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NHS Trust hospital case

NHS Trust hospital case. Aya, Aleksandra, Sandip. Profile. NHS Trust provides a full range of acute and midwifery service to a population of about a quarter of a million people. Organization employs 2800 staff; change involves only 250 people.

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NHS Trust hospital case

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  1. NHS Trust hospital case Aya, Aleksandra, Sandip

  2. Profile • NHS Trust provides a full range of acute and midwifery service to a population of about a quarter of a million people. • Organization employs 2800 staff; change involves only 250 people. • Organisational change: an attempt to introduce multiskilled, ward-based teams of support workers in a medium-sized NHS Trust hospital in the UK. • All staff would be multiskilled and able to do a full range of roles: cleaning, transporting patients, serving food, etc.

  3. Motivation • Herzberg’s two-factor theory helps to reorganize and improve the design of jobs • Extrinsic factors: • Working conditions would improve as workload would be distributed equally, there would be no ‘waiting for action time’, ‘wasted journeys’... • Salary/status: All existing formal status and pay differences (except management) would be removed. However, as a result of generic working, all staff would be upgraded and receive a pay rise. Performance pay would be based upon attendance. • Relationship with peers: it would be a team work, would feel like part of the process • Intrinsic factors: • Advancement: Additional training (food serving, cleaning, portering) • Responsibility, sense of achievement, recognition: Undertake a wider range of tasks, work in team, see the result of work, closer relations with patients.

  4. Motivation • Motivation is improved by job rotation, job enlargement and job enrichment • Give employees opportunity to increase their responsibility and involvement, therefore, opportunity for advancement, achievement and recognition. • Employees benefit from the resultant job enrichment and cooperative teamwork • However, not everyone was satisfied: • Porters thought of a cleaning as a women’s job and didn’t want to do it. • Porters are undestaffed and suffering from a low morale with a poor sickness record • ”fire-fighting” • Only 12 people votes in favour, 150 - against, the rest declined to vote.

  5. Team work • Advantages (in theory): • people perform a range of tasks and don’t get bored with the routine work; • No status and payment difference • the patient cares would improve; • everyone would be included in the social life of the hospital, everyone would feel more responsibility. • Drawbacks (in reality): • one manager: ”It’s about boundaries between groups. […] … and making them work in teams is impossible”. • Not satisfied with work rotation • Was not team work in many cases, some people refused to perform particular tasks

  6. Structure • The structure would be team-based • consist of employees from various functional departments. • Interdisciplinary approach to management. • Permanent team solve ongoing problems. • They tried to radically reengineer job design to improve quality, service, speed and cut costs. • According to modern thinking such approach should have worked. However, in reality it failed to motivate a majority of workers, brought more uncertainty and decreased efficiency.

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