Changing work plan and culture in health and social care means organisations having to do things differently This is obvious in every day practice for example, professionals such as social workers, nurses, doctors and physiotherapists, may have been well trained but not necessarily on how to manage resources at large. In practice, management of resources deserves a special skill and knowledge necessary for anyone wanting to lead a changing organisation. The enthusiasm for health and social care to move into employee-led mutual will create new issues for managers, who have been promoted to a higher levels and those left behind, not least in dealing with each other.
Decentralisation and delegation of authorities would create new management challenges. Managers of employee-led mutual must be comfortable with making money from practice and taking risks for their business to survive and thrive. Invariably, health and social care managers needs to be innovative and entrepreneurial within their particular specialism however, that's quite different from their career and their professionalism could be on the line if that does not work out well The difficulty is health and social care sectors are militated against by its many layers of bureaucracy and management, while guaranteed work flow and pension’s provision, which is fast disappearing and make any change a scary prospect for managers.
To facilitate the move towards employee’s led mutual, decentralisation or innovation within the sectors for example, bottom up management approach has to be explored, though these have been overlooked for a long-time in public sector organisations such as social service. Professionally, employee’s led mutual could be an answer to vocational calls from service users for better services delivery. This would allow leaders to dismantle some of the bureaucracy, frustrations and risk-aversion within sectors. Operationally, employees’ led mutual is a great way of doing things, because you make people fully responsible for what they do. Involving them in the decision-making process means staff does not get to disassociate themselves from the consequence of their actions. The focus now is one of collaboration and empowerment, rather than the hierarchical, command-and-control structure of the organisations.
New ways of working could have some ramifications in practice for example, a recent social enterprise coalition poll of 2,000 people showed that 43% of respondendants would entrust public services to social enterprises that reinvest profits, 36% would prefer the government/local authorities or public sector and 4% want the private sector to run health and social services of the future. This survey clearly rejected private enterprises to run the welfare services. The popular opinion indicated that social enterprise could provide adequate and enviable services to users however, does the sector have the skills, knowledge and experiences that the managers of public sector organisations have. The emerging cultures and work plan approaches are yet to be tested to meet the increasing and complex needs of the patients/service users and their families.
On reflection, health and social care sectors could learn much from private sector models of innovation, and the skills and capabilities of private sector managers must be adopted by those heading the changing organisations. In practice, professionals generally do not particularly have strong skills to manage complex issues within the organisation. People have been recruited on their specialism for example, being the best surgeon does not make you the best chief executive director of service delivery. In local government, there is certainly a propensity to administer rather than manage.
Typically, you will have professionals who have been well trained, but not necessarily to manage for example, social workers or nurses will know how to carry out needs assessment and provide care within resources available to them. However, they may not have the skills and knowledge to manage budgets, capacity and aggregate planning or being diplomatic while managing the services they deliver. Working in a mutual organisation requires a different mindset and requires managers to perform differently outside the protected environment of the welfare service (specialism).
It is no longer sufficient just to do a good job; managers must be able to sell, develop and deliver, knowing that the market will always be on the lookout for a better option. This removes the safety net, meaning they must be less risk-averse, more dynamic and certainly more efficient, effective and economical in order to maximise resources and budgets. In the current climate of new ways of working, managers and leaders will need to adopt many new skills and competencies required to demonstrate their abilities to defend their positions.
In hindsight, health and social care sectors could lose its brightest and best people to employee-led mutual hence they are able to engage user’s participation, more innovative, blending policies into practice and meeting service user’s aspirations. This would embrace new ways of doing things and this would enhance resource management and commissioning of services within best values principles. This would also means getting smarter to work with third sector organisations, though the welfare organisations in particular has not got its head around professionalising in this way.
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