Planning and Managing Resources

The National Health Service was established in the 1940s to ensure that everyone, regardless of economic status, had access to adequate health care. It provides free medical care to inhabitants of the United Kingdom, with the exception of a few costs for dental services, optical services, and prescriptions. It has been rated the best in terms of effective care, efficiency, and cost-related issues, among other things, when compared to services provided by health institutions in more than ten nations. It employs around 1.5 million people and is funded entirely by taxation. The legislation has had an impact on its payment system as a result of its recent transition (Moschella, 2015, p.455) The NHS recruits and employs its workforce from diverse backgrounds regarding nationality, gender race, class and occupation, all with a commensurate reimbursement. The workforce includes full-time doctors and consultants, nurses and midwives, administrative and clerical staff, cleaning, catering, laundry, and maintenance staff. Since its establishment, the NHS has encountered the customarily expected wrangles with its team. Most of them cite reasons such as lack of enough remuneration or other challenges affecting the workers and affecting productivity, worker's lack of motivation, as reasons to slow down or cease to work altogether. The managerial team always sought alternatives, solutions and the loopholes were sealed leading to a resumption of all their operations( Moschella, 2015, p.446)

However, in the recent past, the National Health Service has been hit by a recruitment hitch because of troubles that have the workers have been going through causing a massive understaffing. A recent report indicates that poor pay and limiting of salary increase, pressures in the workplace among other factors are among the reasons the nurses prefer to quit and settle for other jobs or look for greener pastures. Those graduating from learning institutions are also a skeptic on joining the service because of the fear of experiencing such problems. This is because of the current financial pressures, despite its budget in England having been protected in the recent past. These pressures have been attributed to the rise in the NHS provider’s costs rising more than their income leading to a deficit. Also, the drug and staff that consumes the most significant share of the expenditure rose sharply which were more than the income (Johnson, 2016, p.31)

Additionally, there are demand pressures that increase day by day in the NHS that make it inefficient regarding service delivery. These include the population growth, aging rates, rising rates of chronic diseases, new available treatment and services. The population growth, for example, implies that more patients are receiving treatment more than before; the NHS has to keep up with the new treatment services to remain effective. These are among the other costs that the service incurs that supersede their income making it difficult to deliver (Moschella, 2015, p 451)

In a recently conducted research, results show that in the past years, admissions considered as being emergency increased by 2.7%, the elective ones increased by 2.3% and outpatients by approximately 4.4%. It further showed that emergency admissions rose faster than the elective that has created a further financial pressure on the NHS. Such pressures influence heavily on all operations of the service.

The NHS workforce has experienced numerous changes that have affected productivity. According to a recently released report, approximately 40,000 nursing positions are vacant in the NHS. It has also shown that the care providers who are hiring registered nurses are declining thus raising fears on the safety of the patients. It has also been evident that legislators have failed to fund appropriate policies for training, recruitment and retaining registered and more experienced workers.

Also, it is a reflection of failure in the national policies decisions. For, example the decision to do away with the nurses training places, a significant rise in the number of consultants and the failure to bail out NHS deficits. Research conducted recently shows that most of the NHS directors have agreed that most of the hospital's operations are relying on the goodwill of the staff to ensure services are running. Thus, if issues to do with the workforce fail to get the priority in the formulation of national policies affects the national workforce performance. They also indicate that there exist financial pressures of maintaining efficient services. Other than the economic forces, the staff too feels that they have been denied the right motivation and incommensurate remuneration. They have also cited that, due to the issue of understaffing they find themselves working more and for more extended hours without compensation (Henfrey, 2015, p. 3)

In the past years, nursing and midwifery students could apply for bursaries, which were non-repayable. Also, they could get loans depending on where they lived and their tuition paid by the government. This served as a motivation for more students to enroll and later get attached to the NHS and other health organizations. Contrary to the new system where these students will not receive such favors, the enrolment is bound to fall drastically and consequently, the NHS recruitment process. This is because of the few-trained personnel, and the available one will not consider working for the trouble national service.

Last year, the Britons voted for Brexit. This is a decision that shocked many people across the world and will see the immense transformation of Britain and Europe. The effects have begun to manifest heavily especially in the recruitment at NHS. Among many other factors, Brexit and the government's approach towards it have influenced NHS in some ways. Notably, the NHS employs so much on the staff overseas mainly from the European Union, due to the EU policies on the liberty of moving from one area to another and the acknowledgment of proficient abilities. Currently, there is shortage of nurses who are aging and are set to retire in the next 9-10 years (Moschella, 2015, p 446)

Brexit comes with the uncertainty of whether the nurse who has provided services in the National Health Service for not mores than five years will be allowed to remain. In addition to the current understaffing, reports project that in the next three years, the NHS will experience a decline of more than 16,000 doctors and about 100,000 nurses.

Additionally, the NHS has recruited close to 100,000 social care workers whose mandates are to take care of the elderly, and the chronically ill patients in other settings rather than the hospital. This is a crucial aspect of the UK's health care transition in efforts to reduce secondary care expenses. Sadly, even these employees, are mostly recruited from the European countries. With Brexit, the social care workers may also migrate back to their nations leaving the bad situation worse. Therefore, there is also no guarantee of long-term contracts between the NHS and the employees from European countries since the UK government has not stated their stand on the position of the same (Moschella, 2015, p. 458)

The government, in its quest to win Brexit voters, it promised allocation of the expenses sent to EU weekly, which amounts to 350 million dollars weekly, towards the funding of NHS. The promises are yet to be fulfilled leaving NHS vulnerable. Further predictions by an intelligence unit show that in the next 3-4 years will begin to offer the low quality of care provision due to the rising costs of healthcare.

Another possible effect of Brexit is that the UK is likely to lose on the improvement of its healthcare quality and innovation even though indirectly. For example, testing for new drugs for some countries will be forced to apply them in each state, contrary to the EU members who can run such tests on an EU clinical trial database. This will cause a massive burden regarding cost and administrative charges for the NHS. Also, the UK will lose control over the European medicines agency, the body responsible for the approval of drugs within the EU. This implies that the UK will have a different organization to conduct on the same, leading to more spending thus a pinch in the NHS's budget plans (Majeed, 2014, p.68)

The UK will also suffer because it receives funding that it gets from some medical research streams that affiliated to the EU. Also, the coordination of the EU is vital especially in the reduction of potential health outbreaks and other pandemics. The fallout will imply that the UK will be forced to coordinate countries as individuals awaiting the creation of an EU-UK coordination mechanism, which is not instantly created. This is an additional burden to the NHS.

Immigration, caused by Brexit will also have an impact on the NHS regarding the access of treatment in various health institutions. An immigration increase translates to an increase in the patients that require medical attention from the NHS. The EU citizens usually are entitled to insurance that allows them to receive health care during temporary stays in other EEA countries. Also, under The EU regulations, the EU citizens who settle in the UK, or leave UK for another EU country receives the same healthcare as the locals of that country. With the Brexit, people with such privileges are bound to be affected. The NHS too will lack the benefits that come with such regulations (Johnson, 2016, p.32)

In the EU, there exist several rules that will affect the NHS. They include the working directive that stipulates how NHS staff operates. For example, the instruction allows for the opting –out of the 48-hour limit by doctors, which the UK protests. Therefore, should the government decide to amend the working time regulations, NHS would be affected in that the employment contracts would need to be revised.

The vote for Brexit had been predicted to result in an economic shock that would create uncertainty and instability. Should the predictions come to pass, the already suffering NHS would be caught up in the effects of financial instability, such as inflation that would see the prices of essential products such as drugs and other services getting expensive.

The government has been on the receiving end, being castigated as the cause of the many difficulties facing the NHS and the inability to provide solutions for them. One of the most pointed out problems is with the top leadership. Some have argued that most of the managers and Trust directors are ineffective and corrupt, hence are incapable of transforming NHS lack to provide solutions for the problem arising. According to them, they also tend to mismanage the funds directed towards the service. They, therefore, call for a competence-based recruitment in the top leadership. They also assert that the NHS lacks a detailed list of assets and the total value they yield (Moschella, 2015, p.445)

Additionally, most of the assets owned by NHS do not channel the profits they generate to improve the healthcare quality. The solution to these would be involving separate professional companies to monitor such assets and ensure they present the actual value of the property, which can, in turn, supplement the funding NHS receives (Moschella, 2015, p.450)

Thus, political leaders, health sector stakeholders including the managerial staff of NHS, and the public have often suggested the possible solutions that would end these troubles. They include the long and short-term ones, some viable and some that seem imaginary hence not achievable. Some of these solutions include the Five Year Forward plan that has been proposed to ensure that the deteriorating services in the NHS are rectified, thus reclaiming its glory and consequently contribute to the healing the recruitment crisis altogether.

It is evident that to achieve a sustainable NHS and to assure the future health of millions of citizens; there is a need for an urgent upgrade in the prevention and public health. There is need to get serious about prevention of the rising burden of ill health caused by the social, economic factors and lifestyle causes. Approximately, the NHS spends 10 billion dollars yearly on lifestyle diseases such as diabetes. Over 3 million Britons are already living with the disease and a prospective 7 million at risk of becoming diabetic. Prevention of such avoidable illness is therefore vital to ensure that such vast amounts of money spent on them is reduced and can instead be channeled to other health needs. The health services alone cannot achieve this, new range of campaign approaches to improve the health and well-being (Neilson, 2017, p. 15)

A recent report has indicated that there are now over 3,000 drugs, especially alcohol-related admissions in the Accident and Emergency on a daily basis. This suggests that most citizens are not leading healthier lives and this is causing a deep impact on the operations of the NHS. This number supersedes the elective admissions leading to congestion in the health facilities. It further indicates that the ingestion of things that pose health risks among the youths is rising by day. These include junk food, tobacco, alcohol and those with excess sugar. By using the substantial and combined purchasing power of the NHS, measures to come up with ways to ensure that the consumption of such reduces. This is because it contributes the rising rates of road accidents leading to increasing numbers of A&E admissions, rise in lifestyle and chronic illnesses hence a burden in the NHS treatment expenses (Moore, 2014, p.33)

The NHS should strive towards supporting and helping people in getting and staying employed. Referring to a recent study, 22 billion dollars is lost yearly due work absence caused by illnesses, and it also indicates that about 300, 000 citizens take up benefits related to health each year, this can be interpreted individuals collectively missing out on approximately 4 billion dollars of earnings lost each year. It should do so by employing proper-targeted health support to ensure them of their improved well- being and guaranteeing the employed stay at work for a longer time, thus reducing the rising levels of absenteeism leading to losses in finances in the health sector and of the taxpayers as well (Henfrey, 2015, p.3)

An organization is as good as its employees; therefore, ensuring that the workforce stays healthy is critical in ensuring productivity. For example, other than running campaigns that encourage the workforce stays healthy, most of the organizations should see to that, they provide their workers food that does not pose health risks. The NHS for example, has night shift staff most of whom they provide food. It is possible to find that more than half of the hospitals do not offer healthy food to such people. In estimation, the NHS is said to have the capability to reduce the sickness rates of its staff by 3% translating to almost 16,000 out of the over 3 million employees, thus saving about 550 million dollars (Moschella, 2015,p. 451)

Initiatives such as cutting access to products that pose health risks on NHS premises, providing healthy food options to the staff, implementation of food standards, measurement of staff well-being and health, introduction to work –based health schemes and voluntary weight watching mechanism among others are of the essence. This is because, one, the workforce will remain healthy, and, they will feel that their employer is looking out for them and hence feel motivated to work. One of the many factors that have led to understaffing in the NHS is sickness from the staff, due the pressures in work among other factors. They feel less motivated and opt out.

The above initiatives, if implemented fully, there will be a notable change in the whole output of the services. The prospective employees too, will be more willing and look forward to work with to work for the NHS. In addition to the proposed initiatives, the NHS should also ensure the implementation of the existing workplace wellbeing charter, the National Institute for health and care excellence guidance on the promotion of healthy workplaces among others to emphasize on a healthy workforce (Johnson, 2016, p.31)

People with long-term health conditions are generally frequent and heavy users of the health service, but they do not use much time to get attended to by the health professionals. In most cases, their families and caregivers can manage them, thus, if there could be a way to provide the correct and sufficient information, it would reduce the expenses that the NHS uses in the treatment of such patients. Such information would include not only the clinical advice but also their conditions and its history. The advancement in technology should come in handy in ensuring such patients access their medical records and the social care contexts with ease. Also, supporting patients towards managing their health, management of their conditions while avoiding complications and making the correct informed treatment choices is vital. This is critical in ensuring the cost of treatment incurred by in the NHS reduces significantly (Neilson, 2017, p.16)

A step towards increasing the direct control that the patients normally in the care provided to them is of the essence in ensuring efficient service delivery in the NHS. Most of the patients report that they are not allowed to make choices for the hospitals to provide care to them and that they are not involved fully in the making of decisions that regarding their care and treatment. An approach that combines both the social care and health is necessary to ensure that the needs of patients with complex conditions are met.

Moreover, the need to engage the communities and citizen is important in ensuring that they are directly involved in the decision making regarding the future of health and care services is essential. Therefore, the NHS should ensure that they offer the much-needed support to the caregivers who have been ensuring sustainability of the medical sector. It is estimated that there are about 5. 5 million caregivers in England, with the young caregivers totaling to more than 3 million and about 100,000 having reached the age of 80 and above. Their efforts in ensuring patients in and out of hospitals are monitored and accorded that care they deserve is incredibly amazing. They, however, face a myriad of challenges mostly in finances, as most of them major involuntary unpaid care responsibilities. The NHS should ensure that they find new ways to support these care providers and come up with a flexible working arrangement for them (Majeed, p.67)

Furthermore, the NHS should encourage the community to volunteer as volunteers too, play a pivotal role in health and social care. According to a recent study, an approximate of 3 million volunteers across England has contributed mainly to assisting the NHS to achieve their goals in proving health and care services. These volunteers should be appreciated and supported through legislation or other mechanisms that would motivate the other members of the public to volunteer to offer health care services. The NHS might consider helping them become part of them (NHS) and partner with the staff for satisfactory service provision to all including the most vulnerable members of the society especially the elderly. They should also be trained on issues such as the basic life support, helping with vaccination programs and helping to educate the public on how to manage long-term health conditions. NHS should also collaborate with caregiver organizations to offer support to volunteer programs that can provide emergency assistance should cares be in crisis (Johnson, 2016, p.33)

The NHS should work towards fostering stronger relations and partnerships with the voluntary and charitable organizations. The support for such organizations by the NHS and other agencies is normally under pressure especially when funding is tight. Such groups and organizations are more effective in reaching patients in areas where the national government and other organizations cannot access due to the geographical or other factors. In such times, the NHS normally combines the voluntary sector organization with the literal meaning of volunteering. They fail to consider that such sectors also employ expert staff who are remunerated and thus, require consideration regarding funding. NHS therefore, should reduce the complexities that come with the securing of the NHS local funding (Henfrey 2015, p.1)

The NHS should also work in ensuring that their top leadership is a better reflection of the diverse local communities that they serve and offer a non-discriminatory opportunity for its staff more so those from minority backgrounds. This will ensure that employees’ have a chance to get more creative about providing solutions that affect them thus ensuring productivity.

The NHS has proved to be one of the most efficient health providers across most of the European Nations despite its recent crisis that has hit. It is evident that it needs to rise back to its feet so that it can continue providing, efficient and effective healthcare for all citizens. Therefore, implementing the proposed recommendations would lead to significant improvement of the NHS thus aiding in the recovery from the crisis that has hit it.

Bibliography

Henfrey, H. 2015. Psychiatry–recruitment crisis or opportunity for change?.The British Journal of Psychiatry, 207(1), 1-2.

Neilson, E. 2017. Nurse practitioners in pharmacies: a potential solution to the NHS crisis.Management, 12, 17.

Johnson, A., 2016. Raise pay to halt this artificial nursing recruitment crisis. Nursing Standard, 30(32), pp.32-33.

Majeed, A., 2014. The NHS, not medical schools, is responsible for the crisis in GP recruitment. BMJ, 349, p.g6967.

Moore, J., 2014. Patients hardest hit by district nursing recruitment crisis.Nursing Standard, 28(43), pp.34-35.

Moschella, M., 2015. The institutional roots of incremental ideational change: The IMF and capital controls after the global financial crisis. The British Journal of Politics & International Relations, 17(3), pp.442-460.