Kenneth Oliver. PI-R1649126-K313- 14Y

Option B

TMA 02

Word Count

“It is often said that the only constant in the health and social care system is change. Reflecting on the leadership and skills and tools you have encountered so far in K313 discuss how you would go about supporting a group of managers in leading change. What might be some of the challenges and how would you seek to over come these.”

Introduction

One of the major items is leading culture and change, and how as an organisation it is implemented and well managed from start to finish with the pedagogical review of work.

The eight-stepped approach of Kotter, that demonstrates his theory of leading change that tried to make the implementation as smooth and was top-down in its approach of change management, so that this transition should be successful. As we already know that these steps are more practical in application. There are some elements similar to that are described by Kotter, 1996 cited in (Tilley & Jones, 2013). It could then have been argued as creating a dialogue whilst we will engage with senior management and the workforce as a whole.

This will assist in establishing a change in the culture within the society and thus, develop a change of behavioural integrity whilst developing the culture by using the employee voice as a learning tool.

Health and Social Care providers face constant challenges to constant changes and developments in the care sector. These could be a request of the service users. Because of that required change, the quality of service that is being developed could be at risk of being described as of an inferior quality (Tilley & Jones, 2013).

I will demonstrate the need for a dynamic rhetoric of change in our mind from the beginning and look at what we can do to ensure we deliver a robust service. To enable us to do to do this there will be a need for targeted interventions. It will include a localism in its agenda; this will increase in demand for services, present an articulated vision that includes staff in creating and developing the detailed narrative

However during any period of change and no matter how it could be managed and developed there could be some anxiety with additional feelings of excitement, optimism and commitment (Tilley & Jones, 2014). In turn, this might well influence people’s perception and experiences of change within the environment and how the manager or team leader manages the period of transition will depend on how it can move forward

It could be said that both models have something helpful to demonstrate the processes of change. This does however at the same time show the need to take an urgent look at perspective of such structures and what they may really mean in practice for somebody that is tasked with conveying change.

One of the biggest challenges in any period of change is to decide how it will be best to facilitate it. That in a way we would need to analyse it to ensure that will be adequate for the purpose and enable the change to be suitable for the organisation.

There are different tools that managers may use that can assist in the implementation of the policy change.

The best available model that offers the most flexibility is Political, Economic, Sociological, Technological, Legal and Environmental model more commonly known as (PESTLE), (Tilley & Jones, 2013 p 104 (a).

However, this enables us to have a better understanding of the picture as a whole. It also allows you to have a better access for the facilitation of risk assessment at the same time.

We should not forget the other tools that are available to assist in the implementation of a new policy. As it may be appropriate at different times of the development to interchange tools of analysis such as Strengths, Weakness, Opportunities and Threats (SWOT) (Tilley & Jones, 2013 p 104 (b).

The organisation has asked the Senior Management Team (SMT) to update and to develop a Complementary and Alternative Therapies Policy (CAPT) to ensure that it is compliant and fit for propose. Part of this process is that a facilitator works with the SMT to assist in the development and implementation, of the Complementary and Alternative Therapies Policy (CAPT). It will require input from a combination of practitioners, across disciplines; the team will need to be supported working together in new and practical ways. I have there is a identified need to set up working group of all practitioners involved in developing this new service, thus being honest and practising in a competent manner (Taylor, 2013 p 44),

Also, Tuckman 1965 cited in (Browns et al., 2012) discovered that the building of the team and how it interacts with each other changes over time.

There are the typical four stages and adds a fifth later on, and it’s easier to see which stage the are in as the first word is more descriptive in its narrative description, they are Forming, Storming, Norming and Performing (FSNP) with Adjourning coming much later in 1997.

The SMT will need to take a balanced view and a responsive mind to any treatments or therapies that are on offer and to adopt a balanced view with the information as this is presented. I have also found that depending on who has studied or conducted the research that this can show a bias on the results. Oliver 2013 cited in (Stone & Katz, 2005 p 164) this demonstrated this to those users of Homeopathy, which are often more suspicious of Biomedical approach to care,

The team need to show that is this should not be so. The team need to concentrate on what we have with the integration within the NHS. As this model is best demonstrated at, “The Royal London Hospital for Integrated Medicine “, which is part of University Hospitals NHS Foundation Trust, which is the largest integrated centre of Integrated Medicine in Europe. However, as a person advising the team, I need to make the SMT aware that “when you have a change there’ll always be casualties… That is life “Greenshields 2011 cited (Tilley & Jones, 2013).

As we move on to the implementation of the policy that the SMT will implement of the Complementary and Alternative Therapies Policy (CAPT) for a cancer care local hospital. It is not just about the need to ensure that a managed changes in implementation this new service during an immense period in ‘Organisational Change’. The SMT and other managers that are implementing this might well need to be tasked with some swift, and decisive action to get the process moving Smale 1998 talks about the need to “manage those who think they are in charge, and also from those “standing on the rug” as this is taken away from under them “Smale, 1998 cited in (Tilley & Jones, 2013).

Complementary and Alternative Therapies are a relatively new service within the NHS, and the SMT need to proceed with caution in its development. The implementation and development of any policy will need to be read in conjunction with: -

a) Nursing & Midwifery The Code: Standards of Conduct, Performance and Ethics for Nurses and Midwives (NMC 2008).
b) Complementary Alternative Therapies and Homeopathy (NMC, April 2008).
c) Standards for Medicines Management, No: 23 (NMC, February 2008)
d) Complementary and Natural Healthcare Council (CNHC).
e) General Regulatory Council for Complementary Therapies (GRCCT).
f) British Complementary Therapies Council (BCTC).
g) Complementary Therapy Association (CTA).
h) Association of Chartered Physiotherapists

(Blackburn, 2012)

Which are the main policies to be working towards on the introduction of Complementary and Alternative Therapies, in a hospital setting. The therapist may be nurses or specially trained practitioners in that field, thus having the right to use those titles as they are protected by statute (HCPC-uk.org.uk, 2014).

Some of the practitioners will be subject to regulatory control because of a “Protected Title” and thus should be deemed as competent in the administration of the therapy or treatment. As practitioners are independent contractors to the trust they are responsible for the distinct of controlled, and indemnity insurance, but subject to reference and identify checking in line with “NHS Employment Check Standards” which sets out the checking process, validation and security as a minimum (NHS.employers.org, 2014). However, Nurses do still not have that luxury of the protection, and this seems that this could still be some way off. This type of role within the nursing field would most likely to be received from a specialist nurse with extended skills.

There is a definite need to engage with the managers to enable the process of expert facilitation Dobson et al 2008 cited in (Tilley & Jones, 2013) and to be able to empower, rather than take over the teams to put this process of change in place. This needs to be done without controlling or restricting, and some would see this as a risky business.

When a team works well, it gains respect from its managers, and it can then expand and reward those team members for the success in developing the process that have been put into place. When the team is motivated and its working practises are devolved, this is creating an environment where, the leadership’s roles are shared out; this is “distributed leadership”, this is now a standard feature in the health and social care field (Simmons & Lomax, 2013).

The policy for Complementary and Alternative Therapies applies to all of the therapies that can be provided as a service, in particular the following range, aromatherapy, reflexology, therapeutic massage, and acupuncture. The SMT are to ensure that the therapist abides by the guidelines in force, and that the policy is designed to be flexible and works in conjunction with current treatments and that it does not replace any treatment plan in effect.

In relation to current Nice guidelines there needs to be a more guarded approach, as November 2008, The House Of Lords published a report saying that “The report also says that well-regulated and evidence-based CAM therapies should be provided by the National Health Service” (Smith & Robinson 2000)

It was also interesting to note that the article goes on to co divide the therapies down even further in into three particular groups, into Group 1 as well developed scientific groups that are well regulated, Group 2 no diagnostic evidence and not well controlled Group 3 A lacking of any credible evidence based value, Group 3 B nothing specific spoken about here but the therapies included water dowsing

I wanted to touch on in my conclusion that Reflective practice is an important part of the learning journey, also that learning is a lifetime event and the capacity of the practitioner to reflect and engage is one of the defining characteristics learning journey Schön 1992 cited in (Griffiths, 2012)and learning from my experience

By having a structure to the reflective process both on an individual and in a team environment. We all have a chance to question our past decisions and ideas, to work in a collaborative way are often essential to the success of the work that an individual puts into the team. This does enable me to practice and engage with the people that I provide a service to.

By using this tool, this gives me the opportunity to improve the quality of my work and to learn from any shortcomings, to be objective in nature, and to be able to develop my professional judgement. I intend to respond that I can demonstrate a more positive manner to change.

One of the interesting themes of this essay was some of the prior learning in another module that I have used in a few places “K311 Promoting public health: skills, perspectives and practice” which I found especially helpful at times when I was stuck or didn’t know how to progress forward.

The world of Health and Social Care is always evolving almost like fashion we have seen the NHS Campus Closure Plan go full circle, even though it was first spoken about in 1960 by, “The Right Honourable
Enoch Powell MBE, a controversial figure if ever there was one. At times, I have felt complete out of my depth as I have never held a management post unlike some off the other course members. However, I hope to learn from it.

However on the whole I would have hoped that this piece of work would be easy to implement as a team leader, one of my responsibilities was the create community’s of practice within my team. This however meant the whole team should take control of how change promotes learning, and this in its turn excellence Dopson et al., 2008 as cited in (Tilly & Jones, 2013).

(Word count 2059)

References.

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Hcpc-uk.org.uk, (2014) ‘HCPC — Homepage (Health and Care Professions Council)’, [online] Available from: http://www.hcpc-uk.org.uk/ (Accessed 7 December 2014).
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