SD4S07: Policy Report Assessment Answer

Introduction

With the advent of the NHS Patient Choice Policy, a noteworthy transformation is experienced across UK healthcare, owing to the fact that it permits patients the ability to opt for healthcare provider for specific treatments and services (Arnell & Freeman 2022). This ramification of the policy has left impressions in Ramsay Health Care UK, a renowned private healthcare provider. It is needless to state that since this policy is patient centric in nature, it has inherently influenced the working function of Ramsay Health Care or RCH, and it is imperative to evaluate the manner in which this policy will affect its day-to-day operations, aside from influencing strategy, and measures inculcated to care for its healthcare consumers.

The solitary intention of this report is to meticulously scrutinize the ramification of the NHS Patient Choice Policy across diverse working functions of the healthcare institution. Aside from extrapolating the policies’ influence on patient referrals, the report would also analyse the standard of quality service, competition and patient experience offered by the healthcare facility. In terms of substantiating recommendations to senior management, existing strategies and practices of RCH are meticulously analyzed to understand the nuanced effect, which this policy has left, on RCH’s practice. The scope of this report primarily encompasses the strategic decision making that healthcare organizations should undertake, in order to ensure that patient experience is enhanced significantly. Apart from that this report also seeks to draw a comprehensive inference, with the help of which senior management can leverage opportunities and tap into healthcare landscape, so that patient choice policy can be navigated for augmenting patient experience and creating new opportunities to amend healthcare services offered by RCH.

Policy Overview

The NHS Patient Choice Policy was devised by NHS England, entails an instrumental page in the history of healthcare delivery, since it concentrates upon empowering the healthcare consumers with the prerogative to opt their preferred healthcare provider, for certain treatments and services (Charlesworth et al. 2021). Aside from augmenting autonomy for the patients, this policy also intends to solitarily reduce waiting times, thereby fostering a competitive ambiance within the healthcare segment.

The focal point of the policy is to enable healthcare consumer as per NHS, so that they can formulate decisions with adequate information pertinent to their care (Chopra et al. 2018). To put it in simple perspective, it can be stated that if the patients are already substantiated with adequate data regarding their providers, then they would be able to select providers on the basis of their needs. This would not only ease the process of accessibility, but at the same time, the care delivered in this approach would take less time and would be aligned with patient centeredness inevitably. One of the interesting aspects in this context is that, in this manner, it is expected that the healthcare sector will make necessary amendments to their service, in order to get ahead of the competitive curve.

The rudimentary idea associated with this policy can be charted back to its intended purpose of ameliorating healthcare consumer experience, which should not only optimize the allocation of resources, but at the same time, enhance the efficiency of healthcare service within NHS (Christensen et al. 2017). According to a recent study conducted by NHS, it is revealed that timely accessibility to adequate healthcare, not only acknowledges the gravity of the element, but it also alleviates patients’ well-being to a great extent (Dennis et al. 2021). As a consequence of which, NHS introduced patient choice policy, which evolved from addressing the current impediment across healthcare landscape in the United Kingdom. 

Evidence-based argument

With the advent of the NHS Patient Choice Policy, RCH UK started experiencing impediments in terms of staffing dynamics in several manners, which are mentioned hereinunder:

• As far as patient load is concerned, it is observed that with the inculcation of the policy, RCH has stumbled upon an overwhelming 32% increment in terms of patient admissions across diverse specialties in order to avail medical cases (Drennan & Ross 2019). This has solitarily strained the current workforce of RCH UK.
• One of the noteworthy facts regarding the aftermath of the policy inculcation is the deployment of a plethora of services that RCH UK had to offer, which can necessarily be translated into excess drainage of revenue generation of the healthcare facility (Ham & Brommels 2019). The reason being that inculcation of specialized medical staff across multiple healthcare services can only be substantiated by increasing expenditure, which subsequently lead to enhancing complexities of team coordination.
• As a consequence of the policy inculcation the adjusted nurse to patient ratio has also been influenced drastically Simply put, the policy permits patients to opt for their preferred service provider in the healthcare facility, which gives the autonomy to the patient to decide whether they would choose RCH or not, in view of getting quality service. This subsequently results in managing high acuity cases. As a result of which, the workload on existing medical staff, including General Medical Practitioners to Registered Nurses has seamlessly enhanced, where they have to provide quality service around the clock, due to surge in patient flow. For a healthcare facility to operate at its optimum condition, the staff to patient ratio is an essential metric, which assists the organizational authority of the healthcare facility to recalibrate their ability to care for patients (Hoernke et al. 2021). In this instance, sudden spike in patient flow, resulted in disparity across staff availability during the course of peak periods.
• The segment which has experienced the blunt end of this policy is the workforce of healthcare facility. From an apparent vision, it would seem that with incorporation of adequate technology and equipment the overall medical care facility can be augmented extensively. However, crucial facet in this particular context is retaining the existing skilled professional, so that the ongoing concern of the healthcare facility can be maintained from RCH’s perspective. Approximately 16% of staff turnover is experienced within the last couple of years, which not only strained the continuity of providing quality care, but necessarily intensify to evaluate meticulously the existing efforts aligned towards retaining skilled workforce (Johnson et al. 2021). Generally, this can be translated in offering lucrative packages, which inherently influence the budget of the healthcare facility in a detrimental manner. Financially speaking, the healthcare facility has experienced 18% deep in its profitability, in terms of ensuring that the workforce is retained within the organization, by substantiating them with lucrative perquisites and competitive salaries with adequate benefits.
• The notion of skill mix and staffing pattern is quintessential in terms of substantiating quality care as per Patient Choice Policy (Majeed et al. 2020). In view of the reason that since patient now have the ability to choose healthcare providers as per their requirement, oftentimes it is experienced that complicated ailments requires multifaceted solution. In general, the healthcare facility has several attributes when it comes to providing quality service. However, for complicated scenarios, treating the element necessitates interdisciplinary collaboration, aside from General Medical practitioner, specialist in the discipline is necessary. For instance, the patient suffering from rheumatoid arthritis as well as auditory problem, require specialist in both disciplines, so that the journey of recuperation can be delivered to the patient in a seamless and swift manner (McKee et al. 2021). However, the challenging aspect in this context is the staffing pattern. Interdisciplinary collaboration is not always feasible to be actualized in reality with existing staff member, which means that RCH has to undertake recruiting new members and aligning them with their respective interdisciplinary collaboration team, so that resolving complicated cases becomes quite convenient in nature. However, if adequate measures are not taken into consideration, the feasibility of emanating potential conflict across team dynamics is inevitable throughout RCH’s working function.

Staff Training Implications

The implication on staff training of RCH in lieu of NHS Patient Choice Policy inculcation are as follows:

• For the sake of substantiating a broader spectrum of treatments, RCH promptly reviewed its conventional training programs, and made necessary amendments, so that diverse medical cases can be handled effectively by specialists, who referred patients seek. New programs are also tailored so that knowledge horizon of staff members can be evaluated on a regular basis so that the workforce can accomplish excellence in their respective roles.
• On top of that the impact on the morale of the workforce has also been affected by including the new policy. For instance, in one hand, the opportunity to broaden the learning curve on behalf of RCH motivated them to actively engage in augmenting their professional growth. On the contrary, impediments during the course of transition which emanates due to adapting to new training requirements immensely lead to temporary dips in morale (Meredith et al. 2020). At the outset, the workload itself solitarily plummeted the job satisfaction thereby depleting the overall morale within RCH.

Patient Access Challenges

Apparently, it would seem that the policy is attributed with advantages. However, it has its fair share of disadvantages associated with it. For instance, while gravitating towards patient choice, the policy inadvertently failed to realize that it would enhance longer waiting time for receiving proper treatment and appointment, thereby straining the overall capacity of medical resources. The consequence of which would inherently limits the option of availing adequate treatment for all patient concerned in a healthcare facility (Mongan et al. 2018). For instance, if patients suffering from neurological problem opt to avail service in RCH, the feasibility of delivering all patients from the vicinity is significantly limited, even if the channels are communication are open and transparent in nature. It is not always possible for RCH to live up to the expectation of the concerned healthcare consumers, who have opted to receive quality treatment from the healthcare facility, thereby tarnishing the brand equity of the healthcare institution among patience.

Organizational Culture Shifts

• The concept of organizational culture has also been scathed by the incorporation of new policy, owing to the fact that, aside from compromising employee satisfaction due to extensive workload, alignment of staff as per patient centric policy has drastically resulted in conflict emergence, among the workforce, due to clash of inter collaborating assistance (Neubeck et al. 2020). The policy inculcation concentrated upon healthcare as per patient preference, which often seems to create impediments, due to sudden change of schedule among the General Medical practitioners and specialists. The resultant of such conflict is vivid in gradual depletion of employee motivation.
• Apart from that the shift in organizational culture has been detrimental for the responsiveness associated with health care urgency extended by the organization. The consequence of such conflict has significantly surmounted pressure on retention consideration amidst the workforce and in often cases, employees are feeling least motivated or misaligned in their objective, while participating in inter-collaboratory services for treating complicated ailments.

Teamwork Dynamics and Collaboration

The influx of diverse patient cases demands seamless interdisciplinary communication, which is a direct byproduct of the policy, since it establishes a common ground to fosters collaboration amidst diverse specialties to ensure the patient-centred care to be comprehensive in nature (Reibling et al. 2019). Effective Teamwork Strategies such as regular interdisciplinary meetings are hosted by the managerial authority of Ramsay Health Care UK, which are attributed by open flow of communication so that teamwork can be advocated, which would ease the approach of formulating informed decisions.

Professional Autonomy and Accountability

This policy's core tenet lies in the empowerment of healthcare practitioners to customize patient care according to individual preferences. However, a consequential implication emerges in the form of a requisite adaptation of treatment strategies to harmonize with the available medical specialties and resource constraints (Stadhouders et al. 2016). The elevation of patient choice as advocated by this policy substantially augments the dimension of accountability incumbent upon healthcare professionals. This elevation necessitates a heightened sense of vigilance and conscientiousness in decision-making processes. Practitioners are entrusted with the responsibility to ensure that the chosen treatments not only align with patients' best interests but also adhere to stringent ethical and clinical standards.

Bureaucracy vs. New Public Management

The policy's impact on bureaucratic structures and principles of new public management are mentioned as follows:

• The policy's pronounced emphasis on the empowerment of patient choice begets a necessity for streamlined and expeditious decision-making processes. This recalibration is imperative to facilitate the seamless scheduling of appointments and the prompt initiation of treatments, resonating with the ethos of patient-centric care.
• The policy's implementation has ushered in an evolution of the organizational hierarchy, driven by the imperatives of accommodating patient preferences and orchestrating timely care delivery (Stadhouders et al. 2019). This transformation accentuates the values of pliancy and responsiveness, offering a dynamic framework that aligns harmoniously with the principle of patient-centred service.

Power Dynamics and Team Impact

• Power Reconfigurations: The ascendancy of patient choice serves as the harbinger of a perceptible shift in power dynamics. This evolution manifests as healthcare practitioners embrace a collaborative modus operandi with patients, thereby culminating in shared decision-making endeavours that position patients as pivotal actors in care planning.
• Influence on Team Dynamics: The pivotal pursuit of patient-centred care, while seems to be instrumental pivotal, precipitates a landscape wherein the prospect of hierarchies and disagreements within teams emerges. The crux lies in the varying interpretations of patient preferences and therapeutic approaches, necessitating adept navigation to preserve team cohesion, effective leadership, and optimized performance.

The intricate matrix of these challenges and opportunities underscores Ramsay Health Care UK's imperative to adopt a proactive stance.

Theoretical Concepts and Management Theory

These following theoretical frameworks elucidate the multifaceted nature of the policy's influence across RCH’s practice.

• Agency Theory: The policy's emphasis on patient choice resonates with agency theory, highlighting the alignment of patients' preferences with the organization's goals. This theory underscores the importance of effectively managing principal-agent relationships to ensure optimal outcomes.
• Contingency Theory: The implementation of the policy necessitates adapting to external contingencies, such as changes in patient flow and case mix (Wurcel et al. 2019). Contingency theory asserts that organizations must align their structures and practices with external factors to ensure a fit that promotes effectiveness.
• Stakeholder Theory: The policy's impact on patient experience and collaboration embodies stakeholder theory. Ramsay Health Care UK must balance the needs of various stakeholders, including patients, staff, and regulators, to achieve sustainable success.
• Throughout the course of RCA's inculcation of policy driven changes, it is imperative to understand the gravity of transformational leadership, where the leader would not only motivate the workforce, but at the same time would also act as a beacon during the course of transition, so that resilience and adaptability can be fostered inherently among the workforce which would in turn assist RCH extensively (Varatharaj et al. 2020).
• Change Management Models: The concept of inculcating changes, such as this new policy is an emotional one. Hence, as per Lewin’s Change Management model, a structured approach should be inculcated in order to navigate the impediment which the organization is currently experiencing (Vindrola-Padros et al. 2020). Instead of freezing existing practices, it is imperative for RCH to undertake necessary amendments so that required changes can be inculcated seamlessly.

Recommendations

• The first course of action that is imperative for RCH is to incorporate flexible strategy of staffing, which aligns with the demands of the patient and has the capability to adjust fluctuations seamlessly. It is only feasible provided staff are cross trained, and part time contracts are utilized. In this manner, optimal resource allocation can be executed in reality, all while maintaining patient satisfaction.
• On a similar note, determining a structured pathway for skill development of the existing workforce, so that they can ascend gradually to medical specialties, should be conducted under mentorship as well as certification program, to broaden the learning curve of the staff member, so that they can substantiate necessary expertise in time of requirement without external assistance.
• Conveying the patient regarding appointment availability could permit them to opt treatment options and understand the gravity of the circumstances. This should be implemented in online platform, that is user friendly in nature, where even aged healthcare consumer can access the necessary medical information regarding appointment schedules conveniently.
• Inter disciplinary communication should be facilitated with digital collaboration platforms, where data pertinent with treatment coordination as well as peer consultation are shared with optimum efficacy, so that the patient centred care can be streamlined accordingly by RCH.

Conclusion

In essence, an inference can be drawn that although with the gravity of Patient Choice Policy introduced by NHS, the working function of RCH has been subjected to drastic amendment. As a consequence of which, the organization experienced severe impediments. However, if aforementioned recommendation strategies are inculcated with due diligence, then the feasibility of the organization to gravitate towards success within a short span of time is inevitable in nature.

References

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Chopra, M., Munro, S., Lavis, J.N., Vist, G. and Bennett, S., 2018. Effects of policy options for human resources for health: an analysis of systematic reviews. The Lancet, 371(9613), pp.668-674.

Christensen, S., Long, S.H. and Rodgers, J., 2017. Acute health care costs for the aged Medicare population: Overview and policy options. The Milbank Quarterly, pp.397-425.

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