May 17, 2020

NHS could save £200mn per annum and improve patient satisfaction, research reveals

healthcare services
Catherine Sturman
4 min
New research by academics at the University of East Anglia (UEA) suggests that NHS Trusts in England could save more than £200mn a year by managing sta...

New research by academics at the University of East Anglia (UEA) suggests that NHS Trusts in England could save more than £200mn a year by managing staff well.

The report by the What Works Centre for Wellbeing, found Trusts that made the most extensive use of good people management practices were over three times more likely to have the lowest levels of staff sickness absence and at least four times more likely to have the most satisfied patients. 

They were also more than twice as likely to have staff with the highest levels of job satisfaction compared to NHS Trusts that made least use of these practices, and over three times more likely to have staff with the highest levels of engagement.

No link was found between people management practices and patient mortality. 

The research examined whether good people management is linked to high levels of wellbeing and better performance. It found that NHS Trusts ranked higher when they:

  • made extensive use of training
  • carried out performance appraisal 
  • encouraged team working
  • had clear roles for staff
  • allowed staff to take decisions about how to do their job
  • encouraged supportive management
  • involved staff in decisions about their departments and the Trust

Researchers Dr Chidiebere Ogbonnaya and Prof Kevin Daniels, of UEA’s Norwich Business School, found Trusts that made the most use of good people management practices had sickness absence rates of around 3.7%, whereas the Trusts that made the least had absence rates around 4.4%.

They estimate that if all Trusts reduced their absence rates to 3.7%, this could lead to an annual saving of more than £200mn in sick pay for the NHS.

The findings have implications for management in the NHS and elsewhere, as well as patients and policymakers.

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Dr Ogbonnaya, a lecturer in human resource management, said: "A key priority in recent healthcare debates concerns the need for respectful and responsive services that meet patients’ expectations, values and preferences. Our study provides guidance on important good people management practices for improving healthcare workers' wellbeing and the quality of services that patients receive.

"Our key message is that good people management practices are essential for promoting workers' wellbeing and ensuring happier patients. Improvements in patients' satisfaction may not necessarily depend on major reforms and restructuring of the healthcare sector, but perhaps the provision of working practices that foster workers’ skills, personal growth and development.

“Healthcare leaders should pay attention to how these practices may be deployed towards promoting the quality of care that makes a difference to patients."

Prof Daniels, professor of organisational behaviour, added: “In the context of the recent announcement on the new Industrial Strategy and the UK’s productivity lag behind other advanced economies, our findings point to the importance of having high quality jobs and other good people management practices for both promoting wellbeing, reducing absence and narrowing this productivity lag.”

Dr Ogbonnaya and Prof Daniels wanted to find out whether they could predict improvements in wellbeing - assessed as job satisfaction - and performance, assessed as worker engagement, patient satisfaction, sickness absence and patient mortality, from the use of good people management practices.

They analysed data collected in 2012, 2013 and 2014 from between 135 and 243 NHS Trusts in England.

They examined whether changes in wellbeing and performance outcomes from 2012 to 2014 were related to people management practices in 2013. By analysing changes in this way, they were able to show with greater certainty than has previously been possible that good people‐management practices in 2013 led to improvements in wellbeing and performance outcomes in 2014.

Nancy Hey, Director of the What Works Centre for Wellbeing, said: "The evidence shows us that being employed, and the quality of our work, has a big impact on our wellbeing, beyond income alone. This research confirms the importance of choice, autonomy and a supportive working environment in boosting people's job and life satisfaction.

“NHS staff have a vital, but difficult job to do, and this paper shows what a difference it makes to staff, patients, and budgets, when wellbeing is a policy priority. And even beyond the NHS, we know that a focus on management practice can increase wellbeing and performance at a relatively low cost."

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Jun 21, 2021

How health plans can reduce healthcare inequalities

4 min
Jim Clement from Inovalon on the role of health plans in improving access to healthcare

The COVID-19 pandemic has put inequalities accessing the healthcare system in the spotlight. Jim Clement, Vice President of Product & Services at cloud provider Inovalon, tells us that health plans play the most integral role in advancing the health equity movement.

Why did it a global pandemic to highlight the issue of healthcare inequities? 

Health inequity in the US has been well understood by healthcare professionals for many years, but it has become more evident due to the COVID-19 pandemic. It wasn’t until the racial and ethnic differential seen in response to COVID-19 related infections, deaths and vaccinations that many Americans became acutely aware of the health inequity due to sociodemographic factors such as race, geography, education and income.

Fortunately, there’s now a growing health equity movement afoot in America which aims to improve public health and achieve equity in health status for all people by ensuring opportunities are available to attain the highest level of health. While the entire healthcare ecosystem is important to this transformation, it is health plans that arguably play the most integral role.

How can health plans help? 

Achieving health equity means obstacles to health must be removed, including poverty, discrimination, powerlessness, and lack of access to the basics like physicians, hospitals, medicine, technology, and health education. This is not only a social justice initiative, but also a clear call to action for health plan organisations that are bearing the economic brunt of the costs due to health disparities. 

Health plan organisations that recognise the alignment between efforts to improve health equity and broader member engagement initiatives will be in the best position to move the needle. Plans must also understand that the provision of medical services within hospital walls, physician offices and other health services providers is necessary, but not sufficient. 

By recognising that health inequity also includes non-medical factors such as employment, income, housing, transportation, childcare, and more, plans will be better equipped to ensure their members are set up for success. 

What do healthcare providers need to do generally to address inequities? 

Outreach by both health plans and providers is critical to ensuring people have knowledge of available services, the reason those services are critical to their health, and options to access those services based on their unique circumstances. With both stakeholders beating the same drum, progress can be made quickly.

Given the impact of social determinants of health (SDOH), should healthcare providers take a more active role in addressing these, or other agencies? 

While communicating with patients is critically important, what is truly required to address inequalities is helping patients take medical  actions – like regular PCP visits, monitoring A1C and accepting health coaching – that are necessary to maximise their health, along with non-medical actions –like availing themselves of community resources that address homelessness, food insecurity and employment services. 

The most progressive providers and payers have or are putting in place programs to address these non-medical issues.  In addition, non-medical tools such as transportation services can certainly help drive the effectiveness of medical services. 

How important is it to educate patients about their health and how can this be done? 

Education is a social determinant of health and a key lever to be used to drive health equity.  Patients who do not understand their medical conditions or the consequences of non-compliance with their treatment plans are prone to poor outcomes. 

For health plans, understanding member needs is one of the biggest drivers of quality care. A continuous cycle of engagement through feedback and appropriate responses will provide health plans with an opportunity to uncover, discuss, and resolve problems faster. 

Improving member outreach and engagement can be made easier with a programmatic approach involving four stages of intentional outreach: Getting to know your members, educating members, seeking feedback from members and gaining member loyalty. Each stage not only contributes to a better member experience but also to improved outcomes and higher satisfaction scores.

Now that the issue has come to the fore, what do you think things will look like in 5 years or so?

I predict that health plans that get member engagement, education and equity right will achieve better health and greater value, faster. Those who get it wrong or delay will suffer the consequences of competitive disadvantage and pay a larger share of the rising costs associated with health inequity.

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