Business Environment

Table of Contents Introduction 3 Task 1: Introducing Barts Health NHS and its industry and knowing its environment. 4 P1.1 Knowing the background and nature of Barts Health NHS. 4 P1.2 Competitive position of Barts Health NHS in the health care industry. 6 Task 2: Evaluate and explain how managers try to motivate their staff, in order to retain and improve their position in the sector that they compete. 7 P2.1 Use of two factors theory and X&Y theories and Vroom’s theory to motivate staffs of Barts Health NHS. 7 P2.2 Steps taken by managers based on the theories to improve current position. 9 Task 3: Analyzing policies of Barts Health NHS and applying them in improving position. 10 P3.1 Knowing and analyzing recruitment and selection policies of Barts Health NHS. 10 P3.2 Analyzing how the policies help in improving the position of Barts Health NHS. 12 Recommendation 13 Conclusion 13 References 14

Introduction
Health care is a basic human need. This necessity for health care has caused improvement of this industry. Every problem and related research has improved the aspects of this industry. However, the quality is important in health care industry. The quality depends on using of modern technologies, improving employed personnel and improvement of environment. The improvement in environment of health care service has reduced complexities and helped patients to get cured quickly. Improved environment is neither necessary nor luxury for health care. This indicates that environment influences heath care up to a limit. Barts Health NHS is a trust in health care industry in UK. Barts has become cautious about using its resources to improve its position. It has several hospitals, skilled human resources and financial support to provide standard services in a nice environment. In the next portion of this report, we will see how Barts Health NHS operates in the industry and how it can improve its position.

Task 1: Introducing Barts Health NHS and its industry and knowing its environment.
P1.1 Knowing the background and nature of Barts Health NHS.
Barts Health NHS was established with a vision “To change lives” in East London in 2012. A proposed merger was approved in 2011 by NHS London and Trust boards. A meeting of 16 weeks was held with stakeholders. Finally, three legacy trust boards, two commissioning clusters and NHS London approved the merger. After the approval, Barts Health NHS was established to serve local people with health care.
The Barts Health NHS has six hospitals under it. They are Mile End Hospital (MEH), Newham University Hospital (NUH), The London Chest, The Royal London Hospital, St Bartsholomew’s Hospital and Whipps Cross University Hospital. The turnover of Barts Health NHS is 1.25 billion and it has 15,000 employees. So it is the largest NHS trust in UK in this sense (Bartshealth.nhs.uk, 2015).
Mile End Hospital is running complying with Care Quality Commission (CQC) inspection rating. It keeps 91% of registered nurses in day shifts. It shows how well it manages staffs for service. It also engages 98% unregistered care staff in day schedule. So, it emphasizes on caring patients. 101% of registered nurses and 131% of unregistered care staffs for night shift are available. Only 0.16% patients get hurt while getting treatment.
Newham University Hospital provides health services in forty languages. It has 24 hour-open emergency department and urgent care center. Maternity facility was introduced here in 2011. It has modern environment and high quality of services. It also fulfills CQC inspection rating. 92% of registered nurses and 99% of unregistered care staffs are available for day shift and 100% and 124% respectively for night shift (Nhs.uk, 2015).
London Chest served for long periods. Now it has been closed as it could not cope up with the challenges of 21st century. The Royal London Hospital is a leading hospital of East London. It has emergency pediatric center, air ambulance. It keeps 96% of registered nurses and 115% unregistered staffs in day schedule as per compliance of CQC. It also maintains 102% registered nurses and 118% of staffs in night shift.
St Bartsholomew’s Hospital provides health care of cancer, heart, fertility and sexual problems. It also introduced Barts Cancer Center in 2010 by investing £200 million. It also has diagnostic facility. It maintains 104% of registered nurses and 78% of unregistered staffs as per compliance with CQC inspection ratings.
Whipps Cross University Hospital has been serving health care for more than 100 years in Waltham forest region. It stands by least 5% deprived people of UK. It also maintains CQC inspection rating. It has 95% of registered nurses and 106% of unregistered staffs (Nhs.uk, 2015).

P1.2 Competitive position of Barts Health NHS in the health care industry.
Competitive position in health care industry depends on level and range of services provided. The competition also depends on how the availability of competitors in an area. Let’s begin with ranges of services provided by Barts.
Barts Health NHS has named its services as ‘Services A-Z’. This indicates that Barts provides almost all health care services. It has arranged its services in alphabetical order. It’s services include acute medicine, air ambulance, allergies, anesthetics and pain management, behests syndrome, blood tests, breast radiotherapy, cancer, cardiovascular, care of elderly, children health, community dental services, community diabetics services, community health services, community diabetics learning services, community nutrition services, dermatology, drugs, emergency, ENT, endocrinology, fertility, general surgery, gastro taro logy, HIV, health visiting, imaging, immunology, maternity, neuroscience, oral care, palliative care, pathology, plastic surgery and so on. There are some other NHS trusts in the same region. But none of those has all these services. That’s why; it has achieved leading position in UK. Barts also has some hospitals which in combination has made strong market position (Cqc.org.uk, 2013).
However, the quality of services is also important for competitive advantage. The Care Quality Commission inspection rating is a benchmark for quality of services provided. The quality rating has been presented in a chart below for Barts and its hospitals: Name of rating | Mile End Hospital | Newham University Hospital | The Royal London Hospital | St Bartsholomew’s Hospital | Whipps Cross University Hospital | Registered nurses for day | 91% | 99% | 97% | 104% | 95% | Unregistered staffs for day | 98% | 97% | 121% | 74% | 106% | Registered nurses for night | 101% | 98% | 102% | 112% | 99% | Unregistered staffs for night | 131% | 112% | 120% | 89% | 123% | Patients got hurt in last 3 days | 0.16% | 0.16% | 0.16% | 0.16% | 0.16% | FnF test: Inpatient | 100 recommends,6 responses. | 95 recommend 373 responses. | 95 recommends,675 responses | 99 recommends,88 responses | 93 recommends,408 responses, | FnF test: A&E | 71 recommends,61 responses. | 88 recommend 57 responses. | 88 recommends,210 responses. | 100 recommends,47 responses | 88 recommends,224 responses. |
The market for Newhamnad Batholomew is a bit bad but other are pretty good (Nhs.uk, 2013).
Task 2: Evaluate and explain how managers try to motivate their staff, in order to retain and improve their position in the sector that they compete.
P2.1 Use of two factors theory and X&Y theories and Vroom’s theory to motivate staffs of Barts Health NHS.

Two factors theory was introduced by Herzberg. It has two sets of factors, hygiene factors and motivating factors. There are also three human states under this theory, dissatisfaction, no satisfaction and satisfaction. When employees are dissatisfied, they are given with hygiene factors that makes them reach to ‘no satisfaction’ level. In this stage, motivating factors are given to them. This leads to final satisfaction.
Barts and its hospitals use this theory to satisfy its employees. A research showed that some health workers considered some hygiene factors as motivators. Working condition, job status and job security are such motivators. Through the analysis of Barts NHS, I found that it ensures nice working condition. Job status is given to the good performer. It also ensures that employees can continue their job. So, the employees become capable of working smoothly (McConnell, 2008).
It has been noticed that Barts NHS applies X&Y theories to motivate employees. X promotes negative issues regarding employees. Employees are not trusted as per X theory. But Y theory favors and trusts workers. Barts assumes that its workers are self-motivated and ambitious. They can work of their own. They have control over their activities. So, control mechanisms are not applied to workers of Barts. Actually, the health care industry needs to be fast and accurate to serve the patients. As the employees are skilled and trained in Barts, they need not be controlled at all the time. However, Y theory also says that employees accept responsibilities and can solve problems creatively. Employees at Barts take their responsibilities and solve their problems using their own brains (Olu Ogunrin, Ogunrin and Akerele, 2007).
There are three elements required to motivate employees. They are expectancy, Instrumentality and Valence. These three issues determine motivational forces as per Vroom’s theory. Expectancy means employees believe that their effort is enough to attain the desired performances. Proper knowledge leads to high expectancy where complexity in task reduces expectancy. Similarly, high control over performance increases expectancy. Barts assigns its employees the tasks within their capacities. They are given with training to increase skills and knowledge in their related field. Instrumentality means the expectation that employees will get rewards if the performances are up to the mark. The employees who perform high are given incentives, promotion and other non-financial rewards at Barts. So, the employees get relation between performance and rewards. Thus, they perform more. Valence indicates the assessment of employees about the rewards of outcomes. If employees feel that reward is appropriate, the valence is positive. Barts provides employees with appropriate rewards so that they are satisfied. However, motivational force equals the multiplication of expectancy, instrumentality and valence (Lee, 2007).
Additionally, there are some other aspects that are motivating in case of Barts NHS. Barts forms its goals aligned with individual employee performance. The training programs of Barts are focused on the strengths of the organization. Management of Barts always recognizes the performances and achievements of employees. Recognition leads employees to work more and they get confidence for future services.

P2.2 Steps taken by managers based on the theories to improve current position.

We have analyzed the theories used by Barts NHS. Now, we are ready for recommending some steps for improving the practice of human resources in Barts for better services. The management can take the following steps:
Management must communicate its goals with the employees at Barts. It also requires informing them what performance management is expecting from them. Such assignment of goals encourages employees to perform more as they feel themselves part of organization. Management can share current positions of the organization and visualize the contribution of employees to overall outcomes. Employees will be able to use own judgments in their jobs this way. Barts NHS is a large health care organization. So, employees should be made encouraged to initiate open communication system. Late communication may damage the conditions of patients. This will speed up the services of Barts. The management should promote values and ethics in every task to every employee. Ethics leads to fair practices in providing services (Otani, Herrmann and Kurz, 2011).
Management needs to show employees how effective they are in achieving the benchmark of services. A culture of dedication and carefulness should be introduced among employees. Culture can also boost employee performance. Management should be flexible at Barts about its doctors and employees but strict at level of services. Management should listen about their problems and recommendation. Health care is an industry of trust. So, employees should be practicing trust among themselves before they serve patients with trust. The innovations of employees should be taken under research if they are feasible enough. Such innovation is always motivating. The environment is another important issue to focus on. It should be designed in such a way that is great to work in and sound for patients. The environment determines quality and reputation of health care industry (Strindhall and Henriks, 2007).
Barts should spread sense of belonging. It is difficult to work in a hospital. So, the sense of belonging helps to build relationships and reduces boring conditions. Barts can improve service through teamwork. Each and every section of service should have specialized teams to perform services professionally.
Task 3: Analyzing policies of Barts Health NHS and applying them in improving position.
P3.1 Knowing and analyzing recruitment and selection policies of Barts Health NHS.

Recruitment is a way to attract applicants to apply for a vacant post. There are two types of recruitment procedures for Barts Health NHS. One is employee recruitment and another is NTDA recruitment to chair. Each of them has been explained bellow with respective selection processes.
Recruitment and selection for NTDA
NTDA recruitment to chair is a way to recruit potential candidates for Barts Health NHS Trust. Experienced leaders tested in large organizations in related fields are encouraged to apply. They will also be given standards to follow in their jobs. The candidate has to demonstrate: 1. Excellent records in large organizations to achieve both financial growth and quality improvement. 2. Experiences in developing strong terms and leadership in public face through visualizing the clear path to future vision. They have likely to face challenging environment. 3. Power and knowledge to manage both internal and external stakeholders. They need to have strong communication power to secure commitment for future vision. 4. Excellence in governance, expert in financial skills, capable of creating strategic planning and complex decision making and risk management. 5. Applied knowledge over the health care issues in East London. He needs to have knowledge about challenges faced by Barts Health NHS. He must ensure high quality and safe services (Caruth, Caruth and Pane, 2009).
All the interested candidates are usually requested to submit their Curriculum Vitae (CV) within specified dates.
A board is engaged in recruiting and selecting candidates for the trust. Only the applications containing required qualifications are kept. The board communicates those candidates and discusses about mutual issues for development the trust and benefits and compensation offered to candidates. Then the board sits together and agrees upon selecting candidates. The selected candidates are allowed to join the trust.
Recruitment and selection procedures for employees
The recruitment procedures for employees are different from that of NTDA recruitment. Employees are recruited by TMP board. Recruitment is usually completed through online. TMP has long experience and expertise in recruitment using applicant tracking system. A member of TMP project management team will take part in activities of recruitment team. TMP will monitor all stages from requisition to appointment. The main task here is to gather information about candidates. Rest of the members in TMP management team will study about candidates’ experiences. Then the experienced and applicants are selected for selection process (Stavans, 2010).
Selecting employees starts with a written test. The test is designed to justify related knowledge, analytical ability and decision making capacity. The recruitment team checks the scripts and makes a list containing required number of employees. Listed candidates are required to make some medical tests for checking fitness and ability to perform the applied jobs. Only the fit applicants are kept. Fit applicants need to face a viva in front of the board. The members in the board scrutinize pros and cons of the applicants. The board tries to identify instant capacity, thinking power, communicative skills, probable performance, chances of turnover and focus on quality of services. Then board selects required number of employees and appoint them (Benson, 2011).

P3.2 analyzing how the policies help in improving the position of Barts Health NHS.

In the previous section, we have seen recruitment and selection processes and procedures. Now, I will show how those procedures help in improving positions of Barts Health NHS.
NTDA board is engaged in selecting candidates who will operate the trust. An independent board is necessary to evaluate and select candidates. NTDA performs that independent role. NTDA sets the required quality and level of experience in related field for the candidates. If anyone within the Barts NHS would do it, there would have chances of bias. However, the quality set by NTDA focuses on some important issues. For example, members who will operate the trust should have experience in operating large organizations with quality and financial growth. Without such experience, no candidate will be successful in achieving goals and retaining growth. Communicating power and leading capacity will help to make helpful negotiations with stakeholders and lead the employees according to situation. The board ensures that new candidate has capacity to face challenges. Barts NHS faces challenges serving the patients quickly with quality, maintaining environment, maintaining standards, ensuring life safety, innovation and use of new technology, training employees for adverse condition and so on. The member of trust board should be prudent and capable of finding such challenges and solving them. NTDA helps to ensure such issues (Kersten and Clauson, 2015).
There are two boards engaged in recruiting and selecting employees for Barts Health Care NHS. One is recruitment board and another is TMD board. Recruitment board is from the hospital and TMD is from the trust. Recruitment board does every task from collecting information to appointing. TMD helps and maintains standards in those tasks. As a part of a trust, each hospital is bound to follow the rules, regulations and standards of the trust. This is how the trust contributes to maintain standards in recruiting and selecting process. However, TMD helps to find required experiences which are urgent for performing the given job. After the successful appointment, TMD stops its activities (Lussier and Hendon, 2013).

Recommendation

The selection process for employees should include simulating tests which help to determine real life performances of employees in related field. In case of selecting a doctor, the board should be careful about previous records. In each type of recruitment, the board should undertake an inspection about employee’s history. This is especially important where risk is high and safe hands need to be ensured.
Conclusion

Barts Health NHS is a leading trust in London. The position have not come easily. Each hospital maintained CQC inspection ratings accurately. These ratings show how the hospitals perform with its staffs and how people respond to the services. Maintaining such qualities are subject so many challenges. Barts has to maintain its employees and their service qualities, motivate employees, maintain environment, use new technologies, and use financial resources and so on. In case of recruiting, Barts also faces challenges. Prudent steps, strategic planning, smart decision making can lead Barts to success and improve current positions. That’s why, a good leader at the head of trust is necessary. The recruitment process of trust candidates and selection among them helps to get a good leader and make way to vision.

References

Bartshealth.nhs.uk, (2015). Barts Health - Barts Health NHS Trust background. [online] Available at: http://www.Bartshealth.nhs.uk/about-us/our-background/ [Accessed 20 Jul. 2015].
Nhs.uk, (2015). Overview - Newham General Hospital - NHS Choices. [online] Available at: c [Accessed 19 Jul. 2015].
Nhs.uk, (2015). Overview - Whipps Cross University Hospital - NHS Choices. [online] Available at: http://www.nhs.uk/Services/hospitals/Overview/DefaultView.aspx?id=46344 [Accessed 20 Jun. 2014].
Cqc.org.uk, (2013). Search | Care Quality Commission. [online] Available at: http://www.cqc.org.uk/search/services/hospitals [Accessed 20 Jul. 2013].
Nhs.uk, (2013). Overview - Mile End Hospital - NHS Choices. [online] Available at: http://www.nhs.uk/Services/hospitals/Overview/DefaultView.aspx?id=46340 [Accessed 20 Jul. 2013].
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Strindhall, M. and Henriks, G. (2007). How Improved Access to Healthcare Was Successfully Spread Across Sweden. Quality Management in Health Care, 16(1), pp.16-24.
Caruth, D., Caruth, G. and Pane, S. (2009). Staffing the contemporary organization. Westport, Conn.: Praeger Publishers.
Stavans, I. (2010). Health care. Santa Barbara, Calif.: Greenwood.
Benson, P. (2011). Emerging themes in international management of human resources. Charlotte, N.C.: Information Age Pub.
Kersten, T. and Clauson, M. (2015). Personnel Priorities in Schools Today. Lanham: Rowman & Littlefield.
Lussier, R. and Hendon, J. (2013). Human resource management. Thousand Oaks: SAGE Publications.