What the current practices and approaches related to project and change management? What are the current process for planning and delivering in Specialized NHS laboratories?

This segment will provide a brief summary offering to the readers what can be expected and what will be offered. The presentation part of this research will reference the key themes, background and the significance of this study. The dissertation is organised in five sections and all parts will start with an outline of the section and finish up with a synopsis to highlight the fundamental subjects and forecast what the following chapter will discuss about.
1.2 Thesis Structure
Chapter 1 sets out by introducing to the readers the topic and the justification of where this research falls. The importance of this study will be highlighted together with the industry background information. Subsequently, the aim and objectives of this research will be detailed, followed by the research questions. The chapter will conclude with the scope and the limitations of the study.
Chapter 2 elaborates the Literature Review, offering an evaluation of the existing literature on Prince2 project management……(sorry still thinking through this part)
Chapter 3 discusses the justifications for choosing a specific research methodology type supporting the aim and objectives of this study. The chapter describes different data collection methods used to gather necessary data to help the researcher answer the research questions. Quantitative survey strategy and qualitative open ended in-depth interviews were selected as the most reliable methods for this exploratory study. In short this chapter focuses on the research approaches and strategies building a closer connection between the purpose and the outcomes of this study.
Chapter 4 begins with explaining the adopted data analytic method. In this section the collected quantitative data from questionnaire and the qualitative responses from in-depth interviewees are thoroughly analysed and presented. In the process of the analysis, key findings are identified and a conceptual model is formed. The outcomes derived from this investigation are discussed in this chapter supporting the aim and objectives of this study.
The final chapter, chapter 5, provides an integrative summary developed from the previous chapters discussing the overall assessment of the key findings throughout this research. The relationship between the outcomes of this study and the aim and objectives first set by the researcher for this dissertation is to be defined in this chapter. Towards the end of this section, a conclusion is reached with recommendations and directions for future research are suggested.
1.3 Enquiry overview
The purpose of this research is to explore the impact of project management and change management methodologies on Specialised NHS Pathology laboratories and to investigate to which extent it can be utilised as a vital tool in establishing operation strategies to allow these laboratories to become resilient to budget cuts. This research will investigate the contribution of these methodologies in allowing the Department of Eye Pathology (DEP) to adapt operational strategies and pursuit the ultimate goal of financial independence.
Project management methodology has become an important factor in planning successful project and change management have a key role in communicating service benefits to the customer/service users. Change management is a structured approach for ensuring that changes are thoroughly and smoothly implemented, and that the lasting benefits of change are achieved. The NHS change Model will be utilised and it has been created to support the NHS to adopt a shared approach to leading change and transformation. The model (see figure 1) is composed of eight components that collectively improve knowledge and experience it provides organising framework for sustainable change and transformation. Project Management Methodology, mainly PRINCE2, will be explored as a tool for managing operation process elements of the DEP and change management will be investigated and applied on soft elements (staff and communication) of the organisation. PRINCE2 is the preferred project management methodology in Governmental/Public organisation due to its controlled stages, constant review against project plan, business cases and risk assessments, key stakeholder involvement in decision making and project progress and the flexible decision points.

Figure 1 – The eight components illustrated help better understand how to create an environment and programme(s) which can make change happened (http://www.nhsiq.nhs.uk/capacity-capability/nhs-change-model.aspx).
Many studies have been done on both the fields of project and change management, but little is known about the impact on the Specialised NHS Pathology laboratories and their experience with these methodologies on the evaluation of the laboratory operations itself. Although many discussions have been made in the area of healthcare literature influencing operational efficiency, very little attention has been paid to the laboratories within the industry. This is where the researcher finds the gap in the literature and wishes to investigate the contribution of the project and change management methodology in pursuit of operation efficiency that could potentially leads to financial independency.
This research is of both quantitative and qualitative nature and aims to provide managers and practitioners of Cellular Pathology Discipline multitudinous insight in how project and change management methodologies can be utilised in their operation strategies and practices.
1.4 Research Aim(s) and Objectives
This study aims to investigate the financial benefit realisation of operational efficiency in Specialised NHS Pathology laboratories and aims to identify the contribution of project and change management methodology elements that captivate financial independence.
The long term goal of the research is to develop a formalised strategy based on project management and change management system. The short term goal is to provide a comprehensive review of literature and industry practices in relation to project management and change management analysis and outline a conceptual framework for operation efficiency. Particularly, the study has the following sub-objectives:
⦁ To identify current quality management methods in order to continuously improve the quality of the DEP services. This will be monitored in order to identify the impact(s) of suggested operational strategy on quality standards.
⦁ To provide a complete survey of sources and qualities of limitations commonly found in pathology operation efficiency.
⦁ To review current industry practices and researches in regards to project management and change management. A literature review to identify ‘best practice’ and issues on project and change management.
⦁ To blueprint a framework system for utilisation of project management and change management for pathology financial independence. – Devise a methodology for investigating significant insights into how Prince2 is understood currently and link all relevant issues to help develop and promote the adoption of a ‘benefit driven’ pro-change approach in Cellular Pathology.
⦁ To present a business cases to fulfil Prince2 management method requirement. (Develop and propose a process suitable for implementation with the DEP – methods and techniques for defining and monitoring benefits; implementation and validation evidence aiming to assess its utility and usefulness)
⦁ Recommend further work based on the outcome of this research.
1.5 Background and Scope
The Department of Eye Pathology (DEP) is a National Specialist Ophthalmic Pathology Service (NSOP) laboratory and it benefits from a close and long-standing relationship with UK’s largest Eye hospital, Moorfields. Institute of Ophthalmology (IoO) and Moorfields Eye Hospital make up the largest single site for research and eye care in the world (UCL, 2015). DEP structural set up is slightly unorthodox in the sense that the service, although part of university college London and located within a university location (IoO), it provides services to NHS and private sector as well as support to researchers in the UK and internationally. DEP’s core functions are to understand the processes of vision and to develop new diagnostic and therapeutic strategies for the benefit of patients (IoO, 2015).
Healthcare spending plans cuts in the UK are leaving a £30 billon ‘black hole’ in its financial plan by 2020-21 and this thusly are confronting increasing pressure to reduce cost and enhance proficiency, while looking after quality (NHS England, 2014). Laboratory services are not getting away from this pressure, especially since pathology examinations cost the NHS £2.5 billion for each year (Rcpath, 2015). Carter Review, a UK Department of Health-appointed audit of pathology administrations in England, assessed that 20% of this could be spared by enhancing pathology services (Carter Review, 2015). Consequently, the norm of pathology laboratories in the UK is undergoing fundamental changes at a rapid pace. In some areas, multiple hospital laboratories are being requested to merge into a solitary regional laboratory organisation to cope with these changes caused by spending cuts (Kind’s Fund, 2014). The key drivers for NHS Pathology laboratories apart from the obvious respond to political pressure (NHS budget cuts) are as follows:
⦁ Economies of scale and cost improvements in order to reduce the variation that arises from differences in access to approved pathology testing.
⦁ Centralisation due to increase control of scarce resource and to maximise utilisation of technology and expertise for methods, validation and clinical interpretation and thus optimise emerging techniques in order to reduce costs and improve outcomes.
⦁ A single unit will allow maximisation of workforce expertise and enable the development of specialist training centres for specialist and non-specialist workforce reducing variation associated with differences in clinical practice and knowledge.
⦁ Multi-hubs enable the introduction at scale and pace of powerful new technologies to replace existing testing strategies and in turn drive improved quality through collation and sharing of data for patient benefit by standardisation of and participation in minimum agreed datasets, repertoires and testing methods and external quality assessment and benchmarking.
The Carter Review recommend that one of the ways that these investment funds can happen is by dealing with the requests of pathology tests and diminishing inappropriate requesting. As of now, numerous labs are utilising different methodologies to investigating demand management. Another road is that price competition for pathology testing has turned into an element (Kings Fund, 2014). Inside of the NHS, essential consideration trust now tender for pathology testing services and commission those pathology laboratories that offer the most competitive prices (NHS England, 2015).
In spite of these troubles, pathology laboratories have the chance to bring new testing and conveyance systems that deliver and increase the value for service users. However, these new diagnostic advancements requires capital and new scientific abilities, both of which are hard to find as the NHS attempts to shrink budget and squeeze more out of existing assets. In light of these variables, pathology testing in the UK is managing more threats and a faster change than any other time during the six decades of the NHS has been in existence.
One theme of unmistakable fascination is the ways to manage pathology spending plans and deal effectively with commissioners and tenders that could prompt reduced prices for pathology test services. In what capacity can project management systems be utilised to use the pricing opportunities while minimising the difficulties? This research will attempt to provide a ‘framework’ to allow the Department of Eye Pathology to develop financial independence strategies based on project management methodologies and change management system. This ‘framework’ is for the sole purpose to help the DEP directors and managers deal with the new realities of healthcare and associated reforms. This research main focus is the DEP, London, but there is however impossible to exclude all of the National Specialist Ophthalmic Pathology Service (NSOP) in the UK.
1.6 Significance of the Research
From an empirical point of view, this proposal could potentially assist pathology service professionals in the NHS laboratory by formulating an appropriate framework to help expand laboratory proficiency to adapt to spending plant cuts. The consequence of this study will be valuable to the pathology managers and in addition related pathology services in developing better practice and apparatuses for dealing with budget restraints and opportunities for models that allow independence in the public sector. Additionally, it also strives to utilise change management approaches to enhance staff involvement and easy transaction of changes. As a consequence, this will assist the organisation in saving costs as well as the laboratory’s reputation. This research has the potential to help the specialised laboratories fabricate more grounded relationships with service users as well as NHS commissioner officials.
From an individual reflection this research will contribute more knowledge to my comprehension of spending plan confinement on quality of care and help me utilise my insight acquired from the Global MBA in structuring a framework for the department that can be utilised to permit the service to proceed with operation with limited or without commission.
1.7 Research Hypothesis
The research proposes that the higher the service operation efficiency and quality, the higher the possibility of financial independence. It also proposes that a strategy based on project and change management methodology is required to enable the department to become resilient to budget cuts.
Evidence-based project management and change management ‘framework’ would increase the service efficiency and quality and thus increase the department resistance to budget cuts and in time increase chance of financial independence. The relevant hypotheses relate to introducing project management and change management in the existence and mode of operation of specialised pathology services.
1.8 Research question
The following specific research questions will be addressed to fulfil the above purpose:
⦁ How successful is DEP’s cost saving methods? Is the DEP making best use of available resources, skills and knowledge? And to what extend are they to be limited in order to not have a detrimental effect on the service quality?
⦁ What the current practices and approaches related to project and change management? What are the current process for planning and delivering in Specialized NHS laboratories?
⦁ Is Prince2 project management methodology the only suitable approach to pathology services? If not, what are the proper project management approaches that should be adopted to ensure implementation?
⦁ How can the NHS change management model be used to drive long term goal of a hybrid commissioned and independent service?
⦁ How can the key factors that led to successful project management implementation, including user acceptance and satisfaction levels, effective business strategies and what practices be identified and evaluated in both the long and short terms?
⦁ What does the current Key Performance Indicators (KPIs) of the DEP service reveal? With a view to investigate factors deterring the department to strive for revenue growth? And is it possible to develop the most valid and informative measures to assist in settling these ‘fears’ of service disruptions that prevents DEP from pursuing these avenues?
The result of these enquiries will help the DEP team to assist the department to become a patient-centred, user service-driven business and a key player in the specialised pathology service industry.
1.9 Summary
This chapter 1 discussed an outline of this research study. At the beginning of this chapter, synopses of each chapter from 1 to 5 were presented in the enquiry overview section. Aim and objectives of this study were also presented followed by suitable research questions selected by the researcher. Next industry background and the rationale of this study were discussed. Towards the end of the chapter scope and limitations of this study were mentioned. The following chapter 2 provides a critical review of the existing literature related to this study. Gaps in the literature are identified and evaluations of relevant, up-to-date academic literature are demonstrated.

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