In recent years, there has been an increasing body of research linking human resource management (HRM) practices to organizational performance. However, the relationship between HRM and organizational performance is complex and multi-dimensional, and the mechanisms through which HRM affects performance are not yet fully understood. One area of research that has examined the relationship between HRM and performance is hospital performance. In that regard, hospitals are a key part of the National Health Service (NHS) in the United Kingdom, so understanding the factors that affect their performance is important. Besides that, the National Health Service (NHS) is the publicly funded healthcare system in England and is one of the four National Health Services of the United Kingdom. It is the largest single provider of healthcare in the UK, with around a quarter of the country’s population using its services at any one time.
In addition, the NHS was established in 1948 and is currently overseen by the Department of Health and Social Care. In that regard, the NHS provides a comprehensive range of healthcare services, including primary care, secondary care, and tertiary care. Besides, the NHS has a wide range of human resources (HR) policies and procedures in place to ensure that it can attract, develop and retain the best possible staff. However, the NHS is facing several challenges in relation to its human resources, such as the shortage of staff, an aging workforce, and high levels of stress. Further, the PESTLE analysis provides an excellent overview of the possible threats to any NHS HR strategy. It is important to note, however, that the NHS has so little control over these environmental factors. As a result, proposing an approach that focuses on improving an internal issue can be succussed.
To better understand the NHS’s organizational strengths and weaknesses, a SWOT analysis was performed. Weaknesses such as staff shortage and a high workload were noted. The paper will further discuss recommendations for how these issues might be addressed.
PESTLE and SWOT Analysis
The NHS is a complex system made of different organizations with different specialties, roles, and specialties, which make it difficult to understand the system. However, the PESTLE and SWOT analysis are two popular analytic tools that will be used to assess the macro and micro environment of a company, respectively. Pestle analysis will help in identifying external factors that have impacted the organization such as changes in government policy, economic conditions, or social trends. Swot analysis, on the other hand, will help in identifying internal factors affecting the entire organization, such as their strengths and weaknesses or opportunities and threats. Both of these tools will be helpful in developing strategies for overcoming identified challenges.
Conducting the PESTLE analysis first is important to determine the external factors affecting the organization. When identifying the main issues the NHS faces, the PESTLE analysis was conducted and revealed that the organization has various touch points with numerous powerful and influential stakeholders who significantly affected the organization. The analysis will give an outline of any HR strategy that should be proposed. The UK government has a number of policies and regulations in place that affect the NHS, including tax policy, environmental regulations, trade restrictions and reform, tariffs, and political stability (Kelliher & Parry, 2015). Each of these factors can have a significant impact on undermining the NHS’s long-term strategies; for example, the decision to add or cut budget cost for the public sector have affected the implementation of new guidelines.
Besides, the UK government has recently been bound to certain EU- regulations, in turn extending the recruitment potential of EEA workers that did not require an extra work permit or visa (Kelliher & Parry, 2015). According to Fahy et al. (2017), the United Kingdom government bounded to certain EU regulations in turn provided stability and extended the recruitment potential of EAA workers that did not need an extra work permit or visa. The current unpredictability concerning the Brexit outcome dealing between the European Union and UK challenges predicting how NHS will be specifically impacted.
Economically, the organization handles the aging population, thus constantly increasing the cost of medical treatment (Ewbank et al., 2018). Also, the high number of aging workforces has led to a shortage of personnel and high demand for qualified employees. This has put significant pressure on the already stretched resources of the NHS and has led to longer waiting times for appointments and treatment. In addition, the rising cost of living has meant that many people are struggling to afford the cost of private healthcare, straining the public finances and causing problems for the NHS staff such as increased stress and low morale as staffs strain to see more patients within a short time. NHS II (2019) shows that in 2010, the government introduced new saving measures that contradict the advanced technology and the essence of providing training to boost staff morale.
Though the PESTLE analysis has outlined the potential threats to the HR strategy the NHS is limited to these external factors. Thus, SWOT analysis is conducted and revealed similar issues as PESTLE analysis, such as increasing demand for services. The NHS is under pressure to provide more and more services as the population continues to grow and live longer, putting pressure on staff and can lead to problems with recruitment and retention. Also, staff shortage and workload impacting on the quality of care that patients receive and lead to longer waiting times for treatment (Clark, 2014). Lastly, the NHS is facing a funding squeeze as the government looks to reduce public spending. This means that there is less money available to invest in staff training and development, which can impact morale and motivation. After analyzing the NHS, the three key pressing HR issues facing NHS shortage of staff, UK exit from Brexit, and aging workforce and population concurred.
Aging
It is widely accepted that human resource management (HRM) is a key driver of organizational performance. However, the precise nature of the relationship between HRM and performance is still the subject of debate. Baluch et al. (2013) attempt to untangle this relationship by investigating the mediating role of attitudinal and behavioral HR outcomes in the relationship between HRM and hospital performance.
In addition, the findings of the study suggest that HRM does indeed lead to improved performance, but only indirectly, through its impact on employee attitudes and behaviors (Villajos, et al.,2019). Besides, the study finds that HRM practices that lead to more favourable employee attitudes towards change are associated with better performance, but only in the context of organizational change programmes that are implemented successfully (Clark, 2014)
According to research, HRM can play a key role in improving performance and ensuring the success of change programmes, but only if it is done correctly (Manuti, et al.,2020). A key challenge for the NHS is to manage its ageing workforce effectively as the UK’s population is ageing. The number of people aged 65 and over is projected to increase from 12.4 million to 19.3 million in 2034, and the number of people aged 85 and over is projected to increase from 2.3 million to 4.6 million over the same period (Wübbeler, 2018). In addition, the number of people of working age is projected to increase more slowly, from 28.7 million in to 29.5 million in 2034. The ageing of the population will have a number of implications for the National Health Service (NHS). In essence, the NHS will need to provide more services to an ageing population, who are more likely to have chronic health conditions and to need long-term care. The number of people of working age will grow more slowly than the number of people aged 65 and over, so the NHS will have to make do with a shrinking proportion of people of working age to support an increasing number of older people.
In addition, the ageing of the workforce will also have implications for the NHS, as more staff reach retirement age and fewer young people enter the workforce (Wübbeler, 2018). Besides, according to Beech (2019) estimated that the NHS will need to recruit an additional 100,000 nurses over the next 10 years just to maintain current staffing levels. The college has also warned that the NHS is facing a “looming crisis” in the number of nurses retiring, with around a third of nurses aged over 50 ((NHS England, 2013). These ageing population will also have implications for the demand for medical services. The number of GP consultations is projected to increase from 340 million to 500 million by 2034. On the hand, the number of outpatient appointments is projected to increase from 60 million to 80 million over the same period (NHS, 2019). The number of inpatient admissions is projected to increase from 12 million to 16 million. The number of people aged 85 and over is projected to increase at the fastest rate, and this age group is also the most likely to need hospital care (Beech, 2019). This poses a number of challenges for the NHS, in terms of both the demand for services and the supply of labour.
UK vote to leave EU
According to research, the UK’s vote to leave the European Union has created considerable uncertainty about the future of health and health services in the UK. In addition, the impact of Brexit on health is likely to be felt through a number of channels, including changes to trade and investment, labour market conditions, and funding for health and research. In that concern, the UK is a net importer of goods and services, and so Brexit is likely to have an impact on the UK’s trade with the EU. The UK’s trade with the EU is currently governed by the EU’s rules on free movement of goods, which allow for the tariff-free movement of goods between EU member states. If the UK leaves the EU without a trade deal in place, it would have to trade with the EU under World Trade Organization rules, which would involve the imposition of tariffs on goods traded between the UK and the EU. As a result, leading to higher prices for goods, including food and medicines, and could have an impact on the availability of some goods.
Besides, the impact of Brexit on health and health services will depend on the nature of the UK’s future relationship with the EU. If the UK remains a member of the European Economic Area (EEA), then there will be no direct impact on health and health services. However, if the UK leaves the EEA, then there could be significant implications for health and health services. The UK’s health and social care system is heavily reliant on EU workers. In 2015, there were an estimated 1.2 million EU nationals working in health and social care in the UK. This includes around 10% of doctors and 5% of nurses.
Additionally, the EU workers are attracted to the UK by the higher wages and better working conditions. They also make a valuable contribution to the UK’s health and social care system. If the UK leaves the EEA, then EU workers will no longer have the right to work in the UK. This could have a significant impact on the health and social care system (Alecu, 2018). Additionally, there could be a shortage of staff, as well as a skills gap leading to increased waiting times for treatment and a deterioration in the quality of care. Further, the impact of Brexit on health and health services will depend on the UK’s future relationship with the EU. If the UK leaves the EU without a trade deal, then there could be significant tariffs on goods and services. This could make it more expensive for the NHS to purchase goods and services from the EU leading to a deterioration in the quality of care.
Shortage of Staff
According to Daniels et al (2022), the National Health Service (NHS) is in the midst of a human resources (HR) crisis, with regular surveys revealing a staff shortage. This is affecting patient care, with some patients having to wait months or even years for treatment. A shortage of staff is identified as one of the major stressors in a qualitative study of healthcare assistants. In that regard, the National Health Service (NHS) in the United Kingdom is under immense pressure to provide care for an aging and increasingly sick population. As a result, it has led to a shortage of staff, which in turn has increased pressure on those employed by the NHS (Daniels, et al.,2022). This is a major issue, as it leads to burnout and decreased quality of care provided.
Increased pressure on staff employed by the NHS also leads to staff feeling overworked and stressed, which impacts their wellbeing and job satisfaction. For example, a recent survey found that one in three NHS staff are considering leaving their job due to stress. This is a worrying trend as it leads to a further shortage of staff in the future. According to research, several factors have contributed to the increased pressure on NHS staff. for instance, the population of the UK is aging, and as people live longer, they are more likely to develop chronic illnesses that require ongoing treatment. For example, there is an increased demand for community-based care, as older people are more likely to have chronic health conditions that can be managed at home. In addition, the prevalence of obesity and other lifestyle-related diseases is rising, which has also increased the demand for healthcare services. Besides, the NHS is also facing a financial crisis, as it is not receiving enough funding to meet the growing demand for its services leading to cutbacks in other areas, such as staffing, which has put even more pressure on those who are already working for the NHS.
The influence of training and job satisfaction
Job satisfaction is a complex and multi-dimensional concept, which has been the subject of considerable research over the past few decades. A number of different factors have been found to be associated with job satisfaction, including pay, working conditions, job security, opportunities for career development and the nature of the work itself (Kelliher& Parry, 2015). Training is also a key factor in job satisfaction, as it can provide employees with the skills and knowledge, they need to do their jobs effectively and progress in their careers. The National Health Service (NHS) is a large and complex organisation, which employs over 1.3 million people in a wide range of roles.
In addition, the human resources (HR) department plays a vital role in the NHS, providing support and advice on a wide range of topics, including training. The influence of training on job satisfaction is an important issue for the NHS, as it has a direct impact on the quality of care that patients receive.
A number of studies have looked at the impact of training on job satisfaction in the NHS. One study, which surveyed nurses, found that those who had received training in the previous 12 months were more likely to be satisfied with their jobs than those who had not received any training (Atefi et al.,2014). The study also found that nurses who had received training in clinical skills were more likely to be satisfied with their jobs than those who had not received this type of training (Tahir et al.,2020). Another study, which surveyed doctors, found that those who had received training in the previous 12 months were more likely to be satisfied with their jobs than those who had not received any training.
Concept of Flexible Working Practices
Flexible working practices are designed to give employees more control over their working hours and patterns. They can help to reduce absenteeism, increase productivity and improve work-life balance. Besides, the human resources department is responsible for ensuring that flexible working practices are introduced and managed in a way that is fair and consistent with the organisation’s culture and values (Chung &Van der Lippe, 2020). They need to ensure that employees are aware of the options available to them, and that they understand the implications of choosing to work flexibly. There is a growing body of evidence that suggests that flexible working can have a positive impact on employees’ happiness and wellbeing.
In the UK National Health Service (NHS), where staff are under increasing pressure due to growing demands and diminishing resources, flexible working could be a key way to help retain doctors and nurses. Atkinson and Hall (2011) argue that employees who are able to work flexibly are happier and more engaged with their work than those who were not. Additionally, the researcher, also found that flexible working was associated with a number of other positive outcomes, including increased job satisfaction, commitment to the organisation, and a reduction in stress levels (Atkinson & Hall, 2011). While Atkinson and Hall (2011) did not specifically focus on retention, the findings suggest that flexible working could be a key tool in the NHS’s efforts to retain its staff (Granter, et al, 2019). With the number of doctors and nurses leaving the NHS each year on the increase, flexible working could help to reduce turnover and improve retention rates. In that regard, there are several reasons why flexible working might be particularly beneficial for the NHS. First, the NHS is a 24-hour operation, which means that there is a need for staff to be able to work shifts that fit around their other commitments.
Flexible working arrangements can make it easier for staff to manage their commitments outside of work, which can in turn reduce stress levels and improve work-life balance. Second, the nature of the work that NHS staff do can be extremely demanding, both physically and emotionally. Therefore, flexible working can help to reduce the amount of time staff spend on their feet, as well as the number of hours they work each week leading to improved health and wellbeing, which can in turn lead to improved performance at work. Finally, the NHS is a large and complex organisation, which can make it difficult for staff to progress in their careers. Flexible working can help to overcome some of these barriers by allowing staff to work around their other commitments, such as childcare or caring for elderly relatives (Atkinson and Hall 2011). This can make it easier for staff to progress in their careers, which can in turn lead to improved retention rates.
Discussion and Recommendation
Since its establishment in 1948, the National Health Service (NHS) in England has provided free healthcare to all citizens. The NHS is funded through taxation and is free at the point of use, meaning that anyone can receive treatment regardless of their ability to pay. The NHS is a large and complex organisation, made up of a variety of different types of staff. There is a shortage of staff across the NHS, with many roles being under-filled. In essence, this shortage is exacerbated by an ageing workforce, with many staff members nearing retirement age (Buchan et al.,2019). The NHS is also facing challenges due to the UK’s impending exit from the European Union (EU)
The human resources department must therefore address the key issues facing the NHS, such as the shortage of staff, the ageing workforce and the impact of Brexit. In order to address the shortage of staff, the NHS human resources department must focus on attracting and retaining workers. This can be done through a variety of measures, such as offering competitive salaries, flexible working arrangements and good working conditions (Hutchison and Purcell 2010). The department must also provide support and development opportunities for staff, so that they are able to progress in their careers. In order to attract and retain younger workers, the department should focus on providing work experience and training opportunities.
Besides, the NHS human resources department must also address the challenge of an ageing workforce via several approaches, such as offering flexible working arrangements, phased retirement and training opportunities. Additionally, the department should also work with schools and universities to promote careers in the NHS. The NHS human resources department must also address the challenge of Brexit. This can be done through a variety of measures, such as ensuring that staff are aware of the potential impact of Brexit on their jobs, providing support and guidance for those who may be affected by Brexit, and working with schools and universities to promote careers in the NHS.
Conclusion
The National Health Service (NHS) is the UK’s publicly funded healthcare system. It is a large and complex organisation, employing over 1.3 million people. The NHS is facing a number of challenges in the coming years, including Brexit, a shortage of staff, and an ageing population. The NHS human resources (HR) department plays a vital role in managing these challenges. additionally, the NHS is one of the largest employers in the UK, and HR plays a vital role in recruiting and retaining staff. The department is also responsible for managing staff workloads and ensuring that staff are appropriately trained and qualified for their roles. In the face of Brexit, the NHS HR department will need to ensure that staff from EU countries are able to remain in the UK and that they have the right to work here. The department will also need to manage any changes to employment law that may result from Brexit.
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