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Table of Contents
Section 1: Introduction.....................................................................................................................3
1.1 Background of Study...........................................................................................................3
1.2 Problem of Statement...........................................................................................................4
1.3 Aims and Objectives............................................................................................................4
1.3.1 Aims............................................................................................................................4
1.3.2 Objectives...................................................................................................................4
Section 2: Theories for Management and Leadership-Case Study..................................................4
2.1 Case Study Analysis- CQC Management and Leadership Role..........................................4
2.2 Maslow's Theory of Management........................................................................................5
2.3 Transactional Theory of Leadership....................................................................................7
Section 3: Critical Analysis of Case Study- John Hopkins Model..................................................8
3.1 Case Study Analysis-Issues of Management and Leadership..............................................8
3.2 Principles for Mental Health................................................................................................8
3.3 SWOT Analysis of Change Management Model................................................................9
3.4 John Hopkins Model of Reflection....................................................................................10
3.4.1 Model Description....................................................................................................10
3.4.2 Model Application to Case Study.............................................................................10
3.4.3 Rationale for Adopting Model..................................................................................11
3.5 Management Change for Case Study...........................................................................11
3.6 Stakeholder Analysis...................................................................................................12
Section 4: Discussion and Conclusion...........................................................................................12
4.1 Discussion..........................................................................................................................12
4.2 Conclusion.........................................................................................................................13
References......................................................................................................................................15
Section 1: Introduction
1.1 Background of Study
The UK's health and social care system is evolving, making leadership and management skills
more important for physicians to develop. Patients benefit from having strong medical
leadership. Given their expertise in interpersonal skills and introspection, psychiatrists are well
prepared to fill such jobs. However, the need for strong leadership in the healthcare industry is
greater than ever (Bass, 2019). Having competent, high-quality leaders who represent a
collaborative leadership style is crucial in the highest-quality healthcare organisations to sustain
high-quality patient care. Even if they don't see themselves that way, clinicians are looked to be
leaders who can be trusted. Many people in the healthcare industry end up in positions of
leadership, where they oversee dynamic teams and complex organisations. However, clinical
undergraduate training does not focus on developing leadership or management abilities. There
is no instruction given to clinicians on how to remove themselves from the doctor-patient
dynamic to see situations more efficiently (Scammell et al., 2020).
Using an observational time series analysis, Degli Esposti et al. (2021) looked at changes in
inpatient treatment for mental diseases across NHS institutions in England. The researchers
found that overall rates of hospitalisation for mental diseases were reduced by 28.4%, and the
number of bed days decreased by 38.3%. There was significant heterogeneity in trends across
mental illnesses and age groups. While overall admission rates declined throughout the 22-year
study period, those for anxiety and eating disorders rose by about 3 percentage points. For
example, whereas the rate of depression among adults decreased by 63.8% during the same
period, the rate of depression among children increased by 212.9%. Scholars have shown that
there has been a general decline in mental hospitalisations during the last 22 years (Degli Esposti
et al., 2021). However, there was a striking rise in the prevalence of some diseases, suggesting an
increasing need for mental hospitalisation, particularly among youngsters. Male inpatient
detention rates in UK hospitals were 94.8 per 100,000 in 2020 and female inpatient detention
rates were 87.9 per 100,000 (NHS, 2021). Furthermore, the focus of mental health treatment in
particular has shifted from hospitalisation to outpatient care. There has been a 73% decline in the
availability of mental health beds during the last 30 years (The King's Fund, 2021).
1.2 Problem of Statement
The Edenfield Centre is a psychiatric facility that helps both men and women get healthy and go
back into society. The services provided by the Edenfield Mental Health Trust were not properly
recognised. Two recent television documentaries have brought attention back to inadequate
medical treatment. Patients at the Edenfield Centre, a secure mental health institution in Greater
Manchester, were allegedly verbally and physically abused in undercover footage shown on the
BBC series Panorama (Evans, 2018). Understaffing and exhaustion have been identified as major
problems by hospital staff. Sometimes there would be no nurse there, leaving the support staff to
handle everything on their own. The adult secure wards had a nursing shortage. There were not
enough doctors, nurses, and healthcare workers to go around, so people were not getting the
attention they needed. Wards often had empty shifts and there was not always a certified nurse
on duty, and staffing levels often fell below the minimum required by law (Evans, 2018).
1.3 Aims and Objectives
1.3.1 Aims
The study aims to analyse a case study from Edenfield Centre on how it addressed the challenge
of staff burnout and shortage. Furthermore, the study also aims to analyse the verbal and privacy
abuse of patients. The assignment aims to provide leadership and management strategies as
change management for Edenfield Psychiatry Centre.
1.3.2 Objectives
The main objectives of this study are
1. To examine the conditions of staff working at Edenfield Psychiatry Centre
2. To analyse the change management strategies for Edenfield Psychiatry Centre
3. To evaluate the patient's abuse in Edenfield Psychiatry Centre
4. To present a change management reflective model for Edenfield Psychiatry Centre

Section 2: Theories for Management and Leadership-Case Study

2.1 Case Study Analysis- CQC Management and Leadership Role
At Care Quality Commission, I have to serve as the Enterprise Data Platform Lead. It was my
responsibility to evaluate the possible risks to patients and staff from medical procedures and to
ensure that the medical team has the necessary training and expertise to prevent harm to patients.
My responsibilities included improving efficiency, leading teams, managing data, working with
others, and coordinating across departments. I had to be responsible for developing strategies,
protocols and benchmarks to ensure the confidentiality, integrity, and availability of patient
information (Rizwan et al., 2022). To guarantee the health and well-being of my patients, I had
to follow all applicable rules and standards. It was my job to make complex information more
understandable. I was responsible for keeping data and information up to date, developing and
testing them, and ensuring that scientists can use them effectively.
For data security, analysis, storage, and processing, I was also responsible for the design and
implementation of the requisite infrastructure tools. As a crucial part of the Care Quality
Commission (CQC), my responsibilities included ensuring that all aspects of health and social
care were provided in a manner that is safe and up to regulatory and professional standards. The
public was then better able to choose home support services due to this rule (Hammond et al.,
2018). In addition, as a team leader, my responsibility was to work closely with other groups,
such as data scientists, data analysts, and other stakeholders, to analyse their needs and provide
them with the tools and resources they need to effectively promote positive health outcomes. The
organization's analytics approach was also in strict accordance with the NHS's recommended
practices and framework (Wright, Gabbay and May, 2021).
In addition, I supervised data optimisation for hospital performance to guarantee the health and
safety of hospital personnel and patients. I did guarantee the completion of data engineering
projects by leading, advising, and supporting my colleagues. The Care Quality Commission's
main quality indicators can be monitored, identified, and implemented to guarantee the
capabilities and smooth movement of management and leadership within a hospital. The CQC
plan details the organization's plans for the next year. The service's performance was measured
against predefined KPIs with the help of the performance data monthly. CQC had inspected
Edenfield Psychiatry Centre in response to several sets of unsatisfactory data (Castro-Avila,
Bloor and Thompson, 2019). Both management and leadership difficulties were identified in the
inspection report as problematic aspects of the practice.
2.2 Maslow's Theory of Management
In a healthcare context, the Maslow Hierarchy of Needs theory of management may be used to
diagnose and treat problems including understaffing, burnout, and patient abuse. According to
Maslow's theory, people's psychological requirements range from the most fundamental to the
most distinct and these needs must be addressed in a certain sequence (Jc and Mu, 2020).
Included in this category are the demands for physiological survival, social acceptance, personal
growth, and a sense of purpose. In Maslow's hypothesis, after people's fundamental needs are
met, they go on to a higher level of demands until they reach self-actualization. In the workplace,
this may imply finding meaning and fulfilment in one's job and striving for nothing less than the
highest standards of performance (Barnard, Calabria and Griffiths, 2023). Food, water, and rest
are all essentials that should be provided to both patients and staff since they are at the bottom of
Maslow's hierarchy of needs. Hospitals can tackle staffing issues like fatigue and hunger by
providing patients and staff with healthy food and plenty of rest periods. Support for dealing with
stress and avoiding burnout is easier to get in environments that encourage a good work-life
balance. The satisfaction of these emotional requirements may improve the health of both
patients and employees (Adamopoulos, 2022).
Second on Maslow's list of requirements is the provision of a safe and secure environment for
both workers and patients. Hospitals may reduce burnout and staff turnover by making their
facilities safer for employees and patients alike. This includes implementing National Health
Service (NHS) techniques and procedures to eliminate workplace violence, harassment, abuse,
and bullying. Seminars, workshops, and other forms of employee training can assist follow this
step forward (Ștefan, Popa and Albu, 2020). Conflict resolution, violence prevention, and the
establishment of a culture of safety in healthcare administration all need thorough training of
employees. Staffing levels that are too low represent a threat to the health and safety of both the
personnel and the patients. Third, fulfil wants for connection and affection of patients and staff.
Maslow Social contact, teamwork, and a shared sense of purpose are central to the Hierarchy
Theory of Management. The patient's inability to engage in meaningful social contact while
confined at Edenfield Centre may have contributed to their isolation, sadness, and early death.
For personnel to effectively manage their patients, the hospital's culture and atmosphere must be
conducive to a diverse and welcoming workplace (Sadarangani et al., 2022).
Supporting social contacts among employees and fostering a feeling of community are additional
outcomes of activities designed to foster teamwork at Edenfield Centre. In addition, patients'
feelings of being valued and heard through the provision of constructive criticism, rewards, and
incentives may help Edenfield Centre achieve its quality objectives (Southwick and Southwick,
2020). In the fourth phase, entitled "esteem needs," efforts are made to boost employees' feelings
of worthiness, dignity, and respect at the Edenfield Centre for Professional Development. If
employees at the Edenfield Centre are provided with enough opportunities to advance their
careers, they will be better able to do their jobs, and they will be less likely to contribute to the
centre's culture of absenteeism. To promote professional growth and cut down on burnout, this
entails training and employee acknowledgement via gratitude and feedback. Employee morale
and productivity may be increased by creating an environment where workers feel valued and
appreciated for the work they do. Staff members whose self-worth has been enhanced by such
programmes are more likely to put patients' interests ahead of their own, maintain patient
confidentiality, and work hard to prevent any disclosure of patient information (Adamopoulos
and Syrou, 2022).
Edenfield Psychiatry Centre staff members can finally reach a point of self-actualization through
Maslow's Theory. It's all about finding one's way in the world and being the best version of
oneself. Management may reduce employee burnout by giving workers more room for
discretion, creativity, and initiative in their jobs. Management may also provide employees with
some flexibility in their schedules. Staff at Edenfield Psychiatry Centre may improve patient
safety and foster a healthy work culture via the use of patient autonomy, confidentiality, and
ethics to promote leadership skills. Staff satisfaction, less burnout, and an increased drive to care
for patients may all result from this theory of Maslow's Hierarchy of Needs Management (Koch,
2022).
2.3 Transactional Theory of Leadership
Key elements of transactional leadership are organization, supervision, and group performance
(Hu et al., 2022). It perceives communication between hospital administrators and staff as a
transactional process. By taking on their assigned tasks, staff members effectively consent to
obey commands. Burnout among behavioural healthcare professionals and providers is
associated with inadequate patient and provider outcomes. Although it is commonly known that
a leader's style may influence whether or not employees experience burnout, it is not apparent
whether leadership philosophies are more effective than others in this regard. Additionally,
behavioural health care is provided in a variety of contexts, so a leadership strategy that is
effective in one context may not be in another. By setting clear standards, receiving honest
feedback, allocating resources, and giving structure, transactional leadership may help reduce
employee fatigue and decrease staff shortage. However, avoiding patient abuse requires a wider
range of leadership techniques that emphasise morality, supervision, ethics and responsibility of
staff (Chan, 2020).

Section 3: Critical Analysis of Case Study- John Hopkins Model

3.1 Case Study Analysis-Issues of Management and Leadership
On September 28, 2022, the horrifying treatment of inmates in Eden Field's medium
security section was disclosed on a BBC Panorama programme. From March through June of
2022, a BBC reporter undercover covering the Panorama probe worked as a support worker at
the facility. Staff members, including medical careers, were seen on camera, over more than 90
days, inciting or deriding residents who were already vulnerable due to their situations. They
were also shown on tape utilising excessive restraint, including slapping and squeezing victims.
It was also noted that they isolated persons with autism or learning difficulties for long periods.
After the Public Order Act of 1986 required an investigation, NHS England, the Care Quality
Commission, the Greater Manchester Police (GMP), and other local and national partners
worked together (investigated) to protect the safety of the residents and other NHS mental health
units. They want to have a conversation about the possibility of similar crimes occurring at other
NHS mental health facilities. Greater Manchester Police (GMP) conducted thorough
investigations into claims of patient mistreatment after a period of undercover filming at The
Eden Field Centre. To ensure that all offences were documented and that the persons responsible
were identified, stakeholders also found the data necessary to launch a criminal inquiry. After
complaints that patients in the mental health ward were mistreated, eighteen additional
employees were terminated or faced disciplinary action. In addition, the unsolved tape showed
employees prodding vulnerable patients, and a group of experts in medicine, psychology,
sociology, and related fields completed clinical assessments. Experts' well-being and forging
documents to ensure patients' safety

3.2 Principles for Mental Health

The ethical principles for the treatment of mental health tend to be important. The
residents must be treated with the consideration of ethical principles. The first and foremost is
the autonomy of the patients (Rainer, Schneider and Lorenz, 2018). This concept emphasizes the
fact that the patient has the right to make their own choices and participate in the process of
treatment planning. Mental health providers have a responsibility to respect their patient's
autonomy and include them in as many treatment decision-making processes as is practically
practicable. The second one is non-maleficence. According to this ethical principle, mental
health providers are not allowed to do their patients any damage (Milliken and Grace, 2017).
They should steer clear of activities or interventions that have the potential to do the patient
harm, and they should take measures to prevent the patient from coming to any damage.
Additionally, another principle is beneficence. This ethical principle emphasizes the
responsibility that mental health professionals have to behave in the patient's best interests at all
times (Milliken, 2018). Mental health practitioners have a responsibility to the patients they
serve to maximise the advantages of treatment and to improve their overall well-being. Last but
not least is the principle of Justice. Under this idea, mental health providers are obligated to treat
their patients in a just and equitable manner. They should not discriminate against patients based
on ethnicity, gender, religion, or any other criteria, and they should give access to treatment
regardless of a patient's capacity to pay regardless of whether or not they should provide access
to care (Bastable, 2021).
3.3 SWOT Analysis of Change Management Model
A SWOT is an acronym for Strengths, Weaknesses, Opportunities and Threats used to
assess the change management model. Below is the SWOT analysis of the ADKAR change
management model.
Strengths:
● The model of ADKAR tends to provide an approach which is structured towards the
change management which aids in ensuring that all of the needed steps are taken to
achieve the satisfaction (Kachian, Elyasi and Haghani, 2018).
● The model emphasizes the role that a person's behaviour modification may have in the
overall success of a change endeavour.
● The concept is flexible enough to be used for both incremental modifications and radical
overhauls in an organisation.
Weaknesses:
● It is possible that the model does not account for all of the cultural or structural obstacles
that might impede change management, and that it's too simple for more complicated
change projects (Alzubi and Mustafa, 2021).
 ● Changes in the market or regulatory environment, both of which might affect change
efforts, may not be sufficiently accounted for in the model.
Opportunities:
● The ADKAR model is flexible enough to be customised for any business or industry, and
it may be integrated with other change management frameworks and technologies for a
more thorough strategy (Zebreski, 2022).
● By using the approach, businesses can ensure that all employees are on the same page
when it comes to managing change.
Threats:
● Stakeholders that are averse to change or who prefer alternative change management
frameworks or tools may not find the model to their liking.
● If there is no buy-in from top-level management or if there are major cultural or
institutional hurdles to change, the approach may not work (Balluck, Asturi and
Brockman, 2020).
● As other methods of managing change come into vogue, the paradigm may become stale
or irrelevant.
The ADKAR model's merits in offering a systematic approach to change management
and in tackling individual behaviour change are highlighted through a SWOT analysis. On the
other hand, it highlights dangers and vulnerabilities that users of the model should be aware of.

3.4 John Hopkins Model of Reflection

3.4.1 Model Description
An organised method of contemplation called the John Hopkins Model of Reflection was
established by the Johns Hopkins University School of Medicine. It is organised in a manner that
will facilitate meaningful and methodical reflection on the part of healthcare professionals on
their own experiences (Wong et al., 2019). The approach includes three essential steps, which
are "returning to the experience," "attending to the experience," and "reconstructing the
experience.”
3.4.2 Model Application to Case Study
The case study has explained the issues which are related to nurse burnout and physical
abuse with their residents at the time of duty. The model of the reflection proposed by John
Hopkins is the best way through which nurses can evaluate their experiences in terms of their
reasons for the appearance of such shameless acts of physically assaulting the patients. In
addition to this, this model aids in the continuous development and learning of the nurses with
the help of reflection on their events.
3.4.3 Rationale for Adopting Model
It has been shown that the Johns Hopkins Model of Reflection provides a helpful
framework for nurses to engage in reflective thinking (Schaeffer, 2020). Nurses are encouraged
to think critically and methodically assess their experiences using the Johns Hopkins Model of
Reflection. This may aid nurses in better reflecting on their practice and making adjustments in
response to feedback. The approach gives nurses a framework for analysing problems and
finding answers to common dilemmas (Pawl and Anderson, 2017). Nurses may prepare for
potential difficulties by thinking critically about current practices and how they might be
improved.
3.5 Management Change for Case Study
One method of managing change that nurses might adopt to safeguard themselves against
emotional and physical abuse is the ADKAR model(Everly Jr and Lating, 2022). Change
management in both individuals and groups may benefit from this concept. First and foremost,
the ADKAR model emphasises raising awareness about the need of preventing burnout and real
maltreatment among medical carers and the repercussions that might be anticipated from failing
to do so. Methods for achieving this goal include holding training sessions, holding seminars,
and communicating with the leadership. Second, once nurses are aware of the issue, they must be
motivated to effect change (Balluck, Asturi and Brockman, 2020). This involves addressing any
concerns or objections nurses may have, creating a compelling argument for change, and
highlighting the benefits of preventing burnout and physical abuse. Thirdly, medical carers need
to be well informed to avoid exhaustion and real abuse. This training might include instruction
on how to de-escalate tense situations, how to communicate effectively, and how to deal with
stress. Even though nurses know to make changes, it may be difficult for them to put such
changes into practice (Williams, 2022). To remedy this, nurses should be given support in
developing the competence and confidence to use the knowledge they have gained in their
professional settings. Last, but not least, it's vital to keep the changes continuing strong via
reinforcement. This may include striving for constant improvement, receiving feedback and
coaching, recognising and rewarding appropriate behaviour, and receiving training.
3.6 Stakeholder Analysis
The stakeholder analysis is an examination of the stakeholders in a given project,
programme, or initiative is referred to as a stakeholder analysis. This is a process in which the
stakeholders are identified and evaluated (Alzubi and Mustafa, 2021). It is helpful to identify the
various persons or organisations that have a stake in the result of the project, as well as the
degree to which they have influence over the project and are interested in it. The stakeholders for
the ADKAR model are the employees, managers, customers, shareholders, suppliers, regulators
and community.

Section 4: Discussion and Conclusion

4.1 Discussion
There is no doubt that the COVID-19 outbreak has affected national healthcare systems to
varying extents. According to some reports, healthcare professionals in areas where the epidemic
was severe had a heavier workload because they had fewer resources and had to make more
difficult decisions (Westlake et al., 2022). Therefore, the COVID-19 pandemic would provide a
perfect setting for medical staff to suffer from burnout that the UK hospitals have experienced.
According to Farrell et al. (2019), about 80% of physicians in the UK reported participating in
the 2018 National British Medical Association (BMA) survey. However, Farrell et al.'s research
(2019) found that junior and middle-level physicians were generally at high risk for burnout as
shown by extreme fatigue, detachment from and decreased personal effectiveness. According to
the same research, one-third of the aforementioned group had a mental health diagnosis and
admitted to using self-medication, alcohol, and other substances as coping techniques (Clark et
al., 2018).
In addition to ongoing abuse and humiliation by untrained care personnel, the private report from
Endenfield indicated that some of the trained nursing staff criticised the fabrication of care
records in practice. Staff members of the Mental Health Act Commission (2009) failed to stop
these abuses, and Edenfield had a "good" CQC inspection rating at the time of the abuse's
existence. Senior management and clinical directors later chose to disregard these abusive
behaviours (Evans, 2018). These individuals are held by the MH Act under the supervision of the
relevant physician. Staff shortages resulted in burnout and inflexible work schedules. This
increased worker stress resulted in bullying, harassment, and verbal and physical abuse, among
other behaviours of patients at Edenfield Centre (Asaoka et al., 2021).
Additionally, the Edinfield Psychiatry Centre may benefit from implementing the Maslow
Theory of Management, Transactional Theory of Leadership, and John Hokin Model of
Reflection to better identify and manage leadership. To support patient autonomy and
confidentiality, these theories and models demand proper access to change management
techniques as well as a flexible work environment for employees. Establishing clear rules,
educating and training personnel, enhancing multidisciplinary communication, and empowering
resources via constructive criticism are some of these strategies (Barnard, Calabria and Griffiths,
2023). Maslow's theory may help hospitals satisfy the needs of both staff and patients, provide a
positive work environment, and lessen issues with burnout and patient abuse. workers' burnout
may be decreased by creating NHS plans for flexible work schedules, ensuring optimal staffing
numbers where feasible, guiding workers towards a culture of prevention and early intervention,
and removing the stigma associated with having mental health dialogues at work. In Edenfield,
recognising the demands of sustaining staff retention and talent recruitment as well as educating
workers about the signs of burnout may all assist with staff retention, burnout, and abuse
reduction. The NHS Sustainable Development Management Plan will detail the organization's
goals and objectives in fostering individual developing, community unity and inclusiveness, and
opportunity for all. Additionally, interdisciplinary communication can foster a positive work
environment, reduce patient abuse, and promote patient autonomy (MacNeill, McGain and
Sherman, 2021).
4.2 Conclusion
The UK's health and social care system is evolving, making leadership and management skills
more important for physicians to develop. The study presented the conditions of staff working at
Edenfield Centre, analyse the change management strategies for Edenfield Psychiatry Centre,
evaluate patient abuse, and present a change management reflective model for Edenfield
Psychiatry Centre. The Maslow Theory of Management and Transactional Theory can be used to
diagnose and treat problems including understaffing, burnout, and patient abuse. sequence. Staff
training is necessary to reduce burnout and staff turnover, and conflict resolution, violence
prevention, and the establishment of a culture of safety in healthcare administration are all
necessary steps. The Edenfield Centre can help to promote professional growth and cut down on
burnout by providing employees with opportunities to advance their careers. This can be done
through training and employee acknowledgement via gratitude and feedback. Management may
also provide employees with more room for discretion, creativity, and initiative in their jobs, and
with some flexibility in their schedules through NHS sustainable development plan.
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