National Health Service Management


The NHS management must posses a high degree of control, coordination and leadership in order to cope with the huge challenges it is currently facing. It has to solve financial, structural, technological problems. But in order to understand these problems, one should know the history of the organization which is as follows:

The NHS provides its services in Wales, Britain, Northern Ireland and Scotland. The Ministry of Health started it in the year 1948. It was designed to provide healthcare to patients without discrimination, when it was necessary, and for free. It was necessary to form such an organization because healthcare services were not coordinated in the UK. People had to pay for services at the point of delivery while others could not access the services which they required. Its main aim was to improve the treatment, diagnosis and prevention of diseases. The NHS has undergone numerous changes in its organizational structure and also in the delivery of services (Katherine, 2002).

Fast forward to the early nineties: The NHS became overwhelmed with long waiting lists as demand kept rising. Its resources became stretched to the limit hence prompting the government of the day to come up with a plan. It came up with the ‘internal markets’ idea. This allowed family doctors and health authorities to access funds from the government. They used it to buy healthcare from various providers like ambulance services, acute hospitals, and those who care for the mentally disabled. This occurred in the year 1990.

A year later NHS established trusts to fund healthcare and by the middle of this decade all the funding was done by trusts. NHS purchasers were also given budgets to buy healthcare from the trusts. This was done through a scheme named GP fund holding. Consequently, patients became divided into two, i.e. GP and non-GP fund holders. This brought about preferential treatment amongst them. A change was urgently needed. The government put forward a new system in the year 1997; it abolished the internal markets and implemented the white paper. This model was founded on six principles which had the overall intention of cutting down on bureaucracy and improving efficiency.

NHS structural management issues

The NHS workforce is made up of several units that work closely with each other in order to achieve overall organizational goals. Currently, management does not seem to realise this. It runs each unit as a separate entity. Consequently, the organization is unable to achieve its full potential during service delivery.

In line with modern structural changes, health workers ought to diversify their roles. This brings about faster and more efficient work. NHS lacks that kind of fluidity as management is still holding on to traditional practises (Short ell, 1997).

Career patterns within the NHS follow a straight forward path. It is quite rare to find nurses who train and become doctors. The ways in which learning occurs differ from profession to profession within NHS. This acts as a barrier to effective communication.

The current medical environment is best served by flexible persons. There is a serious need for medical care because chronic diseases have increased and so have the aged. This means that health workers need to accommodate new ways of working in order to keep up with the pressure. This is where management needs to step in; they should come up with new strategies to integrate workers from different occupations. This can be done through training and provision of educational programmes to ease these transitions.

Currently, management has not introduced any programmes that facilitate cooperation. It should do this through negotiation between departmental managers and compromises. This will bring about a more cohesive team and better quality (Griffin, 2005).

Technological issues in the NHS

Most hospitals are embracing Information Technology as the next leap in healthcare provision. The NHS has not kept up with this trend. It is the duty of management to ensure that workers have all the necessary incentives they need to perform. IT systems in the NHS work well for administrators but are totally ineffective at the roots.

Information Technology is not coordinated within the organization. A recent research done by Crown Surgery found this to be true. Doctors in the NHS were unable to transfer data from former doctors upon receiving new patients. It was found that about 40% of patient time was wasted when transferring data into computers instead of focusing on treatment (Hyde, 2004).

Complaints have been recorded when doctors try accessing results through the organization’s network system. The NHS boasts of being one of the main record sites for obtaining patient information in the UK. But this is only theoretical; consultants and general practitioners are unable to access laboratory tests electronically. In addition, updates are not automated. Doctors have to resort to manual ways of comparing their records and those ones in the local community health records or health authority records.

There is no link between computers in the organization yet communication to other parts of the world can be done (Handy, 1999).


The NHS had many noble intentions at its inception but because of the growing size of patients, management problems have arisen in various aspects of the organization. If these problems are left as they are, the NHS could be heading for a serious crisis. Management should prioritise implementation of IT systems because this could be the key to increasing productivity within the organization. There maybe other important projects that require attention but IT should be viewed as an investment that can yield high returns.

Management should improve communication between various elements of the organization to facilitate coordination. It should restructure its staff in order to keep up with modern methods of healthcare provision (Dobson, 2003).


Dobson, S. (2003): Leading Healthcare Organizations; Pal grave Macmillan.

Katherine, W. (2002): From County Hospital to NHS Trust: the History and Archives of NHS Hospitals; Harvard Press International Journal of Healthcare Management

Handy, C. (1999): Understanding Organizations fourth edition; Penguin

Hyde, J. (2004): Managing and Supporting People in Healthcare; Bailliere Tindall, London

Griffin, R (2005): Management, eighth edition; Houghton Mifflin International Journal of public Sector Management

Short ell, S. (1997): Essentials of healthcare management; Delmar publishers

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