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NHS and Bupa Healthcare Sample

Executive Summary

National Health Service (NHS) is a name used by four different corporations in the health sector that are normally under the system characterized by public funding in UK. It is only the English NHS that has been officially allowed o use the name National Health Service and the other NHS’s being NHS Wales, NHS Scotland and the Health and Social Care in Northern Ireland commonly referred to as HSC. The system have independent operations and they are politically accountable to the government under jurisdiction; Welsh government, Scottish government, UK or Northern Ireland Government.

Unlike NHS, Bupa is one of the leading health insurance organizations in the UK with its operations going beyond the continent. It has more than twelve million customers in its target population of more than 200 countries. It is not a public healthcare and does not require a private health insurance when accessing the medical services and hospitals. In addition, Bupa runs various hospitals under its jurisdiction and the medical treatment is only accessible to individuals in UK who have private health insurance policy or those that can easily pay for the service.

Critically compare the characteristics of service quality that are evident within the context of the NHS and Bupa

Most of the medical care institutions aim at delivering quality medical service to the customers. In quality service delivery, the medical care institutions ensure that the institution’s goals and objective are met in the short run (Legido-Quigley, 2008). It does not only imply meeting of the institution’s objectives but also the need to fervently deliver high degree of health services to patients that enhances the populations at large to increase their likelihood of the desired outcomes of the health service provided. The health services provided should be consistent with the current professional skills and knowledge.

Bupa medical care service is constantly improving its quality of service provision to the population. It has articulated to the quest of delivering better quality medical service to its customers at an imperatively lower cost. The major characteristics that underlie Bupa’s medical care are safety, effectiveness, timely, efficient, equitable and patient-centered (Cooper, 2000). The philosophy of the health care institution endears to the safety of the patients. This has enhanced the trust and believes in the operations of the medical practitioners in the institution. It is clear that every patient who needs medical attention should possess unqualified expectation of his or her safety. Although, many a times, medical errors are prone to happen in the medical field but Bupa has ensured that the errors which deems preventable or due to sluggishness of the medical practitioner are effectively prevented.

Consequently, the health services provided by the medical institution are timely. The medical practitioners attend to the patients when they need medical attention. The perfection and timely nature of their activities has enhanced them to be ISO certified. Generally, most of the medical institutions have a problem of meeting the required deadlines and patients have been reported to have succumbed to death due to lack of medical attention. Efficiency of the medical center’s activities is also given the first priority in the realization of a world class medical care services (Greenberg, 2000). The institutions’ offers right medical care to the patient’s at the right time. However, as the perfection is not yet attained in most of the medical institutions, Bupa’s medical care service has not realized its objectives of being efficient. According to Bowie (2004), only 70% of the medical operations undertaken by the institution are efficient.

In addition to efficiency, distribution of resources and services to various personnel and patients is equitable. The customer’s satisfaction is only attained when inherent services are offered to them without any discrimination. Quality care is given to the needy with minimal concern to their status quo. This has enhanced the institution to be effective and be competitive in the realization of its strategic goal. The services are also patient centered with much concern being on the need of the patient and not necessarily the practitioners need (Klein, 2006).

Currently, Bupa medical services focus on tackling the unwarranted variations in an attempt to realize effective treatment and care for its patients. The patents ma\y be subjected to different treatment and care which is not normally accounted for in the institution; main policy and objective being equitability. With a clear understanding of the needs of the health care and with the need to reduce unwarranted variations, it is quite clear that there is possibility of designing health care provisions which will ultimately meet the requirements of the general population. According to the report published by Chrvala (2001), an account of the variation in the medical practice was initially on the tonsillectomy incidence among the young kids. It is clear that reduction of unwarranted variation enhances improved patient experiences and outcomes in the medical field.

Contrary to this, NHS also articulates to provision of quality medical services to its patients. The major characteristics that is embodied by its medical practitioners include; recognition of patients with high risk diseases, appropriate evaluation of activities, appropriate diagnosis, appropriate treatment to the patient, ensuring there is appropriate follow-up of activities, stimulation of appropriate compliance to medication by the patients among others. These ensure that top quality practice is attained by the management of NHS (Ranade, 2001).

NHS, in an attempt to foster patient’s disease recognition, has an effective screening apparatus that follows the outlined procedures in order to detect the diseases and impose adequate preventive measures on it. Ideal EHR has been used by the medical practitioners with the aim of achieving precise results in timing vaccinations after it has screened the tests that had been carried out. Automating the process in the medical institution has enhanced quality results as the disease is detected at its early stages therefore appropriate vaccines can be subjected to the patient to prevent the disease.

In the case of appropriate evaluation for quality service provision, NHS uses the EHR option to come up with medical judgment. This does not depend on the medical practitioner’s discretionary decision but the underlying symptoms that the patient has been characterized with. It is clear that such an innovation enhances the overall accuracy and clarity of the results as the clinical judgment is considered the most vital element when coming up with diagnostic decision. However, physician’s discretionary judgment is not fully avoided as he or she is allowed to undertaking tests which are less invasive depending on the circumstances of the patient and the kind of illness that he or she might have acquired (Williams, 2000).

The physicians are well-trained and provide an appropriate diagnosis to the patient implying that the treatment made will be effective as the disease would have been unveiled. The results are interpreted with the life history of the patient in the physicians mind. In case of an incomplete record of the patients health history, the medical practitioner ensures that he reads a given study report performed by an expert. Many delicate changes are imminent in the laboratory indicating the disease in which the EHR and the computer system cannot detect.

The medical practitioners in NHS are known to articulate to appropriate treatment in an attempt to realize quality medical service. Although an appropriate treatment is always considered to be the medical practitioner’s decision, accurate diagnosis provided by the EHR has ensured that the medical service provision is accurate, reliable and unbiased. The physicians are provided with the outcomes of imposing a given treatment on the patient and he or she can effectively analyze these outcomes (Seung-Hee, 2007). In addition, appropriate medical follow-up is practiced by the physicians in order to realize the effectiveness of the medication that was imposed to the patient. The patients feel well catered and cared for, as such, enhancing their competitiveness in the service delivery in global economy.

Consequently, quality service provision is imminent by the practitioner’s compliance to the appropriate therapy. A patient is only satisfied with the service provision when he or she is ultimately cured from the ailment. NHS is articulating on perfect and unbiased therapy to its patients in the realization of improved outcomes. In the currant economy, it has been reported that compliance to the relevant therapy by the medical practitioners is awful; ranging from 10% to 50%. Patients do not have the skills and knowledge of understanding the therapy that they are subjected to by the physicians. In NHS, physicians track their patient’s adherence to the therapy given by use of electronic communication with the relevant pharmacy in order to ensure that they comply with the regulations they were provided with; for example refilling frequency (Neil, 2000).

Evaluate how the deployment of TQM systems within health care services should help to prevent service errors; draw upon the case studies of the NHS and Bupa to provide evidence of theories in practice

Total quality management is highly regarded as an effective system that will enhance accurate measurement of the quality of medical service in a given medical institution. The tools of TQM have been mostly used by the health professionals in measuring the quality of service and care. The quality measure is normally undertaken when the information provided in the records of the patient or the ultimate operational process are analyzed and converted into a percentage or time rate to show how the various medical practitioners and physicians endear to enhance provision of quality service in the medical institution. Over the past decade, scientists have been interested in determining the quality service provision in the medical field and they have developed a clear framework of measurement and subsequent reporting of the information acquired (Stamatis, 2000).

Total Quality Management (TQM) systems have been seen to immensely prevent recording and service errors in the medical institution. The whole process is embodied by the processors, inputs and outputs. In the case of outputs, capital and human resources plays a key role and the characterization of the system enhances overlap among the various processes, structures and outcomes in the medical field (Legido-Quigley, 2008). Generally, the system’s component is identified in accordance to their appropriateness, effectiveness and efficiency. Efficiency ensures that the medical practitioners attain the desired cost minimization which links the service processes in the medical institution to the resource inputs available. Appropriateness of the medical service accords service suitability and ensures that there is a clear link between the service processes and the patient’s inputs. In addition, effectiveness involves undertaking right things by the physicians and result that is being sought. It links the service processes available to the outputs that are critically defined in an attempt to improve the health status of the institution.

The traditional health care quality system that was initially in place has currently been replaced by the modern models which are considered to be the consumer’s quality. In the current approach, the TQM in the medical institutions aims at delivering error-free medical service and that the structure relates to personnel, physical facilities, and the overall organization. The whole process is redefining the interaction between the consumer and the provider of the medical service. The interactive process has been viewed to focus on the functional service delivery from the physicians and the way the patient perceives the competency of the health care provided. In addition technical, medical and clinical qualities are put into consideration. The extent in which the service interaction is guaranteed in the health system ensures that the patent meets the desired medical attention and that it fosters the overall medical outcomes of the institution (Cooper, 2000).

In the case of NHS, the current situation is that the manager’s functions have been disregarded as they are bestowed with the maintenance and enhancement of health provision with concern to the personal experience. This has led to the enactment of individualized models which are based on their own experience in the medical field. Quality managers within the NHS are undertaking an analysis on the effect that the TQM system has on the institution’s on the basis of the determined experience of intra-organization and the idiosyncratic knowledge of the past.

Absence of the modern TQM system within NHS has sprout disagreement among the medical practitioners on what constitutes quality health care in the institution. There has been current disagreement on the implementation of the TQM system in the health care facilitation. In regard to the approaches imminent in the delivery of quality service and articulation to the available national health standards, the system has been less defined with minimal concern to the quality improvement of medical service delivery to the customers (Blythe, 2008).

However, whether modern or not modern, TQM plays a major role in reduction and ultimately removal of the service error in the system. It is clear that the introduction of TQM model into the system of NHS has improved its overall reputation as the problems and faults that were initially spotted are easily sorted out quickly. At this juncture it is evident that the TQM system has been effective in minimizing errors and enhancing quality delivery of medical service by the physicians.

Earlier on, the report prepared by Griffiths Enquiry of 1983 enhanced the management articulation to the TQM model in their system. The case provided that NHS management failed to adequately take the responsibility of assessing the institutions performance on a frequent basis against such imperative measures like the service quality budgetary control, motivation, productivity and the rewarding of staff (Ranade, 2001). It also stipulated the institution’s lack of clearly defined managerial function throughout the NHS. Griffith enquiry argued that such shortcomings in the medical sector have inclined NHS to be prone to service errors.

Contrary to this, Bupa has also been initiating TQM program in its system. This has enhanced the reduction of service errors, and has boosted the morale of employees as they are motivated by indulgence in extra responsibilities, decision making process and team work. In addition, the model has ensured that costs are mitigated and inspectors who are qualified are bestowed with analytical jobs.  As such , Bupa’s culture have been diverted from their normal focus on the governmental initiative, controlled workers, hierarchical decision making, complex processes among others to a more quality focused medical service (Williams, 2000).

In the current program, in an attempt to minimize service errors in the institution, Bupa is currently focused on patient rather than the managerial team, and involves empowerment of process owners. TQM model has also aid the institution in flattening the organizational structure in an attempt to realize reliability in the organization’s undertaking. It has also fostered for coaching, mentoring and leading patients on whatever they are undertaking. It is believed that when the institution’s priorities changes due to the effects of TQM, the culture of Bupa will change for better. Therefore enhancing the employees to understand and acknowledge the vision they are embodied with in order to contribute positively on the continuous quality improvement in the sector.

Identify and discuss the key macro and micro environmental factors (including competitive environment) that would critically influence the key marketing and service strategy decisions Bupa faces currently and in the future.

Generally business environment consists of majorly the micro and macro-environmental factors that affect the marketing strategy of an organization; Bupa Health insurance sector is no exception. The micro-environmental factors comprises of the forces that are closer to the organization and the effect it has to the ability of serving its customers, such as suppliers, labor market, competitors, financial institutions among others. On the other hand, Macro-environmental factors provide an overall picture of the variety of forces at work around an organization. They include; political, economic, social-culture, technological, legal influences (PESTEL) (Croft, 2001). Those forces have a wide implication on the institutions undertakings and influence its activities.

In Bupa Health insurance sector, microenvironment and macro-environment have become intertwined and have repercussion on each other. For instance, IT development converted the whole institution greatly, not only has the type of medical undertakings has been changed dramatically, but approaches of management within Bupa in every level have been more different in comparison with traditional ways (Blythe, 2006). So it is vital importance to realize the complex business environment and cope with all sorts of challenges in order to satisfy the customers and maintain business successfully.

1. The Political Environment

The political environment has an effect on business activity, from the political institutions and its inherent systems and processes, to the specific issues relating to government’s environmental condition that enhance the economy to work effectively and its effect towards the global market  (Ferrell, 2008). The political environment in the health sector comprises of taxation policy, social welfare policies, pressure groups, government activities, government stability and foreign trade regulations not only have an influence, but limitBupa Health Insurance undertakings.UK, having a developed economy, legislation affecting business has increased steadily over the years. The UK’s political environment is sophisticated and stable, and its legislation encourages competition in the marketplace.The government enacts legislation for varied reasons.  From a market’s standpoint, the reason is to make health institutions unfair in marketing competition and to protect consumers’ benefits from their consumption behavior (Mercer, 2001).

2. The Economic Environment

Mercer (2001), stated that the economic environment of an organization, whether in the public or the private sector, includes the macro-economy of the country and as well as the industrial sector environment of the organization itself. There are many indicators to measure a nation’s economy including household disposable Income, Gross domestic product (GDP), and unemployment among others. Generally the prosperity will ultimately increase need of insurance service while recession will lower the need for insurance services.

In the economy of UK, business operations are known to compete in a free market. During the past decade, increase in economical activities was impeded by the recession that was felt globally (Weinstein, 2004). In the health sector, the inflationary activities had an impact on the performance of the institution in the economy.  Bupa Health Insurance sector, with the help of the managerial team, analyzes the changes in the economy and impact marketing strategies that are relevant to the economic condition prevailing in the system.

3. The Social Environment

The society is experience immense change at an increasingly rapid rate. This is characterized by changes in the income distribution, population demographics, and social mobility. Bupa Health Insurance need to analyze the changes in the size of the population and the growth trend, changes in the age structure among others in order to effectively design a market strategy that meets the demographic needs (Schnaars, 2000). Generally, in UK the proportion of aged people is increasing and the health insurance education should be fostered to that population in order to be resilient in the economy. In addition, culture of the people or customers as a whole should be critically analyzed in order to appreciate their value in the society. Consumer movements have been deemed as a factor that impedes the success of many business organizations, as such Bupa Health Insurance need to incorporate the needs and satisfaction of its customers in the marketing strategy in an attempt to minimize any irrelevant costs arising from the movement (Wedel, 2000).

4. The Technological Environment

Capon (2008) pointed out that the business environment is currently turbulent and dynamic and it is driven by globalization, technological change and the competitiveness in the economy. In the current economy business operations should appreciate the impact the new technology have on the success of the business operations. In the case of Bupa Health Insurance, the marketing strategy should embody the use of online marketing in order to realize high sales. Although the technological advancement may be costly in most of the organization, a business entity cannot be successful without articulation to technological advancement in the economy. 

5. The Legal Environment

Understanding the legal framework enables an organization to effectively indentify the vital opportunities ad challenges that most business entities face especially in relation to suppliers, employees, customers and intermediaries (Sally, 2001).

Contrary to the macro-environmental factors affecting the marketing strategy of Bupa Health Insurance, the micro-environment factors also plays a major role. The agents of the Bupa Health Insurance need to be incorporated in the strategy for it to realize full support which will aid in the organization’s success. The customers are considered to be the backbone for every business organization therefore the need for them to be incorporated into the long-term plan and strategy for the organization (Fifield, 2007). Bupa Health Insurance needs to safeguard its customers and aim at attracting more customers into their system. In the case of suppliers, they should be advertently given the attention they deserve. Competitors should not be left aside as they are the ones who endear the organization to achieve its strategic goals and objectives in the stipulated time framework.

Identify and evaluate Bupa’s market segments and its current position in the healthcare market.

Bupa Health Insurance Company is considered one of the leading companies in the health care market of UK. This has been facilitated by the marketing strategy in which the company has articulated to. Earlier on, in the early 1980s, Bupa was dominating the health care market with health insurance policies and networks imminent in private clinics and hospitals. The vital benefits to customers were claimed to be speedy consultations and treatment avoiding hospital queues (Morteza, 2001).

The market segments for the company’s products and services were the business-to business and the consumer as its target market. Research undertaken showed that general public is largely cynical about the health insurance which has created a major challenge in devising the market strategies and segmentation to various marketers. A growing number of householders are being enticed into the private health care market by seductive television, advertising, direct mail and offers ‘piggy-backing’ on the existing contents, home insurance or motor insurance schemes. The core market remains to be the corporate sector with small and large businesses providing policies for their employees along with the company cars and pension schemes (Holbeche, 2005).

The marketing packages that are normally required to easily entice a private consumer at home into protecting his or her family and the proposition necessary to persuade JCB or ICI to comfortably buy a scheme for more than a thousand of its employees are quite different. Bupa aims at effectively defending its position against the growing band of competitors and at the same time successfully attract new category of users into the private Health sector.

In my opinion on the achievement of the long-term objectives and strategic goals, the management of Bupa Health Insurance needs to put into consideration the target market that is effective and can withstand any economic change. The management should segment the market by articulating to the geographic, demographic, psychographic and behavioralistic characteristics of the target market. This will ensure that the company can effectively distribute resources to the places or market segments that have potential of purchasing the insurance cover for their products. For instance, the sophisticated sectors in the economy should be given the first priority in advertising for the insurance services available. Most of the employers require that their employees should provide relevant documentation of health insurance before given an opportunity to work in their premise, therefore, the management should strategies in developing a cordial relationship with such employees so that they can offer their services with minimal competition.