Managing in Health and Social Care

Vivien Martin, Julie Charlesworth, Euan Henderson

• Publisher: Routledge
• Year: 2010
• ISBN:
  9781135153557
• Edition: 2
• Topic: Medicina
• Subtopic: Prestazione di assistenza sanitaria

Managing in Health and Social Care is about developing skills to manage and improve health and social care services. The focus throughout is on the role that a manager can play in ensuring effective delivery of high-quality services. Examples from social care and health settings are used to illustrate techniques for managing people, resources, information, projects and change.

This new edition has been extensively revised and updated, and includes many new case studies and examples, as well as a new chapter on motivation. It covers topics such as:

• interorganisational and interprofessional working
• leadership
• responding to the needs of service users
• the service environment
• accountability and risk
• working with a budget
• standards and quality
• managing change.

The authors explore how managers can make a real and positive difference to the work of organisations providing health and social care. They consider what effectiveness means in managing care services, the values that underpin the services, the roles of leaders and managers in developing high-quality service provision, and the necessary skills and systems to enable service users to contribute to planning and evaluation.

Managing in Health and Social Care is a practical textbook for students of management in health and social care, whether at undergraduate or postgraduate level. It includes case studies with textual commentary to reinforce learning, activities, key references and clear explanations of essential management tools and concepts.

The first edition of this book was published in association with The Open University for the Managing Education Scheme by Open Learning (MESOL)

PART 1
THE MANAGER AND THE TEAM

CHAPTER 1
YOUR JOB AS A MANAGER IN HEALTH AND SOCIAL CARE

In this chapter we consider the nature of a manager’s work. We begin by inviting you to compare your work with that of other managers in health and social care settings and to consider the extent to which your activities are similar to or different from theirs. This will help you to identify your activities and roles as a manager, and thus to gain a better understanding of the job of a manager in health or social care. Whatever your area of work, it is essential to understand the contribution that you can make as a manager, so that you can contribute more effectively to the delivery of high-quality health or social care for service users.

A MANAGER IN ACTION

There are many different types of manager in health and social care. Not all of them have the title of ‘manager’, but they include people who manage service provision, who manage delivery teams and who manage the various support systems for service delivery. Although management responsibilities may be very different in different types of work and in different types of organisation, the focus of the work is the same for any manager in health and social care – the delivery of high-quality services to those who need them. The activities which managers undertake to carry out their work have many similarities, although the contexts in which they work may be very different.

Let’s begin by looking at a manager in action. We asked some managers in health and social care to describe their work. Each of their reports illustrates the wide range of activities that managers undertake and the correspondingly wide range of skills and knowledge that they use. Second, they show that a lot of these skills are common to many management jobs, irrespective of the level or functional specialisation involved. Third, they illustrate how the various skills and competences described may complement each other to produce an effective managerial approach.

ACTIVITY 1.1

What, exactly, does a manager do? The following passages are descriptions of the work of three different managers in health and social care:

Case Study A: an intermediate care services manager

Case Study B: a practice manager

Case Study C: manager of a resource centre for children with disabilities.

Glance through all of them and choose one to read carefully – you might like to choose someone who works in a context similar to your own or to focus on the work of a manager in a very different setting.

As you read the description, consider what the manager did and how he or she achieved outcomes. You may like to highlight the activities or to make brief notes.

Case Study A: intermediate care services manager

For the last five years, I’ve been a manager of intermediate care services – a joint appointment between a unitary council and a primary care trust. Initially I spent a year as a project co-ordinator and that was about looking at how the service needed to change and engaging people. The task the next year was to integrate the services. I was then appointed as the service manager.

You learn a lot about being a manager in a different organisation. I think it was a real opportunity. If I was just a manager for the PCT I would just have learned about PCT management. The biggest challenge, though, is personnel management. We had about 150 staff of various different grades.

The interesting thing is that, when you start in a new job, you start with a blank computer, empty desk and blank diary. The first hard thing is being clear what the job is and what the parameters are. There’s a tendency to take on everything that comes your way in those first few months, and fill the diary. There should be a process of being able to stop and to reflect and plan, start making contacts and going out with the individual service teams and really find out what they do on the ground, talk to some of the service users and find out what the experience is like for them. So the first thing was to gather information and the next thing was to start working with some of the key stakeholders and a lot of that was working with the other service managers.

So we set up a project team and it was very action-focused. We often worked with flip charts, doing process mapping and SWOT analysis and

then gradually building up a picture of how the service needed to look. Some of that was around a single point of access and a lot of work was done on that. Once there was a clear picture, we developed a draft strategy for the next five years and consulted on it. It was clear that when you are merging services together, roles will change and potentially that was the most difficult thing. It was about getting HR support with that and making sure the process was done properly.

One thing I’ve learned is that you should never start a project unless you’re very clear what your budget is going to be. It affects everything, for example what staffing you can afford. The budgets for intermediate care weren’t going to change, what we had was the amalgamated budgets from the services. The objective of projects to redesign services is often to reduce costs but with this one, it was to increase activity and capacity.

The difficult thing was not planning the project or implementing it, it was when it started to affect people – that’s when the problems started. As a manager it was probably one of the most traumatic experiences of my life, I lost a huge amount of weight, I was exhausted and I couldn’t sleep at night. When you’re leading a project it’s a very isolating job. Our project group had all the service managers on it, including those who would be directly affected. While people were very supportive up to that point, then they became a little bit blocking and it felt extremely difficult to get things moving.

What I did at that point was to identify somebody who was really influential in the organisation and that person worked alongside me to support me especially at group meetings and that was so important. I think the only reason we got through that project was because I had got somebody who was important to provide that support to me. The problem was that, as a project co-ordinator, I wasn’t actually managing the budget or managing the staff. I didn’t have any influence. All I had was persuasion and if people don’t want to be persuaded to do something, they’re not going to do it. So it was about getting somebody who had got that power and that influence. Through her support, we managed to get the services integrated and changed.

There was a lot of resistance from other managers. It was manifested mostly through negativity. I felt that people were going away from our grou...