Addressing The Change In Patient Care In Nhs Assignment Sample

Introduction to Addressing The Change In Patient Care In the NHS

The concept of organisational change has a significant impact on employees alongside associated operations such as employment, payment and conditions of service and roles and responsibilities of staff (Odour, 2018). In healthcare organisations, changes in organisational settings also involve operations in regards to the patient care process alongside managing different health conditions. This also includes the involvement of employees in terms of addressing those changes in patient care services and other chronic health issues, such as kidney and liver, in case of making decisions regarding the treatment (England.nhs.uk, 2023). As the concept of co-production in transformation care always requires a shared contribution towards the sense of care approach and identifying purposes, it is also important for providing improved support for the patients while encouraging them to take part in it (Qielft, nhs.uk, 2023). A similar approach in the care system is also implied in the case of German and Spain healthcare systems since the year 2009 (Qi.elft.nhs.uk, 2023). While approximately 95% of the total chronic disease patients maintain self-care for their whole life, only 5% of the population are capable of communicating with health workers while managing their transformational care approach (Ndti.org.uk. 2023). Therefore, there is a requirement for change for increased awareness on the staff and patients’ sides in regards to managing self-care for chronic disease conditions and taking part in making decisions for one's well-being. The overall approach was accepted into the operational part of the NHS to improve patient care by involving them and achieving the utmost results. The following context is intended to address the overall change process in the NHS, alongside describing the change steps and theoretical perspectives.

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On the other hand, while addressing the changing steps in terms of pointing out the policies for the care process, it can be stated that the primary focus of introducing co-production in the case of transformational care refers to the improvement of the relationship between CKD patients and healthcare providers (Hunte and Bengoa, 2023). This step involves opinions from the clinical co-chairs of the board, along with clinical leadership from the board level, for the development of the main care process and workstreams. This is followed by focusing on the change of transformation care on policies such as ways of working and honorarium of patients’ involvement for UK Renal Registry expense policies (England.nhs.uk, 2023).

As the implementation of Co-production transforming care is also part of the NHS's 5-year forward view plan, it is outlined to empower CKD patients while being fully engaged with positive choices towards the care process (England.nhs.uk, 2023). This also includes plans on personal customised care along with shared decision making to encourage the patients to be active and involved regarding the maintenance of participants in Co-production. Therefore, it can be stated that the overall change in care plan is emergent while addressing the effective personalised comprehensive transformation towards CKD patient care and involving employees to associate them for a better patient experience and services.

Organisational background and stated need for change

While change is inevitable in the case of healthcare, it has a severe impact on developing hospitals' involvement in the form of engaging employees, adequate information for the staff involvement and proper training and supporting staff for the change by the management (Hunte and Bengoa, 2023).&While co-production in transforming care involves care partnership along with care work between the groups of people who are working together with the aim of improving services, it also helps in supporting patients with learning disabilities and displaying behaviour to face challenges (Sangiorgi et al. 2022). For the following in the case of CKD patients, it can be stated that taking medicine at home care and living with CKD requires knowledge on proper care processes in the form of medical aspects, dietary management and physical activities and lifestyle management (Manley et al. 2022). This is followed by a regular review and monitoring process with the care team in regards to the identification of present symptoms, medication, tests on kidney function and monitoring dialysis. However, as a small population is capable of continuing these monitoring and continuous visitation in regards to the present functionality of the kidneys, the requirement of improving home care in the form of inducing co-production transforming care is important. This is also effective in terms of engaging patients to be habituated to their strengths and capabilities to handle themselves, going with dialysis and managing their medications and lifestyle for better health (Conquer, 2023).

While addressing the strengths of the NHS's previous care process for the CKD patients, it can be noted that the organisation is effective in managing the treatment process of patients, along with the provision of regular review and monitoring, which involves its staff managing the operation. This is followed by managing the care process along with finances and benefits, providing treatment care (Mc Laughlin et al. 2022). The primary aim of these includes providing a proper medical lifestyle for the patients with the help of professional caregivers, where the patients are required to maintain a continuous visit and monitoring as part of the treatment. This is followed by the role of professional supervision by the healthcare teams to maintain well-being for the care process for patients at home.

The weakness includes over-dependency of healthcare professionals on post post-discharge state for the patients. This also includes engaging with healthcare professionals and being dependent on continuing the treatment and receiving dialysis. This also includes the cost factor for the patients in terms of continuing with the dialysis process. Approximately 0.9 to 2.4% of the affected population discontinue their dialysis on the basis of the high rate of dialysis in the UK, alongside requiring a long-term period for proper kidney recovery (O'Mara-Eves et al. 2022).

The opportunities of the previous care process include medical assistance for the patients along with established care facilities for the formal caregivers in terms of continuing the dialysis at the hospital setting and managing the patient's medication and well-being.&

However, in the case of threats to the old care approach, it can be stated that it is overly dependent, and no mutual decisions are made in order to continue the process. This is followed by a fixed structure to manage patient care by the employees with previous care settings of the NHS, and not looking out for opportunities to make the overall process affordable and transform it for patients. However, with the changes in co-production transforming care, the shared decision and engaging with the healthcare professionals, there are 50% fewer patients in terms of continuing the previous follow-up treatment without continuing at home (Kingsfund.org.uk, 2023). However, it impacts the hospital setting positively by reducing workload for employees and associated healthcare professionals.

Description of the change process for key functional areas

Kotter's model is considered a significant framework that is implemented by the organisation in order to implement successful changes and focuses on the creation of urgency in order to make the change happen (Kotterinc, 2023). I selected this model as this model is considered effective to provide logical and stage guidance to gain transition towards successful changes in eight steps [Refers to appendix 2].

The initial stage is called creation of urgency, and this helps the leader of the organisation to convey the significance of requisite change and ensure the process by making everyone feel motivated and involved. The selected model emphasises the change process without threatening the momentum of the change process and thereafter reducing the level of urgency on the basis of needs (O'Mara-Eves et al. 2022).

This has been created in the case of the NHS, while having the ultimate goal of transforming participation and introducing co-production for the CKD patients. It is part of the NHS five-year plans, along with the involvement of universal personalised care process from 2019 (Nhs.uk, 2023a). This step is followed by the creation of internal communication involving NHS staff, along with local newspaper and social media posts, with the aim of growing awareness among the patients and their families. While the employees were promised a raise in their remuneration package, the patients were involved in terms of accessing a positive care approach and maintaining their well-being (Lightfoot et al. 2022).&

The second stage is the formation of a guiding coalition, which can be achieved by identifying effective change leaders along with stakeholders and requesting their involvement, along with commitment in terms of managing the overall process. This is followed by developing a powerful change coalition in the form of a team and identifying weak areas for improvement. This is followed by ensuring the overall team involvement across the functional department to achieve the proper result (Pearce et al. 2023).

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During this stage, the roles of patients and healthcare staff, along with their responsibilities, have been identified while recognising their values to form a broad range of assets. This is followed by recognising strong leadership and an agreed route for grievances, requirements for dealing with unresponsive behaviour (Schroeder et al. 2022). This step also helps in forming the hierarchy board by recruiting patient leaders along with the maintenance of workstreams roles while enabling a collaborative approach for the clinical co-board. As the NHS is a public service, non-profit bodies, along with co-governance and co-management, clinical teams were formed for the stakeholders’ duties (Banerjee et al. 2022) [Refers to appendix 1].

The next stage is the development of a vision and strategy by identifying core values, realising change and ensuring implementation of the plan.

The vision for the plan refers to presenting updates in the form of a patient clinical shade approach and endorsing the use of proper knowledge and skills for the care of patients (Schroeder et al. 2022). The strategic plan involves encouraging patients to gain their confidence and understanding in regards to managing care plans and doing their dialysis at home, alongside providing training and resources to employees to continue the new care approach. On the other hand, the renal unit associations of the NHS explain the strategic plan of this program by ensuring the replication of the dialysis process at home and enhancing the quality and delivery of co-production transforming care by employees while using proper training and hospital resources (Kingsfund.org.uk, 2023).

The fourth stage is communicating the vision by understanding the requirements of the target audience and arranging proper communication while involving stakeholders.

For the following, the target audience refers to the CKD patients who have been discharged from the hospital setting and are currently in need of continuous consultation and dialysis. This also includes the involvement of healthcare professionals who are capable of enhancing the perspectives of patients' experience in regards to the care process by co-production, transforming care. The communication measurements that have been taken are PAM (patient activation measure), along with PROMs (Patients reported outcome measure) and PREM (Patient Reported Experience Measure) (Kingsfund.org.uk, 2023).

The fifth stage is empowering activities, and here, under the NHS's 5 years forward view, patients were empowered to be fully engaged while making positive choices in the presence of professionals regarding their health and lifestyle at home care process and continuing dialysis and consultation (Farrand et al. 2022). This is followed by involving the organisational staff and resources to improve the overall care process, along with a mindful continuation of patient care services (Farrand et al. 2022).

The sixth stage is the creation of short-term wins, and for the following, it refers to the routine collection of patient and healthcare professionals’ communication, along with improving patients' own experience within 10 renal units. This is followed by increasing the overall processionals expertise by the renal unit for positive staff management and implementation of resources in patient care (Whitehouse et al. 2022).

The next stage is consolidating gains, and for the following, it includes involving patients, families and healthcare professionals for knowledge improvement along with skills and confidence while making decisions at home care services for CKD patients (Kingsfund.org.uk, 2023). It also includes developing partnerships with healthcare providers and improving clinical markers.

The last stage is sticking to the change process, and here in the NHS, the team has maintained the consistency by using surveys in CKD patients and employees regarding health and work streams while managing co-productive approaches for customised patient plans and conducting learning events for employees (Kingsfund.org.uk, 2023). These events include the role of a healthcare professional’s team to comprise 50% of patients, along with developing a 30- 60- 90-day implementation plan and encouraging small circle visits for maximum results (Kingsfund.org.uk, 2023).

Roles and perspectives of key functional areas

Before the co-production care process, the stakeholders group included no representatives from the governance and consisted of only healthcare professionals managing patient care in a top-down approach (Manley et al. 2022). The primary role and responsibilities of the pre-change care process involve the leader's association in the form of a transformational approach to manage the team and assisting patients with proper care in the form of patient-reported outcome measurements (PROM) (Nhs.uk, 2023b). This is followed by involving senior clinical employees in a hierarchical manner from the identified unit to report and manage the clinical team in terms of continuing the post-discharge care process of patients without involving home care. In addition, the visitation is also limited for the 10 units dialysis, followed by a continuous follow-up and supervisors under the guidance of an in-home carer (England.nhs.uk, 2023).

However, the primary stakeholders who are involved in the case of employing co-production transforming the care process for the CKD patient referred to NHS England clinical experts, patients along with professional clinics and 12 to 22 board members who are aware of the patient's condition and treatment procedures (Nhs.uk, 2023b). This is followed by a governing guidance alongside a program core group that consists of one patient and a co-chair, and clinical leaders and a work stream that represents a partnership between the patient and clinical work stream. This is followed by co-production champions and groups from the renal unit working that are connected with real and cultural change in regards to the patient group who receive treatment (Manley et al. 2022). The primary roles and responsibilities of clinical leaders refer to the follow-up of emerging patients by inducing patient involvement, leading towards changes and co-production of cultural change in the case of the program care team and board members. It also includes arranging resources for employees and training for the professional competencies, alongside a remuneration package for the continuation workstream. The use of transformational leadership is effective here as it improves the overall productivity in the case of managing patient care and elevates job satisfaction among employees to achieve maximum outcome (Eason et al. 2022). In the case of Co-production transforming care, this has been managed in the form of including PAM and CS-PAM for improving employees’ skills and engagement with professional clinicians by arranging educational training and resources alongside patients to form a shared decision-making on the overall care process (Sangiorgi et al. 2022). Besides, the change in care process is considered soft practices in the form of strengthening training, communication, teamwork and participation by employees with the aim of committing to the excellence of organisational operation. This also helps in supporting the patients in the form of managing visits and calls, sharing the learning process alongside cohort calls, newsletters and bulletins in terms of continuing communication and ensuring everyone's involvement for the co-production care approach. Besides, as a change in organisational setting requires a bottom-up approach in terms of accessing current patients and employee data and the rate of the continuous treatment (Sturmberg and Njoroge, 2017), it also helps organisational leaders to build perceptions to move forward with changes. Similarly, in the following context, the same approach is implied to access information in a bottom-up approach and then transformational leadership is implied to sustain the changes for a better care process. This also helps in making the original care service a sub-service of co-production in the form of emergent changes and employees reporting to their respective unit leaders in a matrix structure of healthcare to continue the hierarchical relationship with the board and stakeholders (Eason et al. 2022).

Application of the key theory to the case study

The context of complexity leadership theory (CLT) is considered to be significant in terms of balancing formal and informal organisation dynamics by addressing complex adaptive systems to manage learning, creativity and adaptation for changes in the organisation. This is followed by addressing the belief in regards to the organisation leadership's success on the basis of knowledge, innovation, creativity and learning in competition with motivating employees in the form of transformational aspects (Verma and Mehta, 2022). This theory is effective in the following context, based on addressing leadership towards changing the care process for the CKD patients in the NHS, showcasing nonlinear dynamics ina work setting alongside the adoption of changes under the transformational leadership to justify the emergencies and receiving feedback from employees and patients to solve chaos in the hospital unit. This participation of healthcare professionals is effective for healthcare leaders to motivate them and other staff while conceptualising the primary actions in patient care and staff management in terms of collaborating and managing complex system thinking for the innovation mindset (Schophuizen et al. 2022). As the following context is based on the changes of normal healthcare process for the CKD patients with co-production transforming care process, it also relies on the capabilities of leaders to manage collaboration with identified stakeholders alongside engaging patients for an innovative care approach. This is also noticeable that changing and transforming the care process of chronic health issues is considered a big step for the organisation while expecting a positive outcome (Verschueren and Sveinbjarnardóttir, 2022). However, in the case of the NHS's co-production transforming care, the patient group is sharing their decision with clinical leaders with the aim of improving the overall outcome and involving everyone using local people and groups. The leaders in the medical field are capable of using the new transforming care partnership to improve their skills, communication power and involve organisations towards shared decision making.

Conclusion

In terms of concluding the following context, it can be stated that the implementation of Co-production transforming care towards CKD patients at the NHS increased the overall engagement of patients in post post-discharge state. This is followed by improving decision-making by using shared points of view while aiming for an effective care approach. However, in the case of the overall patient's number while being dependent on the healthcare professionals, there are less population and fewer survey processes in order to address the effectiveness of the care approach. This also includes the implementation of Kotter's change model to imply a new approach by involving stakeholders. While the change model has successfully addressed the inclusion of patients and clinical care professionals, it has also directed the effectiveness of the partnered collaboration while managing an improved care approach for the CKD patients.

Lessons Learnt

I have learnt the change process that impacted the identified organisation positively in terms of improving traditional health care approaches, alongside the overall improvement of care services towards a specific chronic health issue. This includes improving the policy of renal registry expenses and a way of working and collaborating in the form of co-designing events to manage the care approach for co-production (McLaughlin et al. 2022). I have also realised the impact of the new approach on the organisation by improving health surveys, the views of patients in terms of reporting their experience, while continuing post-discharge care approaches. The participation and collaboration of patients and healthcare professionals also improve the CKD program by sharing learning aspects and participating in Renal units with the aim of facilitating shared approaches and clarifying the vision for patients to be aware of useful knowledge and skills (Thinkkidneys.nhs.uk. 2023). I have also observed the enhancement of the overall delivery and quality of the care program with the concerted effort from healthcare professionals and patients in terms of improving a co-productive approach for the renal unit and working groups, patient champions and peer supporters.

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