Good management is essential for the provision of various services to the community in efficient, sustainable, equitable and appropriate manner. It is only achievable when there is a balance between the different resources essential for service delivery. Although the aspect of management is crucial in ensuring efficient running of the day to day activities of an organization, a balance between the number of the directorate staff and that of the technocrats like clinicians is necessary so as to avoid the existence of a bogus working environment (West et al. 2015). Good managers always strive to be better leaders, thus requiring management skills to achieve effectiveness. On the other hand, leaders guided by their vision can communicate to all the concerned parties on the best approaches towards achieving the set objectives. The need for medical leadership has been rising in response to the decreasing resources. While most hospitals have been hiring managers and clinicians differently, most physicians have been ambitious on taking up the roles of leadership within the organization all with the aim of improving the effectiveness of operations (Veronesi et al. 2012). However, clinicians are facing numerous challenges in their pursuit for leadership. Their frontline duties are far much demanding such that in taking up leadership positions, there would be higher chances of undermining service delivery (Klaber & Lee, 2011). On the other hand, a greater number of managers within the organization results in friction from the clinicians considering that people will perceive them as more of theoretical in their approaches towards leadership rather than practical methods that involve working together towards achieving the desired results. It is notably easier for those in practice and knowledgeable of the day-to-day demands to influence clinical undertakings (Powell & Davies, 2016). The paper seeks to disagree with the perception that NHS has more managers compared to the expected number of clinicians, and the need to empower clinicians to take up the management roles thus bridging the gap that exists.
Under management is evident at NHS contrary to the claims showing the existence of a disproportionate number of managers compared to medical staff. By the year 2011, NHS had an employee base of 1.2 million workers, and of the total, only 40,094 served in the management positions. An increase of up to 65 percent on management numbers between the year 2000 and 2011 with approximately 30 percent rise in the total employee population over the same period (The Kings Fund, 2011). The issue of a disproportionate rise of management against other employees as raised by the media might have based on the 65-30 disparity, yet it was not an inclusive arithmetic that should have based on the percentages as factors of the overall population. On analysis, only three percent of the entire NHS populations are managers by the year 2000 and rose to slightly above 3 percent by 2010. The census undertaken in 2011, by the organization showed that out of a headcount of 1,193,334 employees, only 3.2 percent made up managers and senior executives (Klaber & Lee, 2011). After a comprehensive analysis, the NHS Confederation complained that it was unreasonable for one of the leading employers in the world with a spending of about 2 billion pounds a week, and providing health care services to over sixty million patients to have such a small management index. It is thereby clear that NHS management is lean, and the policy of lowering the number of managers to cut on costs being uninformed as it results in weakening the commitment and motivation of the managers thus compromising on the capacity to oversee the implementation of change within the organization (Klaber & Lee, 2011).
In various industries, management is an essential aspect towards achieving productivity, and thus NHS is not an exception. NHS managers are considered part of the greater medical team all united by the common objective of delivering quality healthcare services to the millions of patients (Institute of Health Care Managment, 2015). They are responsible for the coordination of all the medical staff to use most of their time and available resources in nursing the patients in an accountable and transparent system. The managers also have the responsibility of implementing an increasing number of policies within the facility which include waiting for time targets which are among the new health regulations (Laubscher, 2008). The senior managers, on the other hand, need to plan for a transition into a 24-hour service facility. At the same time monitor the quality of service delivery by attending to patients complaints, incident occurrences, and investigating on the reasons for unexpected deviation in performance thus keeping the clinicians accountable for their actions (Laubscher, 2008). From the look into the various roles of management, it is evident that the existing numbers of managers in the organization are far much overworked thus compromising on their outputs. Lesser managers are unable to respond to sustainability challenges in time due to the lack of time (West et al. 2015). Without enough management workforces, it is unlikely to offer services that are equitable, affordable, accountable, fair and safe due to the complex interactions involved.
Although there is demand for increased management personnel in NHS, it is notable that building a control force from the clinical staff would be the most efficient way rather than employing new managers. The reason for the approach is the historical existence of tensions between healthcare professionals and the directors (Wiskow et al. 2010). The struggles between managers and clinicians in finding ways of working together will reduce significantly through impacting leadership skills to the clinicians. They will in return efficiently collaborate with the juniors towards delivering on their mandate since they will be having an ordinary perception and understanding of situations and needs (Institute of Health Care Managment, 2015). Currently, it evident that there exists little communication between the managers and the front line practitioners due to misunderstanding in perceptions and approaches towards aspects of work. It leads to a need for an open and efficient communication model that appreciates the proposals of all members and works towards determining the most appropriate approach acceptable to all (Veronesi et al. 2012). In most cases, physicians focus on the client contacting them and endeavor to provide the best services but lack the power to do so considering that they have no capability to provide all the necessary resources. On the other hand, the manager focuses on increasing the number of patients visiting the facility and working on the submitted budget to maximize on the outcome (Dickinson, et al., 2013). Since managers do not interact directly with the patients, they often do not understand the pressure that clinicians meet with in their day to day activities hence the core reason as to why they never work together considering the different understandings of the situation at hand.
A look into the NHS working environment shows that workers are overwhelmed by duties due to the lack of proper guidelines on the priorities and responsibilities of each employee thereby resulting in inefficiency, stress, and low-quality health care. These occur as a result of ineffective leadership and management considering that it is the role of the directorate to ensure that duties are well defined and distributed towards achieving efficiency (Klaber & Lee, 2011). The lack of enough managers and leaders is to blame for the poor running of operations. Disparities in leadership portrayed by ordinary managers and medical managers have been noted by patients to influence the quality of medical care provided, with most patients noting that in situations where the managers work hand in hand with the clinicians they are always satisfied with the quality of the services (Bohmer, 2012). Like NHS, other sectors in the UK face a challenge of fewer managers in comparison to the overall workforce. In approximation, out of the entire UKs workforce, only 15.4 percent were managers by 2010. The statistics also show that only 77, 000 employees of the whole hospital workforce in the UK are managers making up only 4.8 percent (The Kings Fund, 2011). It is thereby notable that the problem is widespread in the country and it is not NHS alone that is facing a shortage of management personnel. Most of the health facilities have opted to nurture clinical practitioners into leadership positions thus reducing the existing gap between management and other staff, and also solve the issues arising from misunderstandings between clinical personnel and the managers (Wiskow et al. 2010).
The reduced number of clinicians in management positions is due to the professional bureaucracy that favored non-clinical managers and made the clinicians stick to clinical works. However, in the recent years, there have been an increasing number of clinicians occupying management positions due to the growing advocacy of clinical leadership in medical studies, but still, their move into management is affected by bureaucracy (Storey & Holti, 2013, p.18). Clinicians just like doctors have the suited professionals for management and leadership positions because they are credible and have adequate knowledge of patient-centered care. Most clinicians have the tendency of performing clinical roles thus attracting them into management requires a thorough understanding of the factors affecting their involvement in leadership positions. According to Guthrie (2010, p. 241) availability of mentors and roles models, and workplace engagement is the leading factors affecting the entry of clinicians into management and leadership positions. Therefore, enhancing organizational support and commitment in encouraging clinicians to play leadership roles, boosting individual interest in leadership, availing more examples of leaders and recognizing career drivers are essential in leveraging training programs. A good understanding of the elements is important for NHS as an employer during training and recruiting clinicians into leadership and managerial positions. A significant percentage of clinicians life is in the medical wards, and little do they involve themselves in administrative work as only a small percentage involve themselves in health management careers.
One of the ways of offsetting the low number of managers in NHS is to convert more clinicians to assume leadership and administration roles. It is the concept of clinical leadership which (Ham 2013, p. 1978) define to be the act of increasing autonomy and decision-making roles of clinicians in healthcare. Increasing the number of clinicians in leadership and management positions has an implication of reducing the tussle between the non-clinical managers and clinicians. The application of clinical leadership to offset the growing number of executives in NHS entails the use of two practice, enhancing their leadership and management skills through training, and conducting health care reform to give them equal autonomy and powers as the managers.
Regarding the act of training clinicians to acquire skills and knowledge for...
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