leadership assignment 2 done

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Leadership & OB NUNES, I

BUS723 - Multiskilling at Rossett NHS Trust 1

Contents

INTRODUCTION ...................................................................................................................................... 2

Motivation.......................................................................................................................................... 2

Motivation Theories........................................................................................................................... 2

Leadership .......................................................................................................................................... 7

Groups and teams .............................................................................................................................. 9

RECOMMENDATIONS ....................................................................................................................... 10

CONCLUSION .................................................................................................................................... 10

REFERENCES...................................................................................................................................... 11




BUS723 - Multiskilling at Rossett NHS Trust INTRODUCTION 2

INTRODUCTION

Today we are witnessing the era of globalization, in which the movement of capital, peopleand knowledge are constant, amplify the patterns of demand and competitiveness, andfinancial pressures are increasing. An only company with competitive advantages is that it

can survive and overcome the competition, increasing the life cycle of their products and/orservices and its profits. This reality affects all businesses and industries in general, but inparticular the hospital industry, because it is inserted in a highly competitive business, wherequality of service is a critical success factor.The performance of the employees of a hospital is associated with the quality of servicesbecause the customer will interact with the employee. That is, the performance of employeeshas a significant impact on hospitals, because their level of motivation and commitment willmake all the difference between a mediocre service and high quality service. Similarly, but ina different light, we have the leadership that today is a hotly debated topic, increasinglybeing assigned to lead a vital role in the performance of an organization.In this context this study aimed to contribute to the improvement of knowledgelevel of the hospital industry in Rossett NHS Trust, particularly in terms of human resources

and leadership.On this report we will look a case study, it will talk an attempt to introduce multiskilled, ward-based teams of support workers in a Rossett NHS Trust hospital, a medium-sized hospital inthe UK, which in this particular site operate with 250 people.

Motivation

Robbins (1996: 212-213) explains that the motivation correspond to the wish of exercisehigh levels of effort in view of the organization's goals, conditioned by the ability of effort tosatisfy some individual need. Rosenfeld and Wilson (1999: 74-75) argue that motivation isthe level of willingness on the part of an individual to increase the effort, to the extent thatthis additional meeting some needs.

The motivation is then, no doubt, responsible for stimulating and channeling human behaviorin order to achieve a particular goal and that in this context stimuli serve as drivers of human

action. So the motivation will be significant in the manner and intensity that will be used by

an individual to perform a given task.

Motivation Theories

The motivation has captivated over time the attention of many scholars, who try tounderstand the behaviours and attitudes of employees in organizations, so that it can predictand control employee‟s performance. Thus, there were a number of ideas, giving rise todifferent theories and perspectives of looking at motivation at work. On the basis of mosttheories of motivation is the interaction between the situation, needs and driving forces of

individuals (Wilson & Rosenfeld, 1999: 75).

According Lashey and Lee-Ross (2003: 93) these "theories can be separated into two

groups depending on whether the focus on meeting the needs of individuals or the cognitive

processes involved when establishing priorities with their motivational needs". HRM Director

at NHS Trust, felt it would improve worker motivation as porters would „feel part of a team‟

and „be included if chocolates were give out or nights out were planned‟. They would ‟take a

pride in their work‟ and „be recognised at ward level‟.

Needs Theories

The group of theories of individual needs, as an explanation of the process motivation of

individuals, highlights the internal needs of people and behaviour resulting from the effortthey made to reduce or satisfy these needs. The needs theory more relevance are: the





Needs Theory of Maslow's, the Needs Theory of Frederick Herzberg, the Theory of NeedsAlderfer (ERG) and the Theory of Needs McClelland.

Maslow's needs theory

The Maslow Theory of Needs comes in 1954 with a representation of human needs pyramid,stating that individuals construct their priority needs in accordance with a distinct internalhierarchy. Maslow (1943: 22-23) argues that people are motivated by the desire to attain ormaintain the various conditions under which is the basic satisfaction and by certain moreintellectual desires. Maslow's theory is based on three major assumptions:

Principle of Dominance, which corresponds to the fact that human behavior isinfluenced by the unmet needs;the principle of hierarchy, which corresponds to the fact that needs can beassembled according to a hierarchy;Principle of Emergency, in which one level of needs emerges as a source ofmotivation and consequently will determine the individual's behaviour, only when therequirements of level or lower hierarchical levels are met.

Through Figure 1 it can verifies that the needs of individuals are ranked from the bottom tothe top of the pyramid and the importance of these moves in that direction.

The pyramid is divided into five levels, each with a specific set of needs: the first level (base)

are physiological needs, which relate to food, rest, shelter and sex on the second level are

the needs of safety, which relate to security and protection against danger, disease,

uncertainty, unemployment and theft, on the third level are the social needs that include the

relationship, acceptance, friendship, understanding and consideration for others, the fourth

level are the esteem needs, which relate to pride, self-love, progress, trust, recognition,

appreciation and admiration for others, in the fifth and final level are the need for self-

realization, which refer to the realization full of every individual, personal development and

improvement of their talents.

Figure 1: Maslow’s theory on the hierarchy of human “needs”

Source: Adapted from http://steves.seasidelife.com

Thus, the motivation is stimulated by the level which is still not satisfied. This means thatindividuals are motivated to satisfy needs that are unsatisfied. At the time that the level of





needs is satisfied, the next level of needs becomes more important, causing individuals toexpend a set of efforts to meet them, and this evolution, i.e., rising from one level to another,made from the bottom to the top of the pyramid of needs. According to Maslow's no need isfully satisfied, but need can only have a highhanded action, when there is a high degree (butnot complete) satisfaction. "The main consequence of the satisfaction of every need is aneed that is submerged and a high level of new need arises" (Maslow, 1987: 33). AlthoughMaslow's Needs Theory is based on an intuitive logic, the reality is that empirical tests of thistheory have been limited and recent studies show that its predictive power may beambiguous (Lashey & Lee-Ross, 2003: 94-95) has also been criticized for being static,descriptive and overly devoted to the ideological side (Wilson & Rosenfeld, 1999: 75-76).However still the best known theory of motivation in the world due to its approach, whichappeals to common sense and be easy to use.

In trust scenario “Many of the porters, almost exclusively male, quite openly expressed theirunwillingness to undertake cleaning duties, which some thought were „women‟s‟ work‟. Thisgender issue raised its head in many consultations between porters and managers and wasa frequent topic of conversation between porters”. In other words, porters are not motivatedto perform certain tasks.

In the case of Rossett NHS Trust directors only concern about successful implementing thegeneric work it benefits which would help to „provide good value for money‟ and „make costsavings‟. Therefore, it seems that NHS Trust don‟t really care about the need of itsemployees.

Equity theory

According to equity theory, each person would tend to compare what is offered as a rewardfor their performance with what was offered to people like him. In this comparison, impliesthe pursuit of fair treatment, or, as stated by the theorists, the pursuit of equity (Bergamini,1997). In the interpretation of Robbins (2002), employees make comparisons between theirwork - inputs (effort, experience, education, competence) and results (pay, raises,

recognition) - and the inputs and results of others. When they realize that relationships areunequal, they experience a tension of equity. This state of negative tension provides amotivation for broker action (Adams quoted in Robbins, 2002).

As proposed by Adams (cited Bergamini, 1997), those who contribute most to anorganization also expect to receive more in terms of reward. In this sense, the theoryprovides useful guidelines for equity so that we can understand the different types of socialrelationships in the workplace. It is essentially based on the comparison necessarily implythe existence of a reference point for this comparison to performed.Robbins (2002) states that, according to the theory of equity, when the worker perceives aninjustice, he is expected to make one of these six choices:

1. "Change their inputs (make less effort)

2. Change their results (for example, employees can receive part produced byincreasing their incomes by producing more parts with less quality)3. Distort their self-image (for example: "I thought I worked at a moderate pace, butI realize now that I work much more than others ")4. Distort the image of others (for example: "Mike's work is not as interesting asI thought it was ").5. Search another point of reference (for example: "I may not be earning as well as mybrother-in-law, but certainly more than my father made when he was my age").6. Leave the ground (for example, leaving the position)"

It is important to note that employees seem to seek equity in the distribution of other

organizational rewards. For example, the positions of status and luxurious offices in the

equation results serve as equity for some employees (KING, MILES DAY cited andROBBINS, 2002).





Figure 2: Herzberg View

Source: Adapted from Robbins (2002, p.56)

Herzberg was a staunch defender of intrinsic motivation, emphasizing the limitations ofrewards and extrinsic punishments. Its proposition is the motivation for their work, to beachieved through job enrichment (Vroom, 1997). For Herzberg (1997), the enrichment of the job is how to increase employee satisfaction, as this offers the opportunity to enrichpsychological growth of the employee. It is a proposition that should not be deployed atonce, but continuously. The initial changes should last a fairly long period and should boostthe position up to the level of the skill challenge hired. Those with greater ability can bestdemonstrate this ability and achieve promotions to higher positions.

The major contributions of the two factors theory to understand the motivation for the study

were: the possibility that the employee has greater autonomy for planning and carrying out

their work, the appreciation of the enrichment processes of positions and a differentapproach on the role of remuneration on the motivation to work.

“Denise Lipton, the manager responsible for establishing the pilot scheme which ran on onelarge ward, argued that „The domestics think it‟s a great idea‟, „Women will go for it to seemen cleaning‟ and „they really enjoy the varied workload‟. Others attempted to explain whystaff were positive about change with comments like, „Now they don‟t know what other dutiesthey‟re going to be doing and they really enjoy that, so their job satisfaction has gone up‟.That‟s doesn‟t seems good practice in term of leadership roles, because it doesn‟t goaccordingly with Herzberg theories practices.

Among these factors, security and relationship status with colleagues is not seen present at

NHS Trust. With change implementation in NHS Trust, employees won‟t get a good salarywhich may not be satisfactory. Apart from basic salary, employees would get bonus





according to their performance which could be inexistent because of lacking in motivation

from staff member which would lead to a poor performance. At NHS Trust there are not

suggestions and feedbacks from employees which could be at first stance always welcomed

and it seems there is no relationship between staffs and directors. Staff is discontent or

dissatisfied with management at NHS Trust. The team might fail to move on to the next

stages in their reactions to change, and commitment to the change process won‟t develop.

Leadership

Leadership has been studied, and there are several concepts formulated by differentauthors:

"It's the ability to mobilize free individuals, employees, to raise their voluntary participation inthe achievement of objectives" (DULUC, 2000: pag.79). "Leadership it‟s about courage andcapacity to lead a company forward and progress, despite all the difficulties that might sow inthe way" (Adair, 1993: p.12).

Leadership Theories

Traces theory

According to Robbins (2007), this theory divides the traits of a leader in social, physical,intellectual or personality. The difference between leaders and non-leaders can be observedthrough seven basic traits: ambition and energy, desire to lead, honesty and integrity,confidence, intelligence, high self-monitoring and knowledge relevant to the job. Extraversionappears to be the most important aspect of effective leader (Robbins, 2007).

Behavioural theories

The difference between the approaches of the traits and behavioural traits is that theyassume that the leadership skills are innate. The behaviour, in contrast, it believes that theseskills can be taught.

Theory of contingencies

The theory of contingencies, finally, emphasized that one should also focus on the influenceof the situation. Some approaches to the identification of basic situational variables weremore successful than others and thus received wide recognition, namely: Fiedler's model,situational theory of Hersey and Blanchard; theory of exchange between leader and led, goaland path models, and models of participation and leadership (Robbins, 2007, p. 263). In themodel of Fiedler effective group performance depends on the fit between leader style andthe degree of control that the state gives (ROBBINS, 2007, p. 263). If leader wants toincrease organizational and group effectiveness, they must not only train more effectively theleaders, but also to build an organizational environment where he can do well (Bergamini,1994, p. 55).

For Fiedler's contingency theory, the supervisor must establish interpersonal interactionsbetween group members and between the leader and each member of the group, so thatthey expand the tuning ability of the individual.

It should also work in favour of the individual motivation of each member and dismiss anindividualized training for each lead (Bergamini, 1994, p. 55).

NHS Trust sounds that is lacking of relationship between leader and its employees.Employees are not being involved in group discussions and they are not participating in keymeetings with directors. It makes them feel as a part of the organization.

The Absenteeism in NHS Trust among ancillary staff, those largely affected by the change

(generic or multiskilled working), is about double the hospital average. It is because lack of

task structure to which they didn‟t react accordingly. Such a blow was due to improper





groups without any goal to achieve. At NHS Trust, there is no proper orientation of groups

and that too without any goals to achieve and due to which they might lose their market

position.

At NHS Trust sounds, position power has been seen as rewards are being given out to its

employees and promotions are being made, some of the porters are assigned to specificdepartments or directorates, such as X-ray, but most are „located‟ in a central pool and

respond to demand for their services. There are three porter-managers.

According to Fiedler`s contingency model, two factors, leader – member relation and

position power is well oriented at NHS Trust sounds that they are lacking in task structure as

no goals are defined and no situational actions are made. One of reason the change

implementation is failing it‟s because of lacking of task structure and consequently they are

suffering dissatisfaction among staff.

Leadership Styles

In the practice of art is to lead individuals to carry out a job, every leader has his particularway, his own style of relationship with employees. However, they can within a certain extent,change their perspectives, with the acquisition of new knowledge, attitudes and skills (Silva,Matos, 1992: pag.117).

Several authors who have addressed the types of leadership but Rowe (2001), there areessentially three types of Leadership: Autocratic, Democratic and Liberal.

Autocratic style

The emphasis is focused on leading leader who sets the guidelines, without any groupparticipation, determines measures and techniques for implementing tasks. At NHS Trust, asmall domestic team comprising the Director of Site Services, her deputy and the managers

of domestic and portering staff fine-tuned, „customised‟ and planned the implementation of this initiative. The managing team change of NHS Trust did not gather the whole workforcetogether to discuss the changes. All the decision has been made through managers anddirectors without consultancy of the majority of staff. The small management team wasenthusiastic and dedicated. They articulated the benefits of the scheme with conviction.

According to Hogg and Vaughan (2002), in the case of NHS Trust the directors and teamleader's autocratic leadership style did not fit the requirements of the task and thus sowedthe seeds of resistance to change. The poorly managed change process became costly tothe NHS Trust due to the loss of human resources, reduced staff morale and lowered thecredibility of the management. The changes might left the team members feeling betrayed,and individual team members traumatised.

Democratic style

The emphasis is focused on the leader and subordinates. The guidelines are discussed anddecided by the group, encouraged and assisted by the leader. The group itself outlinessteps and techniques to achieve the target.

Liberal style

Emphasis on subordinates. There is complete freedom for group decisions or individual, withminimal participation of the leader; (Rowe 2001).

The NHS Leadership Qualities Framework (DOH, 2002, p34) suggests leading changethrough people with effective and strategic influencing is essential in a Rossett NHS Trustenvironment. This is supported by Rowe (2001) who suggests that strategic,

transformational leadership is a key element within an organisation staffed by professionalsand that a collaborative style is required to achieve transformational, lasting change.





However, the team leader's leadership style in NHS Trust is autocratic and the teammembers were no longer consulted about matters concerning it, which was inappropriate inteam work approach.

Rowe (2001) suggests that a democratic leadership style works best with a mature

experienced team with shared responsibility and accountability. The change in leadership

style meant that the team felt disempowered and uninvolved in decision making which didnot allow ownership of the change process to emerge. Furthermore, the flow of information

to the team slowed down and the team's concerns about the change did not reach top

management implying that communication channels in the new organisational structure were

not functioning efficiently.

Groups and teams

According to Drucker (2001), a group can be defined as the combination of two or more

individuals which work together for a specific goal or task to achieve in a standard way.

Every individual in a group is given specific role to play. Groups need to be well managed to

achieve a specific goal. Groups which are not well managed doesn‟t achieve their goalseasily. Specific goals and standards to achieve that goal within a particular period of time is

given to a group to perform better in an organization.

According to Cameron and Green (2003) Skills are the distinctive capabilities of key people.

The nature of the team membership implied a range of key skills interdependent on the other

for effective performance. At NHS Trust sounds that different teams/group did not receive

appropriate training on the information system or to do portering or cantering or even

performing x-ray roles with generic worker implementation it would became a source of

frustration and confusion. The fact on rotating jobs and with significant and unfair payment

distribution it may contribute to staff's frustration and negative attitudes with the change

process.

With changing implementation at NHS Trust, it sounds that there are groups of individualswhich are not that well organized and without any goal to achieve. This is one of the mainreasons for its downfall. At NHS Trust show that groups are not well maintained. NHS Trustshould maintain their groups very well with specific task to achieve in a particular period oftime its goals. It should declare a “better” rewards and performance bonus to the one whoachieve the particular goal within time with better performance. NHS Trust should managegroups in effective way to attain a certain goal. There are 4 stages with which groups can bemade and progress in a certain way for particular task. According to Robbins & Finley (1997)and Boyett & Boyett (1999) these are:

Forming

This stage, members are learning to deal with each other, little work is done and there isgreat insecurity and anxiety. First impressions are formed and the leader or coordinator mustprovide directives to the group;

Storming

This is the negotiation of working conditions, where hostility, tension and conflict prevail. Theleadership at this stage is crucial to explain limits, offer suggestions and maintain order;

Norming

Members come into alignment and acceptance of their roles in the team, which began to

gain focus and unanimity. The information is freely shared, and the focus is now onmaintaining relationships, which help cooperation among members. The team is still not fullyfocused on tangible results;





Performing

It‟s the phase of conquest, where optimal levels of income are finally achieved - productivity,

quality, decision making and interpersonal relationship. There is a healthy competition, which

predominate the help and mutual respect and the atmosphere is one of enthusiasm.

The different team at NHS Trust might consider the change as a natural part oforganisational development. However, the team became increasingly resistant to change

when it felt that the organisation did not really care about its employees, their concerns, and

the ultimate reason for the organisation's purpose, being the patient. The team members felt

that their concerns about the lack of “resources” had not been taken seriously, and this

inevitably led to a feeling that the Trust did not care about its employees or their views.

Strong emotions such as anger and frustration were expressed by the team members. The

lack of formal communication channels meant that the team members took them out on each

other. Johnson, Scholes and Whittington, (2005) argues that at times of change, rumours,

gossip and storytelling increases in importance and that team members engage in counter

communication, thus unconsciously spreading distrust, suspicion and negativity which leadsto lowered staff morale and job satisfaction. The key resisting force in the change process

was a lack of communication and poor leadership at NHS Trust. However, due to poor

project planning, Trust management failed to consider the internal factors that had a major

impact on the change.

RECOMMENDATIONS

Given the improved performance of employees in the NHS Trust hospital, as well as theeffectiveness of their leaders, we can draw attention to some key points:

Draw up periodically, at least once a year, satisfaction surveys of employees, in order

to gauge their opinion about the conditions in their workplace, bearing in mind thatthese are the motivating factors to which employees make more importance. Basedon their opinions, it should be created working conditions that encourage thecommitment and dedication of employees, increasing their satisfaction in same timetheir productivity;Develop opinion surveys to determine the degree of satisfaction given the existingleadership by analyzing the characteristics and behaviours of the leader towardsemployees, trying to adopt the leadership style most appropriate taking into accountthe prevailing circumstances;Make a continuation bet on the qualification of employees, in order to improve theirperformance and quality of service;Take into account the inter-personal relationships with employees, encouraging their

participation in decision making.

CONCLUSION

The team leader's task-oriented leadership style did not suit the context of the changeprocess, and partly contributed to its failing. Cameron and Green (2003) suggest thatleadership will be most effective when the leader's leadership style, the subordinates'preferred leadership style and the requirements of the task fit together. A directive leadershipstyle therefore is ineffective if the subordinates' preferred leadership style is democratic,even though the task is well defined within tight parameters. In addition, Hogg and Vaughan(2002) argued that the most effective leaders are those who are able to combine task andsocio-emotional leadership styles, and organise team members to work towards achieving

goals at the same time promoting harmonious relationships. The new team leader paid no





attention to the team culture and failed to communicate to management about the impendingissue.

This report has as main objective to bring to discussion the issue of leadership andmotivation in the NHS Trust hospital. Also aims to contribute to a better understanding of thebehaviour of employees in this particular case and determine the true importance of

leadership in the success of the hospital.In terms of leadership allows a more complete picture of the existing style of the leader ofNHS Trust hospitals, contributing to the changes at the institutional level in the hospital isdone most effectively and efficiently.

In short, it is now evident that the leaders of the NHS Trust hospital are not participatory andnot worried about people having a great influence on the motivation of their employees, withserious consequences affecting the performance and commitment of workers, highlightingthe leadership in business as one of the critical success factors more important.

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http://c/Users/Nana/Desktop/LEADING%20AND%20MANAGING%20PEOPLE%20ESSAY%202/www.dh.gov.uk








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Websites

http://steves.seasidelife.com/2006/03/16/maslow%E2%80%99s-theory-on-the-hierarchy-of-human-%E2%80%9Cneeds%E2%80%9D/ - Accessed 16/01/2012

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