and should have many leaders. The NHS should not be accused of being over-managed due to the complex nature of health care.

The Audit Commission and the national audit office have accused the trust of poor leadership styles. Collectively, the two critics have accused the trust of spectacular managerial failures which has led to poor care, hospital acquired infections, surgery deaths, and long waiting times for the patients. Due to the increase in the aging population and the situations at hand such as long waiting times, the leaders have to change their leadership styles. The leaders seem to stick to their styles regardless of the increasing challenges in the trust.  The contingency leadership theory suggests that leadership style should be changed to cater for certain situations for there is no single way of leadership. It is the high time that the leaders in the trust changes their style of leadership to address the current issues of long waiting times, poor care, and caring for the ageing population.

Exchange leadership theory urges that leadership is only effective when the leader gives a motivational value or a reward, either motivation or punishment to his follower (Zhang et al., 218). This theory means that a leader should be given sufficient time to reward and motivate the juniors. Demotivating the followers will lead to poor results. However, the current managerial culture in the NHS betrays the Exchange Theory of Leadership.

Leaders are given a short tenure of two years. Two years are insufficient to reward and motivate the juniors. In addition, the short leadership terms cannot enable the leaders to handle the problems in the trust. The external pressure from critics and political parties demotivates the managers. The leaders should be given room to lead the trust and managers should have longer tenure for them to address the current issues in the trust (Jiang, Hu & Wang 2018). Blame games demotivate the employees. The trust has a culture of blaming the employees or a manager in case there is a failure. The managers and medical directors have blamed the nurses and clinical officers for the failures in the hospitals. The blame games demotivate the nurses and the clinical officers rather than motivating them.

Training and Development

Service delivery is depended on the level of training staff gets before and on the job (Larsen, 2017). Job training gives one chance to learn through experiment (Saks 2015). Experimental learning theory suggests that one can best learn through experimentation, reflective observation, and abstract conceptualization.

Organizations should, therefore, have training sessions for their staff. Training also gives a chance to incorporate new staff into the current organizational culture. The NHS staff should be trained in managing people and on business finance. So far the NHS has shown a willingness on training its staff by coming up with business finance course aimed at training all their staff regardless of their positions. Changes in technology and continuous research by health professionals call for regular training to equip the staff with the new skills being invented in the health sector all of which can be deployed using strategic people management.

To train the employees, the NHS has established several courses. The employees can access short-term courses, bachelor’s degrees and master’s degrees. It gives a chance for nurses and clinical officers to subscribe to different courses and enhance their skills. This shows that the NHS is committed to improving the quality of health care it offers. The trust faces negative issues of caring for the ageing population and long waiting times. In contrast, none of the courses offered by the trust is concerned with the two issues.

Strategic People Management and Culture

It seems to be part of the NHS staff beliefs that long waiting times are normal and nothing should be done on that. A staff training should be carried out to change the attitude and beliefs on long waiting times. Theory of planned behavior purports that training changes the attitude and belief in certain behavior (Montano & Kasprzyk, 2015). The NHS, therefore, should organize training aimed at changing the attitude on long waiting times. 

Strategic People Management Dissertation
Strategic People Management Dissertation

It is commendable that the NHS organize in-house induction with updates in statutory areas on annual basis. The NHS managers hold meetings with staff on a regular basis where training and development opportunities are discussed. The staff are also allowed to apply for funding in case of a professional development course. However, the course must fulfil a professional need and support of the manager is required. 

The training offered by the NHS is only concerned with health care and not human resource management. Good health care can only be delivered under the effective leadership of people. The trust should come up with training programs aimed at equipping the staff with leadership skills. The trust participated in the South Central Leadership Program. The program was aimed at enhancing the leadership program for the senior staff. Skills development in health care is essential in health care and not a mere luxury. South Central Leadership Program should, therefore, involve all health staff regardless of the positions they hold.  The NHS continues to call for applications of their courses which open to anyone who wished to work in the health care department.

Talent Management

The first step of managing talent is on recruitment (Davis, Cutt, Flynn, & Mowl 2016). The human resources department should come up with a rigorous recruitment process aimed at selecting the best staff to work for the trust. However, talent management is not a function purely on the human resources department. The top management has to manage talents once the employees have been selected.

The human resources departments should offer assessment tests before recruitment and give a probation period before an employee is confirmed. This will make sure that the best employees are employed by the trust. Once an employee secures the job, a room should be given to express self-initiative. However, the current situation at the NHS does not give room for self-initiative. The blame game from the managers and pressure on the employees due to high workloads impairs their self-initiative. The external pressure on managers by critics also scares the managers from expressing their self-initiative.

For performance appraisal, the NHS has come up with a policy to identify the poor performing employees. Employees performance will be assessed according to complains received from visitors, fellow employees, and the observation of the manager. In case of a poor performance the employee will be asked to give feedback to the manager. The managers are supposed to fill a performance form for each employee in their department.

However, the NHS does not propose differentiated workforce in its policy and only proposes penalties for the employees who perform poorly. In the differentiated workforce, the best performing employees are rewarded better than others (Collings 2017). The differentiated workforce is to recognize the best employees and to avoid losing the key and the experienced employees to other organizations.

The NHS also lacks a wide pool of talents since people from other organizations are reluctant to work for the trust due to undue pressure on its employees and high workloads compared to the people working in private hospitals and those working for NGOs. The trust also has a culture of appointing people who have worked for it before which keeps away candidates from the private sector and other government institution.

Conclusion and Recommendations

Strategic people management is very important for every organization and should never be undermined. Poor management of people results in poor performance of the whole organization. The NHC has many managers. However, due to the complex nature of the health department, it can be concluded that the trust is not over-managed. There should be clear roles for every manager to avoid leadership bureaucracy. The trust faces a lot of pressure from external bodies and within itself. The trust has a culture of blaming employees of any fault during the line of duty. The trust also has a culture of having short tenures for its managers.

The trust offers training for its staff but the training given is a drop in the ocean since it is not concerned with managing people. The training given is only concerned with increasing treatment knowledge to the staff. The trust lacks a wide pool of talents due to its recruitment policy which selects people who have worked for the trust before. The performance appraisal policy of the trust only forces the staff to perform better but it does not recognize the best performing employees through differentiated workforce.  I wish to recommend the following to the NHS;

  • The South Central Leadership Program should involve both junior and senior staff. This will increase the chances of creating future leaders for the trust.
  • The public and critics should avoid giving undue pressure to the leaders of the trust and give them room to lead.
  • The trust should increase the tenure of its leaders. A longer tenure will give them time to fix the current problems facing the trust.
  • The NHS should recruit managers from the private sector and other government organizations. This will help in increasing its pool of talents.
  • On top of South Central Leadership Program, the trust should establish a leadership center for mentoring future leaders, offering training, and to support innovative programs.
  • Adopt a more robust approach in relation to strategic people management.

Bibliography

 Bailey, C., Mankin, D., Kelliher, C. and Garavan, T., 2018. Strategic human resource management. Oxford University Press.

Collings, D.G., 2017. Workforce differentiation. Oxford handbook of talent management, pp.301-17.

Davis, T., Cutt, M., Flynn, N. and Mowl, P., 2016. Talent assessment: A new strategy for talent management. Routledge.

Ham, C., Baker, G.R., Docherty, J., Hockey, P., Lobley, K., Tugendhat, L. and Walshe, K., 2011. The future of leadership and management in the NHS: no more heroes. Report by The King’s Fund.

Jiang, Z., Hu, X. and Wang, Z., 2018. Career adaptability and plateaus: The moderating effects of tenure and job self-efficacy. Journal of Vocational Behavior104, pp.59-71.

Larsen, H.H., 2017. Key issues in training and development. In Policy and practice in European human resource management (pp. 107-121). Routledge.

Montano, D.E. and Kasprzyk, D., 2015. Theory of reasoned action, theory of planned behavior, and the integrated behavioral model. Health behavior: Theory, research and practice, pp.95-124.

Saks, A., 2015. Managing Performance through Training & Development, (Canadian ed.). Nelson Education.

Spector, B.A., 2016. Carlyle, Freud, and the great man theory more fully considered. Strategic People Management12(2), pp.250-260.

Zhang, X., Zhang, Y., Sun, Y., Lytras, M., Ordonez de Pablos, P. and He, W., 2018. Exploring the effect of transformational leadership on individual creativity in e-learning: a perspective of social exchange theory. Studies in Higher Education43(11), pp.1964-1978.

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Recruitment Practices NHS Dissertation

Impact of Recruitment Practices on Employee Retention: A Case Study of Community Nurses in the NHS

This dissertation is based on evaluating the effect of recruitment practices on the retention rate of an organisation. The study focuses on the health sector on NHS and analyses the reason for the high turnover rates of the NHS nurses. Thus, the report is dedicated to the analysis of secondary qualitative and quantitative in finding the effect of the recruitment practices on retention rate in NHS nurses. The report shows the recruitment practices of NHS and the possible reasons for their high turnover.

The study has allowed evaluation of the recruitment and selection practices that have an impact on the retention of the community nurses in the NHS. The reasons of increasing employee turnover or lack of retention as found in the research are; poor recruitment planning, the wrong expectation of job roles and responsibilities, ineffective communication of job roles, and lack of use of technology to express the company’s culture, norms, and facilities. The high turnover rate is linked to the recruitment practices using the literature review of the past studies. The study found a difference in the actual practices and advertised practices of National Health Services.

This is one of the many reasons the NHS nurses are dissatisfied in their workplaces. In the NHS, internal recruitment effectiveness is a primary driver of motivation of nurses and consequently to their retention. The study suggests areas for improvement in the recruitment practices in terms of addressing diversity, regional shortcoming, technology usage, internal recruitment effectiveness, national and international recruitment, and demographic balance.

Dissertation Objectives

  • To explore the impact of recruitment on retention in the NHS
  • To evaluate the existing recruitment practices that drive the retention of NHS nurses
  • To make appropriate recommendations for effective recruitment practice that contribute to the retention of community nurses in the NHS
  • To achieve the research objectives, the following research questions are set:
  • Research Question 1: What are the recruitment practices for community nurses in the NHS?
  • Research Question 2: How the existing recruitment practice are relevant to employee retention on NHS focus?
  • Research Question 3: Which of the best recruitment practices should NHS adopt that retain in the NHS?
NHS-Recruitment-Practices-Dissertation
NHS-Recruitment-Practices-Dissertation

Dissertation Contents

1 – Introduction
Background of the study
Purpose of research
Research questions and objectives
Rationale of research

2 – Literature Review
Human resource management
Recruitment
Retention
Recruitment process
Sources of recruitment
Methods of recruitment
Recruitment challenges
Selection practices
Initial screening and application form
Assessment centres and psychological testing
Interview
Employee turnover
Employee Retention factors
Compensation, reward and recognition
Promotion and work-life balance
Training and development
Job motivation and satisfaction
Job characteristic model
Herzberg motivation theory
Job satisfaction and employee retention

3 – Research Methodology
Research design and approach
Descriptive research
Research approach: Inductive vs deductive
Research methods
Research strategy
Data collection and sources
Study population
Data analysis

4 – Data Analysis
Community nursing expectations framework
Quantitative data
Community nurses as a proportion of the total workforce
Demographics of community nurses
Workforce statistics and shortfalls of community nurses
Percentage change in community nurses
Joiner and leaver of community nurses
Turnover rate for community nurses
Workforce nationality and overseas employees
Qualitative data
HR planning context
Recruitment and selection practices
Retention practices and Rate at NHS
Retention issues and challenges for community Nurses NHS

5 – Result and Discussions
Summary of quantitative and qualitative findings
Evaluation and discussion of results

6 – Conclusion and Recommendations
Conclusion
Recommendations

References

Appendix

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Nursing Practice – Ethical and Legal Issues

Nursing Practice – Ethical and Legal Issues

Title: Ethical and Legal Issues in Nursing Practice. Professional ethics involves the use of reasonable and regular communication, information, medical skills, emotions and doctrines in nursing practice. The mission of nurses is to provide health care of high quality and improving and maintaining public health. Ethics being a vital element of professionals in the healthcare department plays a major role in the moral behaviors of nurses to patients. This, in turn, influences patients’ health improvement.

Furthermore, the principles of nurses are to respect human rights, dignity and values. Nursing comprises three basic principles of caring, namely ethics, clinical judgement, and care. Nurses must adhere to ethical rules and carry out their duties according to governmental and governing statutes. Moreover, nurses encounter various dilemmas, ethical or legal in nature in the middle of performing their duties. However, other nurses may be unprepared to tackle dilemmas and be unable to answer questions pertaining to their conduct.

Ethics is a principle that describes what is expected in terms of right and wrong while a law is a set of rules that involves punishment in the event of an offence. A nurse often encounters the law through possible litigation in which the nurse may have unlikely involved in. Furthermore, a nurse can also encounter the law in case of the unlawful act is done like malpractice and negligence. Nurses undergo various situations and may be classified as ethically correct but not legally accepted, or legally unaccepted but ethically correct. Circumstances such as death, euthanasia, and abortion may put a nurse into a quagmire.

In the event of a nurse giving a patient incorrect medication, the nurse automatically hides the fact to protect himself or herself from being caught by the law. This scenario raises relevant questions focusing on the legal and ethical issues of nurses. Another circumstance that is ethical but not legal is whereby a patient is allowed to smoke bhang as a remedy for an illness. In addition to that, there is a situation that relates to ethical and legal issues focusing on a patient being forced to a drug or a test contrary to his or her will or without proper information.

Conflicts existing between the Law and Ethics in the Nursing Practice

When nurses are faced with dilemmas and need to make professional decisions, the nurses are held amid two contradictory sets of demands. The first set is from a professional mission and the second one is from lawful provisions. Healthcare professionals and nurses become entangled in civil or unlawful justice organizations. This occurs when nurses commit an unlawful act by not renewing the license for nursing in time.

Other unlawful actions may involve abuse of the substance, as in the case where nurses obtain medications by not following procedures within medical settings. Nurses ought, therefore, to differentiate morality and law as an action may be immoral but legal. For example, a directive to carry out resuscitation for a patient who is dying might be legal but immoral. However, an act might be illegal but moral like in a case where there is an emergency of a patient falling ill at home, a driver may pass the speed limits when taking the patient to the hospital and this may be considered as illegal but it is moral.

Conflict may emerge between the law and ethics in the case where a nurse decides that there is no reason for certain medical services such as therapy services. In such a case, the professional code of ethics states that no fees should be charged by the practitioner for such services. Meanwhile, nurses are legally obligated to render services to the patients indiscriminately. In relation to that, conflict in the nursing practice might arise from customer expectations and opinions such as a patient’s rejection of blood transfusion. In some instances, agreement with a legal obligation might look as unjust, harmful, or invalid.

Besides that, nurses stay away from an absolute agreement, particularly when the law seems as contradicting ethics. Sometimes, nurses are not ready to sacrifice own values or patient well-being to a system that is not perfect outlining regulations and rules. For example, the failure of nurses to adhere to professional responsibility in revealing private information. Additionally, conflicts may emerge between ethics and law in the process of making a decision for the dying and incompetent, as well as matters regarding people with disability and the right to life matters.

Nursing-Practice
Nursing-Practice

Ways by which Nurses can Negotiate Conflicts Existing between the Law and Ethics

Instances which conflict between the law and ethics might manifest might rotate around values such as fairness, patient choice, truthfulness, privacy, patient well-being, respect for life, confidentiality and privacy, and preserving commitments to oneself, patients, colleagues in nursing, a profession in nursing, and practice settings. The values remain importantly shared by the public. However, in the case where two of the set values can be applied to a condition, though supporting diverging courses of action, conflict emerges.

The ethics code defines the mission of nursing practice of meeting patient needs and answering to surrounding forces that may stem conflicts between law and ethics. What may put a nurse to a risk in the profession of nursing is when there is a conflict between a nurse’s ethical duty to a patient and the nurse legal duty to the employer.

There are no sufficient procedures in resolving the quagmires prominent in the practice of nursing. Nurses that acts as a patient advocate may not be legally protected by the ethical codes and might be abstract to put on with regularity. On the contrary, the government in some instances does not permit nurses to attend to certain individuals or carrying out their practice in certain manners. This is in contrary to the practice in the nursing, specifically on the grounds of responsibility to care for patients.

The nurses, therefore, are expected by the practice code to respect the conclusions taken by the patient, so long as it is well-versed consent. Sometimes patients or patients’ families may not follow recommendations provided or treatments by the provider which in turn brings conflict and a moral quagmire for the nurse. Moral dilemma comes from situations’ where two concise or more moral values apply, but they backup mutually varying foundations of action.

How Nursing Conflicts between the Law and Ethics were handled historically by the Nurses: Reacting to prejudicial rules

Conflicts arise in the event that a nurse encounters a burden that is reasonable, conscientious objection, a personal danger, and matters pertaining personal competence. A burden that is not reasonable manifests in the event that the nurse’s competence to provide safe care and satisfy Standards of Practice is challenged by expectations that are not practical, insufficient resources, and threats on personal welfare. Nurses are neither allowed to neglect their patients nor are they authorized to position themselves in circumstances where the care delivery would bring dangers that are not logical to their individual safety. This involves diseases that are communicable, violence, sexual, and physical abuse. In the case of personal competence, the expectation from nurses is that they should practice constantly and competently acquire new knowledge and skills within the surrounding environment of practice.

Nurses are only allowed to provide care that is not beyond their level of competency. In the rural areas, the nurse may encounter cases whereby he or she is requested to provide care beyond his or her capability hence the nurse often provides care that he or she is capable to offer. It is therefore appropriate for a nurse to seek advice from his or her employer in case of conscientious oppositions where a certain method of care conflicts with the nurse’s religious beliefs and moral. The nurse should, therefore, refrain at all cost to provide care. An individual judgement which conflicts with the patient’s lifestyle ought not to provide a basis for conscientious objection.

Historically, nurses have made use of the expert code of practice in resolving conflicts which emerge between law and ethics by polite communication, and the direction provided by the code of conduct in the nursing practice. This code comes from the common belief that the main roles of nurses involve preventing ailments, easing client’s suffering, and the safeguarding, promoting and restoring patient’s health among the caring of people, families, groups, and societies. Institutions that deals with healthcare are expected to offer multidisciplinary ethics committees that provide education, support and counselling on ethical matters.

Through this, a platform on which variable views are expressed, provide support for caregivers and reduce legal risks for the institution. Professional standards help the nurses to understand the conduct of professional nursing by making sure that the nurses are in the track of providing unique care for the sick, the nurses showing signs of commitment to the communities, outlining the essential ethical morals for professional conduct, offering guidance to the nursing professionals in their mission for self-regulation.

Conclusion

Nurses should therefore, apply the codes to practice in coming up with decisions of ethics by recognizing the patient’s right to competent, ethical and safe care. However, in some cases, the nurse’s personal rights and principles can be in contrary to the patient’s right to be given care. In such a situation, nurses are required to define the facts and point out the dilemma. Upon highlighting the dilemma, the nurses are required to simplify the dilemma, after which the nurses should implement options that are available and come up with a plan and ultimately implementing the suggested plan. Nurses should not contravene the set of ethical and legal standards in the nursing practice on the basis of satisfying client well-being. In the event of a group of nurses violating the set legal and ethical standards due to the conflict between held principles and the ethical obligations, it is important to guarantee that the nurses’ behaviors are rooted in sound legal judgment, instead of self-interest, rationalization, or prejudice.

References

Danjuma, A., Adeleke, I., & Ominiyi, S. (2015). Knowledge, attitude and practice of nursing ethics and law among nurses at Federal Medical Centre, Bida. American Journal of Health Research, 3(1-1), 32-37.

Dehghani, A., Mosalanejad, L., & Dehghan-Nayeri, N. (2015). Factors affecting professional ethics in nursing practice in Iran: a qualitative study. BMC medical ethics, 16(1), 61.

Zahedi, F., Sanjari, M., Aala, M., Peymani, M., Aramesh, K., Parsapour, A., & Dastgerdi, M. V. (2013). The code of ethics for nurses. Iranian journal of public health42 (Supple), 1.

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