Some outsourcing practices in the National Health Service in England: a case study of/ a critical or investigative look at recruiting, training and retaining key healthcare pro’s (nurses, social support workers, assistant medics, midwives) in North Essex University NHS trust.
Task: Complete the following points.
2) NHS and Private healthcare Practice
3) Recruitment Process of the key health care professionals
4) Comparison of the NHS with other practices such as retention practice, training and recruitment
5) Role of management in leading, planning, directing, evaluation, controlling and performance review
6) Healthcare teams
7) Merits of the outsourcing for healthcare professionals
8) Gaps in Knowledge
This literature review has cast light on the long-term discussion on the outsourcing practices of the NHS. Although the practice has started with escalating success, however, with time, the pessimistic effects are revealed raising concerns on the acts of outsourcing. In the following paragraphs, detailed evaluation would be done on the underlying factors of the outsourcing and the recruitment, training and retaining practices of the hospitals and healthcare professionals.
The theme of outsourcing has been introduced in the 1980s to counter NHS workforces thus cutting their costs for services. The Government has stated during that the introduction meant an increase in quality and recognising the importance of responsibility in the private sector. Nicholas Ridley in his 1988 pamphlet has argued that concentration on the sanction of services rather than providence is a better idea for focusing on entrepreneurship and innovation. Nonetheless, the Labour party has opposed to privatisation of the services suggesting for monopoly power one only the private sector. Under the Labour party operations in the aftermath of 1997, the public services started getting outsourced. NHS integrated the same principles thereby outsourcing the "waiting list". Concerns are raised on the constant manoeuvring of the issues related to employment rights, regulation and accountability. However, the researchers believe that the future of this process would depend on the transition of the core services (Theguardian.com, 2011).
2.2 NHS and Private healthcare Practice
The NHS stands for National Health Services in England is synonymous with enhanced care for the patients across the country. The primary antecedence of the institution lies in the provenance of care and improvement of health care services. They are also responsible for inclining the decisions of the national debate over the elevated care priorities. The mission and vision of the organisation share a common objective where their pivotal concern lies in the greater control of the wellbeing and health of the individuals. Moreover, they stress on the healthier and longer life quotient as well. To achieve this, the basic factor is to have attainment of the colossal amount of quality care services. The organisation is satisfied to offer the choices through acquiring around £100 billion in various holds and funds for accounting expenditure of money for clients (England.nhs.uk, 2017).
According to LaingBuisson (2013, p.12), the NHS may be dominating the provision of health care services in the country, however, the country has its own reign of private sectors as well. The authors have pointed at a £6.42 billion sector where they are offering treatments and operations and the only exclusions are the mental services and primary care. Owusu-Frimpong et al. (2010, p.211) have cited that there exist a highly disintegrated market mostly of undetermined treatments which are procured by supplementary professions to the medical practice such as acupuncture, physiotherapy, homoeopathy, psychotherapy and podiatry.
2.3 Recruitment Process of the key health care professionals
The NHS abides by the Codes of Practice that defines the principles required to be followed by every healthcare professional while on duty. It is the opinion of Kielmann et al.(2010, p.60), that NHS listed organisations are urged by the Government or the NHS to apply the services of the listed agencies for recruitment processes. These agencies are favoured or backed by the Department of Health who are keen on elevating the quality of care and services offered to the healthcare organisations.
The NHS has shed light on the recent "Workforce Plan for England", which has vowed to identify the right workforce for the NHS supported organisations. The management of the organisation has cited that they have introduced a robust planning process focusing on the recruitment of staff in the correct numbers as well as skills so that they may lead to alluded behaviours and values for delivering high-quality care (Hee.nhs.uk, 2016).
Cleland et al. (2012, p.1) have cited that the NHS has integrated an assessment to analyse the best doctors. The medical students are required to take part in the training and medical education after which, the selection process begins to recognise the best doctors. However, Woolf et al. (2011, p.d901) have criticised that the assessment of the doctors by thorough monitoring of the performance and the later performances are poorly defined. The authors have furthermore argued that the UK has traditionally dependent on the educational attainment. The medical students who have acquired higher grades are accepted for the position after they are successful in the assessment of non-academic abilities such as motivation and maturity.
Becoming a registered Nurse for the NHS requires diversifying skills. Cameron et al.(2011, p.1094) have pointed out that the primary factors are the requirement of a nursing degree and registration in the Nursing and Midwifery Council (NMC). Moreover, the authors are of opinion that the nurse should obtain higher specialisms that include learning disability, mental health, children and adults. Before the proper recruitment process begins, the qualified nurse is asked to complete half year of supervision at local hospitals or community settings. Windsor et al. (2012, p.215) are of opinion that a registered nurse should possess a high level of analytical decision-making skills and technical competence. The RCN is defined as the trade union body indirectly acquainted with the recruitment of the professional nurses. Nevertheless, the authors have warned that the employers are stringent on following the nursing principles and decision-making aptitude.
2.3.3 Health Care assistants
The Health Care assistants play a crucial role in procuring enhanced patient care by working alongside the professional nurses in helping the patients in varied ways. McMurdo et al. (2011, p.afr115) have cited the example of the King's College Hospital and their recruitment process for the health care assistants. The applicants require applying online and fill the application form. The organisation in their website has cited that the suitable candidates would be invited for an assessment that would focus on their competence. After they are successful, they would be asked to attend the final interview process (Careers.kch.nhs.uk, 2017).
In order to get approval for practising in the hospitals, the midwives require registration into the Nursing and Midwifery Council (NMC). NHS has always focused on the revalidation process focusing on the commitment to learning as well as updating their knowledge on a regular interval. This process is critical for professional and recruitment process as failures in the revalidation process may cancel the registration into the NMC (Health careers.nhs.uk, 2016).
Cameron et al. (2011, p.1087) have opined that NHS leadership Academy has offered supports for the midwives to understand the elements of leadership. In many cases, the midwives fall convict to the self-confidence. The NHS ensures that during the recruitment process, this program builds up their inner confidence.
2.4 Comparison of the NHS with other practices such as retention practice, training and recruitment
2.4.1 Role of the agencies in recruitment process
As opined by Findlay et al. (2013, p.148), there are various agencies that recruit medical professionals on the behalf of the NHS and other private organisations. In many cases, the authors have cited that the organisations such as NHS outsource their recruitment process to these agencies. The difference lies in the facts that NHS favoured agencies are deployed by the Department of Health. Humphrey et al. (2011, p.d1817) are of opinion that private agencies often face dogma of finding highly professionally trained medical staffs. In such cases, the quality of the health care is compromised for obtaining of higher profits. The recent backlash of the public regarding the outsourcing of patients to private hospitals have revealed that such hospitals often recruit from these agencies and the failing health care needs are the pertinent proof of their cheap services. On contrary, Birt, C.A. and Anders Foldspang (2011, p.134) argue that recruitment agencies such as Allied Health Professionals Recruitment Agency ensure that their professionals are trained for months or even years to gain the clinical competence for exercising analytical decision-making skills.
2.4.2 Educational system or University recruitment process
Frenk et al. (2010, p.1955) have pointed out that with each passing day, the NHS although providing excellent services, is becoming prone to the unsustainable financial structure. They are failing to entertain the huge number of demands and thereafter looking forward to the private educational system or the universities to meet their requirements. The private sector is aiming for high profit and as a result, General Practices or GP is experiencing retention and recruitment crisis. The authors have argued that the universities are training the medical professionals on target driven environment. This has led to significant rise in abdominal patient experience. One of the pundits, Jocelyn Cornwell has stated that it is vital time, the Government recognises the requirement of compassionate care in the medical practices. The medical schools fail to deliver the quality and during the recruitment process, the medical professionals enter the organisations without proper knowledge of the same. Moore and Kearsley (2011, p.48) have shed light on the association between the medical schools and the hospitals who overlook the basic requirements and recruit the medical professionals. Moreover, Plint, S. and Patterson (2010, p.323) have pointed out that in the sheer pressure on the resources and the people involved, the doctors are experiencing more disengagement with their work.
2.5 Role of management in leading, planning, directing, evaluation, controlling and performance review
In the sheer competence of the market, the healthcare organisations are integrating the principles of business management to improve the quality of patient care. One of the central factors of the business organisations is the leadership and management. This element is incorporated here to have effective results from building multidisciplinary teams.Al-Sawai (2013, p.285) have cited that in healthcare systems there is a spectrum of departments and professional groups who require engaging in both linear and nonlinear interactions. The authors have opined that it is a complex phenomenon, which is a result of unparalleled constraints associated with multidisciplinary staff, disease areas and multi-directional goals. The role of the management here is to allude to leadership in order to capitalise on the assortment happening in the organisation. The objective here is to effectively implement the resources and while designing the processes of the health care services. Proper leadership would encourage the employees on working towards achieving the common goal.
Slipicevic, O. and Masic (2012, p.106) have pointed out that health care managers need to be competent enough to deal with the issues faced by the healthcare organisations. The management services should emphasise on the assessment of the healthcare services, analysis and research identification. One of the principal elements that every health care manager should possess is planning effectively. Thompson et al. (2012, p.45) have pointed out that hospitals have to deal with emergency problems. Therefore, the management should procure an effective planning for evaluation of the analytical skills of the medical professionals. The managers are also responsible for the accomplishing the targets set, which is primarily achieving the priorities by procuring performance targets. The management plan for evaluation of the performance of the medical professionals through endurance of performance reviews as well. Garman et al. (2011, p.211) are of opinion that the management should incur tactics and various strategies to motivate the employees on achieving communication between the subordinates. The authors have also cited that monitoring of the performance and activities of the professionals would cast light on the actions. The management would be able to introduce corrective actions for elevating their performances.
2.6 Healthcare teams
The medical team is compelling for delivering care to the patients. In the healthcare profession, the medical team is defined as the unit of multidisciplinary people coming together to procure an interaction on achieving the same goal by maintaining stability and encouraging problem-solving discussions. Mitchell et al.(2012, p.15) have opined that medical teams are responsible for approaching toward the disaster management services in the hospitals. They are required for performing operations during the emergency services, caring for acute patients and even some medical teams look after the ambulatory patients as well. The authors have opined that the medical teams either be virtual or face-to-face and its size either small or large, nonetheless, their work is to function for obtaining patient outcomes. According to Baker, G.R. and Denis (2011, p.356), the tasks are heterogeneous in action and varies in accordance with the settings, patients, function and structure. Furthermore, the authors have cited that in the past 20 years, the healthcare sector has grown enormously and undertaken the assistance of new technologies, which is the driving force for the transition into a modern complex health care service.
2.7 Merits of the outsourcing for healthcare professionals
Iacobucci (2015, p.h875) have cited that outsourcing in the NHS has increased in the last 15 years due to political pursuits. The primary concern for the Government has been to ellate the market of internal healthcare. The authors are of opinion that the increasing waiting list of the NHS has been hampering the quality of services. The authors are of opinion that while the country is in a rage of discussing the demerits of this facility, the global phenomenon of outsourcing of medical facilities has actually gained importance. The NHS into the private sectors outsources the medical professionals. One of the principal factors that played a part here is the accession to trained and expert professionals. Guimarâes and de Carvalho (2011, p.141) have pointed out that NHS medical professionals are severely trained and expert on their services. Outsourcing them to the private sector means they would impart their decision-making skills and analytical technical skills to the private organisations where they would be to procure effectively and high-quality patient outcomes. The outsourced partner organisation would not be troubled for employee retention, as NHS would be responsible for the management of the outsourcing. This would result in improvement of the care experiences and positive patient outcomes.
2.7.1 Demerits of the outsourcing
In the recent times, the government and the NHS have faced the rage of the public with their outsourcing of the services and the medical professionals. Last year and in the years 2014 and 2015 reports have claimed that the patients have faced issues regarding their treatment and care services. Usman et al. (2015, p.438)have pointed out that the highlights of the reported problems are the issues with the declining quality. Even the Care Quality Commission has raised on avocations regarding culture, management and quality of care. The investigations led by the CQC team have shed light on the delays in the procurement of pain reliefs and a catalogue of failures happening at the hospitals.
Rahim et al. (2010, p.1) have cited that the Royal National Institute of Blind People (RNIB) have reported that the number of patients is growing in the non-NHS sectors. Thus, they argued that patient safety guarantee is of major concern now. The private providers have operated many critical operations of the NHS. However, the authors have shown that many of the patients suffered from critical injuries or negative patient care in the hospitals. The consultants of the NHS raised their concerns on the patients coming for postoperative complications.
NHS stands on a foundation of key principles. However, Child (2013, p.150) have feared that with privatisation and outsourcing, these principles would erode away. The authors have opined that one of the basic factors is the delivery of free care services, which in the private sector is not entertained. Moreover, the above reports have revealed that even with a huge amount of money, they are failing to provide improved services. Furthermore, the medical professionals have warned that this has lead to fragmented health care service that is detrimental to the patients. Usman et al.(2015, p.438) have cited that one of the private hospitals have tried to obscure the declining patient care. However, the lawyers that threatened that they may result in defamatory objection of the hospital. This example has cast light on the lesser transparency of the private sectors. The authors have illustrated that one of the derogatory factors is that confidentiality masks the negotiations of the contracts and therefore, the public remains unknown to the public spending and degraded quality care.
2.8 Gaps in Knowledge
There are gaps in research and the literature that has occurred due to the confidentiality of the private sector. Thus, the actual count of the reports has remained obscure. However, most of the research has depicted the arguments regarding the outsourcing and the recruitment, training and retention of the medical professionals.
The literature review has cited all the arguments and counterarguments associated with the recruitment, training and retention of the medical professionals with a detailed account on the NHS and the private sector. The evaluation of the outsourcing also sheds lights on the pros and cons related to the alleviation of the quality of care services.