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Problem-Solving And Decision Making

Introduction- Problem-Solving And Decision Making

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Task 1

Slide 1: Introduction

  • Based on the case study scenario, it has been idealized that, in recent days, the NHS has faced staff shortage-related complications.
  • Addressing the problem is discovered throughout this study.

The NHS is one of the 4 systems of healthcare services in England that was established in 1948.

Slide 2: Research-informed discussion on the nature and impact of the complex problem

Nature of the problem

  • Hospital acuity as well as an aging workforce typically linked up with the crisis nature of staff shortage in the NHS (Taylor 2020)
  • In this regard, staff shortage is comparatively underlined with massive disruption structure to employee morale.

Staff shortage or labor shortage in an organization indicates that employers are having difficulties recruiting new employees.

Slide 3: CONTD…

Impact on the employees

  • Work overload
  • Poor performance of each assigned employee at NHS (Nyashanu, Pfende, and Ekpenyong, 2020)
  • Deterioration in physical and mental health

A shortage of employees in an organization is obvious to increase the burden on the existing employees. A low workforce means more work pressure because the work is not being able to get divided into the number of parts it requires. Eventually, this will have an effect on the performances of the employees who would otherwise work effectively. As per the Case study, the NHS was affected by a shortage of almost 100000 employees. The motivation of the employees is facing a severe decline and might lose the will to work. In the matter of healthcare, this problem becomes more significant because it involves the lives of people.

Slide 4: CONTD…

Impact on the organization

  • Difficulty in reaching desired goals
  • Deterioration of the satisfaction level of customers (Johnson et al. 2021)
  • Lower revenue

The disruption in the supply chains of pharmaceutical companies due to a shortage of employees results in less production. There might be delays in providing service and that would result in a loss of satisfaction in the customers. The set goal might not be reached due to this eventually hampering the economy of the organization. The NHS is a reputed healthcare organisation and such low revenues can affect its integrity and name in the market. The customers that had been gained in the long journey will eventually be lost. This level of loss in the organization will eventually hamper the motivation of the existing employees and result in the deterioration of their performance.

Slide 5: PESTLE analysis of Macro-environmental factors

  • Political factors: A single governing body has been negatively impacting on NHS staff selection system (Senek et al. 2020)
  • Economical factors: Additional costs of other healthcare equipment and the salary structure of staff are massively responsible for enhancing complicated mode (Wood et al. 2021)
  • Social factors: Unequal job opportunity

The decision-making of the policymakers plays a huge role in the occurrence of staff shortages even in reputed organizations like the NHS. One single body governs these organizations and that prevents any kind of innovation. The decision taken by the governing body is final and if it decides to not hire new employees due to a budget shortage there would be no way to hire them even if the organization is in an emergency. The primary economic factor is the issue of additional costs that would be necessary to hire new employees. An organization might be under an economic crisis and that would prevent it from hiring new employees. The hiring of new employees would prevent the problem of employee shortage in an organization. However, some regions even in the most developed countries have taboo social beliefs that prevent certain sections of the society from working. This includes people from the LGBTQ community who might not be provided equal job opportunities even if they are qualified. Women in some societies are not allowed to work and in some cases, they might choose that these factors pose serious social threats in the matter of staff shortage.

Slide 6: Contd…

  • Technological factors: Lack of advanced technology (Afolabi, Fernando and Bottiglieri, 2018)
  • Legal factors: SOP of hiring is also associated with staff shortage-related risk (Gray et al. 2019)
  • Environmental factors: Poor evolving structure of active work environment

The main reason concerning technological issues is that an organization might lack enough technological advancement, which increases the workload of employees. These employees, in turn, leave the organization in search of better opportunities which leads to staff shortage. Legal factors leading to staff shortage in this context are mostly employee background related which will prevent them from being hired even if they have the required qualifications. The main environmental factor that would be affecting the employee shortage crisis is the work environment, which depends on whether or not an employee wishes to keep working there.

Slide 7: Cause and effect analysis of the problem

  • Causes of the problems: Management, lack of involvement of human resources, poor up-gradation of processes and environmental resources create a massive risk of generalizing staff shortage (Drennan and Ross, 2019)

The concept of the fishbone is also known as the “Cause and effect diagram” which is mainly used for the proper analysis of the case study to provide a clear concept about the relationship between the causes and effects. The layout represents the current scenario of the issues as well as the relationship between the potential causes and their effects (Drennan and Ross, 2019). The main aim behind the use of the “Cause and effect diagram” is to focus on the real causes not on the symptoms of the causes, which will ultimately provide a clear concept about the effect of the causes. It is also used for the identification of the areas of the problems, which will provide the proper action plans against the problematic situation and ultimately produce the positive effect from that negative field. After the analysis of the current situation, the identification of the major causes is done which will provide the ideas about the possible effects of the existing causes. “Poor environment” is the cause and for that reason, the excessive workload is present on the health workers. The second cause represents the less amount of involvement of the authority, which ultimately creates the lack of shortages in the health care field. The last cause is the lack of a poor management system in the field as a result a poor infrastructure can be observed in this particular field. Overall, the fishbone represents the different existing causes and their effects, which is ultimately creating a shortage of staff in this field.

Slide 8: Evaluation of alternative solutions

  • Increase in work hours
  • Contractual employment can be a choice to suppress staff shortening (Xu, Intrator, and Bowblis, 2020)
  • Technological advancements

The use of advanced technology will also reduce the need for manual labor and in that case, employee shortage would not be a problem.

Slide 9: Contd…

Contractual employment is the most appropriate solution

  • Minimum wage requirement (Walsh et al. 2020)
  • Employee motivation

The additional costs involved in hiring new employees on a contractual basis are low. In addition, employees under contractual jobs can look for new jobs at the time of their employment which is good for their personal development too.

Slide 10: Conclusion

  • An overview of the problem can be discussed in this study
  • An appropriate solution such as modification in staff selection will solve this crisis

The most possible solution, in this case, would be to rely on contractual employment.

Task 2: Report


Shortage of staff has never been a significant problem in the NHS but with the rising complications in the matter of health, it has turned out to be a problem. The problem of staff shortage is dominating the pharmaceutical industries, especially after the pandemic, and that has mandated the need for a strategy to mitigate it.

Elaboration of issues, impacts, PESTLE analysis based on staff shortening

The gist of the problem and its impact

The pharmaceutical industry has faced several losses due to shortages of staff. Mainly, a loss of revenue and a loss of potential customers were the results. Work productivity has shown a significant decline as an obvious result of fewer employees (Sizmur and Raleigh, 2018). The demands after the pandemic, however, have increased which would require more employees but there has been a decline in the number due to several employees falling sick. Some organizations have followed the cutting of employees as a cost-cutting strategy due to financial instability. Due to this, all the aspects of the organizations have been affected and it has been evident from the case study, the NHS has also been a victim of it. Although it is one of the main governing bodies in the healthcare of the UK, the losses faced due to employee shortages have been dynamic.

Overview of the PESTLE analysis

The main political factor that has led to the staff shortage is the absence of versatility in the decision-making bodies of the organizations. The cost issue has been the obvious economic factor for the arrival of this problem. On the other hand, social issues are mostly ethical involving the mentality of people (Duncan 2020). The unequal access to opportunities for different sections of society has been the social reason along with some irrational social beliefs. The employees will certainly be subjected to tremendous work pressure in case of staff shortage and the stress levels and physical exhaustion can make them weak. In addition, this immense stress build-up can result in mental imbalance.

Declaration of the cause and effect analysis

The implications regarding staff shortage have been arising due to the problem of staff selection and recruiting as it possibly might be due to the absence of qualified candidates or due to budget issues of the organization. This inefficiency of the organization leads to the problem of a shortage of employees (Oluyase et al. 2021). In addition, management issues like failing to maintain a secure work environment have led to losing efficient employees. Human issues mainly the change of decisions of employees regarding continuing work in the organization have been another cause.

Chosen solution to mitigate risk

Increasing the work hours of the existing employees will lower the need to hire new ones. Hiring employees on a contractual basis will require additional costs only for a certain period. Hence, this strategy can be considered beneficial when compared with the others and the drawbacks are minimal in this case.

Plan to implement decisions to solve complex issues

Chosen strategy

The process to implement the decision on strategy

Necessary factors

Success indicators

Way to measure the effectiveness

Necessary actions

Develop a recruiting system by focusing on Contractual employment

This identified decision regarding the contractual employment “approaching a staffing company”.

? Time duration of 6 to 12 months

? Cost of about $ 3 million

? Humanitarian workforce

? Technologic interventions 

Services development and customers satisfaction

Revenue increased and patients had positive health outcomes. Measures of efficiency, effectiveness, and risk are the common three measures of this strategy.

HR departments need to show their legal concern on Recruitment and develop an overall system of selection service of employees based on their experience and capability.

Table 1: Action plan to suppress staff shortage issue at NHS

Analysis of the implemented decision

The present account has been rendered to a delivered major issue of lower staff in the organization. Therefore, these major issues have associated with different issues for the organization. Core or internal competencies have been reduced the major services and outcomes related to positive impact. Hence, the services and actions taken by the management are mainly aimed at creating a significant staff with contractual employment. This proposed strategy is required to be implemented by selecting or approaching a company that is involved with supplying skilled and knowledgeable employees for the particular organization. Therefore, the contractual employment services delivering companies are important to deliver major skilled and knowledgeable employees to the certain (Bernhard-Oettel, Sverke and De, 2018). In this strategic planning and acquisition, development over the NHS's existing issues mainly required these implementation interventions. The cost of an organization expanding for labor cost is going to be lowered with service extraction.

Discussion of a success indicator

The success indicator for this contractual employment strategy implementation in NHS is highly remindful. The high demand and less competition are the two key indicators of outcomes of employees associated with contractual interferences. Thus, the services development and organizational development are going to be indicted with revenue development and services development. Inclusive leadership is the indicator to imply the functional adjustment into the NHS body. The performing aspect of this organization is mainly dealing with patients. Thus, the policy development and contractual interferences of the organization are being carried forward. Flexibility is another key approach that can be facilities with the indicating aspect of this strategy (Rodriguez, 2020). Therefore, the satisfaction of customers is linked with service management. The contractual employee is going to be involved with creating services development for staff for patients in NHS.

Way to measure the effectiveness

The efficiency of contractual employment implementation in NHS with staff requiring organization selection is required to be tested with effectiveness. The effectiveness is demonstrated with services and performance monitoring. The KPIs evaluation with measurable identification is performed to analyze the risk associated with strategic implementation. The risk involves cost and time management. The renewal and tracking of the contract are going to be potential risks for implementation (Virtanen et al. 2022). Thus, the measurable three-dimension is going to deliver major goals and achieve the prospect of staff development with service management.


The problem of staff shortage is dominating the business world, especially healthcare after the pandemic. Reducing the problem would require a possible solution that would help resolve it and in this case, it has been observed that contractual employment can be the best possible solution.


Task 1

Afolabi, A., Fernando, S. and Bottiglieri, T., 2018. The effect of organizational factors in motivating healthcare employees: a systematic review. British Journal of Healthcare Management, 24(12), pp.603-610.

Drennan, V.M. and Ross, F., 2019. Global nurse shortages: The facts, the impact, and action for change. British Medical Bulletin, 130(1), pp.25-37.

Gray, T.A., Wilson, P., Dumville, J.C. and Cullum, N.A., 2019. What factors influence community wound care in the UK? A focus group study using the Theoretical Domains Framework. BMJ open, 9(7), p.e024859.

Johnson, S., Dalton-Locke, C., Vera San Juan, N., Foye, U., Oram, S., Papamichail, A., Landau, S., Rowan Olive, R., Jeynes, T., Shah, P. and Sheridan Rains, L., 2021. Impact on mental health care and on mental health service users of the COVID-19 pandemic: a mixed methods survey of UK mental health care staff. Social psychiatry and psychiatric epidemiology, 56(1), pp.25-37.

Nyashanu, M., Pfende, F. and Ekpenyong, M., 2020. Exploring the challenges faced by frontline workers in health and social care amid the COVID-19 pandemic: experiences of frontline workers in the English Midlands region, UK. Journal of Interprofessional Care, 34(5), pp.655-661.

Senek, M., Robertson, S., Ryan, T., King, R., Wood, E., Taylor, B. and Tod, A., 2020. Determinants of nurse job dissatisfaction-findings from a cross-sectional survey analysis in the UK. BMC Nursing, 19(1), pp.1-10.

Taylor, M., 2020. Why is there a shortage of doctors in the UK? The Bulletin of the Royal College of Surgeons of England, 102(3), pp.78-81.

Walsh, D., Spiby, H., McCourt, C., Grigg, C., Coleby, D., Bishop, S., Scanlon, M., Culley, L., Wilkinson, J., Pacanowski, L. and Thornton, J., 2020. Factors influencing the utilization of free-standing and alongside midwifery units in England: a qualitative research study. BMJ open, 10(2), p.e033895.

Wood, E., King, R., Senek, M., Robertson, S., Taylor, B., Tod, A. and Ryan, A., 2021. UK advanced practice nurses’ experiences of the COVID-19 pandemic: a mixed-methods cross-sectional study. BMJ open, 11(3), p.e044139.

Xu, H., Intrator, O. and Bowblis, J.R., 2020. Shortages of staff in nursing homes during the COVID-19 pandemic: what are the driving factors?Journal of the American Medical Directors Association, 21(10), pp.1371-1377.

Task 2

Bernhard-Oettel, C., Sverke, M. and De Witte, H., 2018. Comparing three alternative types of employment with permanent full-time work: How do employment contracts and perceived job conditions relate to health complaints? Work & Stress19(4), pp.301-318.

Duncan, D.L., 2020. What the COVID-19 pandemic tells us about the need to develop resilience in the nursing workforce. Nursing Management, 27(3).

Oluyase, A.O., Hocaoglu, M., Cripps, R.L., Maddocks, M., Walshe, C., Fraser, L.K., Preston, N., Dunleavy, L., Bradshaw, A., Murtagh, F.E. and Bajwah, S., 2021. The challenges of caring for people dying from COVID-19: a multinational, observational study (CovPall). Journal of pain and symptom management, 62(3), pp.460-470.

Rodriguez, E., 2020. Marginal employment and health in Britain and Germany: does unstable employment predict health?. Social science & medicine55(6), pp.963-979.

Sizmur, S. and Raleigh, V., 2018.The risks to care quality and staff wellbeing of an NHS system under pressure. The King’s Fund: Oxford, p.24.

Virtanen, P., Vahtera, J., Kivimäki, M., Pentti, J. and Ferrie, J., 2022.Employment security and health. Journal of Epidemiology & Community Health56(8), pp.569-574.

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