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Analysis of the Causes of Change

North-East Langley Hospital Trust (NELHT) is a trust who runs on the government finances but due to some wrong leaders and their actions, it has allegations like money fraud, no organized method for money management, and its proceedings. When the Secretary of state for health analyzes the whole trust at that moment many of the issues were moved towards. This write-up includes the issues in North-East Langley Hospital Trust (NELHT) associated with the organization's culture and its procedures. These issues are No set of priorities, lack of professional behavior, lack of paper/information management, no standardized process for any action, No maintenance of buildings, and unavailability of an IT system for management of records like cash flow or patient details. Necessary changes and their effects on the organization’s culture and its procedures are included in this paper. A section for some important recommendations to improvise things in NELHT for a longer time is also included.    

NELHT has many imperfections that need to be determined and make necessary changes for upcoming times. These changes will improvise the conditions of NELHT and make it apposite for patients and also for the staff. For analyzing the causes of implementing changes first there is a need to identify the issues and then show some changes to check their effects on the organization. Some of the issues in the organization and preferred solutions to them are:-



There is no standardized process for any type of action and due to this a lot of mess is faced by the staff. Lack of proper procedures many of the time staff are confused about what to do or whatnot.

Establish standard policy and procedures (Grol eta l., 2013).

Some staff of the organization has poor professional behavior towards others and these make things very unprofessional. Due to this other professional working staff also face difficulty in their work and leave their job or face working issues.

Conduct behavioral training sessions (White et al., 2015).

Lack of money administration and this is the point due to which this Trust is infamous. No system is available to check or record the money flow and thus government funds are used illegally.

Establish an IT system for money management and flow control (Finkler et al., 2022).

The staff has not set of priorities and this makes their service very awful. Staff is making their priorities high as per the patient or organizational priority.

Set a proper priorities chart (Barasa et al., 2015).

Patients and other information related to staff have no maintained record. lack of paperwork or information maintenance raises many issues.

Use the proper system to manage all the paperwork (Boonstra, Versluis & Vos, 2014).

To stabilize the organization and manage all the things according to the requirements some changes are applied to the organization. These changes may be accepted by some people but some peoples deny accepting the change or making things work hard. Some of the causes of changes are:-

  • An improvising step in the course of organizational priorities will make the hospital service much healthier. Making patients a priority and following procedures second is needed for the organization because this will ensure the high-quality working of staff(Mosadeghrad, 2013). But in this process maybe some of the members who used to unorganized manner will deny following and this thing takes time to change.
  • An improvising step in professional behavior ensures good staff working and maintaining a professional environment. Professional behavior is an important thing and following this indicates respect for work and organization. Some professionals who used to unprofessional behavior could raise their voice or oppose the change and this will lead to some harsh stands or decisions.
  • Implementing some record maintenance system will increase awareness about changes and if needed in the future then any time they could be accessed. In this scenario maintaining paper records are best in a way because they cannot be hacked but still, Proper maintenance also provides security to the personal details of the patients(Handayanietal,2017). Systems are always able to hack so proper maintenance of security like firewall is also essential.
  • Implementing a system that contains proper safety records of money or funds given by the government(De Groot et al, 2020). This will also ensure proper use of funds for patients and a proper record of every penny is also measured. But similar to the last point all systems can hack so maintaining a proper firewall will make things work mandatory.
  • A standardized process will make things work according to policy and procedure and this working guarantees proper flow(De Groot et al, 2020). Proper management of all necessary parts results in the best outcomes that are necessary like the flow of work and proper service to patients.

Every organization contains any one type of culture and while implementing any change in the organization the culture of the organization also changes but this change implementation on culture is not very easy. After reading the scenario of NELHT it’s hard to say that they are even following any culture because everything is just unstable and unorganized. There are four cultures for different types of organizations and every organization or firm follows any one culture to run in the market (Jacobs et al., 2013). NELHT is a type of organization that follows Non-profitable working culture. Its working culture is based on the funds from the government side. Its culture and social dimension are very weak and due to this any type of change is not very effortless.

Cause of Changes

NELHT has some wrong leaders and thus this makes the working of the organization very negative and the service delivery of the trust is not very appreciative. The director of the NELHT is not very focused on the work and never took any stand toward the improvement of hospital service. This culture is defined as the Dominant culture of an organization because the director only does what he wants to do. Due to his dominancy, there are several money transfers or usages that are not listed in the finances chart. The money funded by the government is not for personal use but after the investigation of the Secretary of State of Health, they find many sums are not in the accounts and are used somewhere else. The result of this action of direction organization is infamous and the staff is also very free to work unprofessionally or unmannered way (Morello et al, 2013). The manager of the company is also dominating and if any voice rose against any of his actions or circumstances then he used to make every effort to terminate or avoid the voice. Decision-making is also an issue because most decision-making steps are only done by one or two persons and this approach is not very appreciative. Only the director or the manager are the persons who used to account for decisions whether they are in benefit to the organization or non-beneficial to anything.

Applying change in culture to the organization is not very easy because some individuals may support eth change but there are still some individuals who oppose the changes and do not work according to change. There may be some political hands behind this scenario and thus applying this change of culture is not unproblematic. Some organizations peoples may also use some political rules to oppose this change because this change has a proper standardized method to run an organization (Pavithra, 2021). While applying this change there is need to train the staff because till date they are preceding everything on paper but now they have to fill excels or use other IT system to manage the work.

NELHT has a weak dimension of work and due to this their decisions and the working process is not very strong and determined. Organization leaders are working in a way to maintain incoming funds from the government but the purpose of hospital trust is to avail the best service to the patients. Due to this, things are not going well and thus the reputation of the hospital isn’t very high. While upgrading the dimension of the organization then a strong opinionative leader and handling person are authorized to perform the tasks and thus this changes the organization dimension from weak to strong (Haddad et al, 2016). And strong dimension will lead the organization on a strong path and this change is also not very easy because staff who is enjoying the lost tracks of working have to work and follow things according to order. Political and cultural issues also need to face while making changes in dimensions. Political challenges like people may group against the change, trying to make resistance in the path of change, lack of communication, or conflict making will be some of the issues that need to be faced while implementing change (Tucker & Carr, 2016).

Analyzing the Consequences and Reaction to Change

Power, conflicts, and politics, and the effect of these are much coupled because power is the only thing peoples run to achieve and if power is not gained by any action then people use politics to gain it. This politics results in conflicts many times. For NELHT power is the person who is on a high chair and his orders will be followed on any condition. While making changes some peoples want that high chair and try to take the power into his hands but to maintain the things according to them. To gain power many conflicts can be raised and thus this makes things harder to implement. While selecting the hands for using power there must be some rules or boundaries that need to be set so that inappropriate usage of power cannot be done. While culture implementation many conflicts may raise to stop or change the process of implementation to continue the order process. This politics also affect decision-making because if any wrong decision is taken then unkind results could be seen (André & Sjøvold, 2017). These two side things affect the employees who are supporting change and maybe they quit the job just for the reason that there are conflicts for power and change management is not possible to can be done easily.

Power, conflict, and politics also impact dimension change just because many things need to be done to make NELHT a strong position organization from a weak dimension organization. These strong standards and dimensions would raise the level of living and work because when a proper professionalism standard is used to run things employees would also learn to work and live better (Buchanan & Badham, 2020). Following the professional standards improve the reviews and the service standards but still, some staff may use politics or raise conflicts to stop this change. These conflicts may increase the issues in respect of situational and organizational development. Social working of the NELHT is very down because this is the organization that works for the people on the government funds but due to a lack of organizational standards, development and priorities it has a low grade of service.

In NELHT many things need to be implemented for purpose of achieving the best standards and services. Some of the most essential practical implementations that need to be implemented are:-

  • There is a need to set some organizational standards of working to process the organization progressively. As a firm grows, so does the need of adhering to established workplace rules and regulations. Here, you can find a collection of declarations and descriptions of the company's culture as well as its expectations for its personnel(Rinawati & Nasution, 2020). The setting, expressing, adhering to, and improving upon standards of work is the practice of standard work. Standard work starts with the creation, clarification, and dissemination of knowledge by process operators regarding the most efficient way to accomplish a job that is presently known to everyone conducting that process.
  • Organizational priorities are an important point to consider. If any organization has no priorities for their customers or staff then working in that organization never provides adequate outcomes and non-adhere to a set of priorities will make their work useless or aimless(Sujan et al., 2015). NELHT has to set the priorities to accomplish the goals and make things work according to the requirements and government standards (Blumenthal et al., 2016). For hospitality trust government always set some responsibilities and working aims, therefore, to accomplish them NELHT has to work on its services related to the customers and improve the set of work for every employee to adhere to their tasks.
  • While analyzing the case study a point of professional behavior is very highlighted because a bunch of employees is not following professional behavior and many other employees are facing harden ship in the work. A lack of professional working behavior will create an environment of conflict or confession(Kim & Kang, 2015). To improve this there is a need to implement some strict rules about professional behavior and the consequences of avoiding the regulations. A general session every week is taken for all employees to make them know about the professional behavior, this session conducts some discussion about the behaviors and allows employees to interact positively (Mohammadimehr et al., 2017). If anyone is still not following regulations related to the behavior then strict action should be taken to set an example to others.
  • In the case study, information management is a high issue because there is no set of technology to collect information and store it properly. Information about customers, organizations, and staff is very sensitive and confidential. Collection and management of this information is a priority task to do and improving this condition is necessary(Nippak et al., 2016). To improve this 2-3 staff members should be appointed to take responsibility for this so that if any issue rose then this group could handle the situation or could be investigated by authorities.
  • After the secretary of state of health investigation, a big fraud has been detected in the money handling and a couple of figures are not listed in the cash flow table. This could be done because inspection by the state of health is not conducted on regular basis and this gives the director a chance to do unlawful actions of money fraud. A regular audit is need to be set by the state of health and check every cash flow statement in deep and also take patients' reviews on the service so that standards followed by the organization can be understood.
  • Money management is high priority task to improve the service of the hospital to the patients therefore to improve this service they need to make a better flow of money management(Jones et al., 2018). A person should be appointed directly by the state of health so that he/she is directly answerable to the secretary of health about any fraud or anything. This will improve the cash flow and utilize the funds for some good purposes like organization development.
  • Some training sessions also need to conduct because many things require to be improved as like staff members need to learn some professional skills of management so that they can understand the organization level work as per the requirements. Staff members learn about the new policies and procedures to know how to follow them. This will make their responsibilities clear and work finer as per the requirements of the organization. Some ethical rules are also needed to teach them because this will improve the work friction in the organization(Gordon & Schildmann, 2016). Some ethical behaviors are like obeying the rules, being respectful to all, always completing the responsibilities, always managing work according to priorities, improving communication, contact authorities in any confusion or conflicting situation. This type of teaching will increase the efficiency of expected outcomes from the staff.
  • The issue of information management and cash flow management is very high and this makes things very too conflicting. Due to the unavailability of the IT system, this management is done on paper and this makes things hard to manage. An IT software and system implementation will give them a source to manage all the documents related to the patients, staff, and organization(Cleverley & Cleverley, 2017). Recruiting, keeping, and utilizing people in an increasingly interconnected and scattered company environment demands constant communication and cooperation. Information technology has a major benefit in terms of its capacity to simplify both internal and external communication. The prompt and effective delivery of services. Fewer employee hours and decreased human or machine errors result in cost savings. Resource planning may be improved by having access to accurate, timely, and complete financial information (Chiarini  & Baccarani, 2016). With this implementation data, analysis and management are done more efficiently and this will help to understand the customer's demand and requirements.
  • Implementing the resources like new sustainable pieces of equipment will increase the efficiency of service. Environment sustainable types of equipment usage improve the image of the hospital and attract more customers(McGain & Naylor, 2014). New pieces of equipment improve the working like new maintained types of equipment help staff members work faster and with full efficiency. This step improves the service of the hospital for both patients as well as staff. Evaluating things as per the requirements will help the organization develop in the field and work more with the best outcomes (Zhang, 2013).


In this above write-up of NELHT, a health trust discussion is conducted related to its issues and the effect of issues on the organization's work. Due to a lack of maintained organizational standards staff and patients both are suffering from a lot of problems. Lack of organizational priority and professional behavior staff members are facing issues to work with efficiently and this can be seen in their work. This also includes the issues faced by the organization and what is affecting the organizational purpose. Some of the required changes are also shown up in the report with the issues that are faced while implementation. Political, cultural, and dimensional issues and conflicts while implementing these changes are included in the report to show the friction in making changes. Some of the required changes are also included in the above write-up to show the needs of the organization and how to implement changes to get the positive and expected outcomes. This recommendation carried out some important considerations like IT implementation and some training sessions by which new policies and procedures can be understood by staff properly.


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