3CO01 Business, Culture and Change in Context explores how external factors, along with the digital and commercial environment, influence businesses and shape the cultures they operate in. It also highlights how people’s behaviour affects organisational culture and why this matters for managing change effectively.
AC 1.1 Examine two key external influences impacting or likely to impact the activities of the organisation that you work for (or an organisation with which you are familiar)
This assignment examines Greenfield Community NHS Trust (hereafter referred to as ‘the Trust’), a medium-sized provider of primary, community, and mental health services across a semi-rural region in the North of England. The Trust employs approximately 4,500 staff, including clinical professionals, administrative support workers, and specialist people practice teams. As a public-sector healthcare organisation operating within the National Health Service, the Trust is subject to a uniquely complex set of external influences that shape its strategic direction, operational delivery, and people management practices. Two particularly significant external influences are examined below.
1.1 External Influence One: Economic Pressures and Public Sector Funding Constraints
The prevailing macroeconomic environment represents one of the most consequential external influences on the Trust’s activities. The United Kingdom has experienced a protracted period of economic turbulence, characterised by persistent inflationary pressures, constrained public finances, and successive government austerity measures that have directly impacted NHS funding settlements. While the NHS Long Term Workforce Plan (NHS England, 2023) committed to significant investment in workforce expansion, the practical reality for individual trusts has been one of real-terms budget pressures, as rising costs for energy, pharmaceuticals, and equipment have outpaced funding increases.
For the Trust, these economic pressures have manifested in several tangible ways. Recruitment budgets have been constrained, limiting the Trust’s ability to compete for scarce clinical talent in an increasingly competitive labour market. The CIPD’s Labour Market Outlook (2024a) highlights that the healthcare sector continues to experience acute skills shortages, particularly in mental health nursing, allied health professions, and specialist clinical roles. Pay awards negotiated through the NHS Agenda for Change framework, while welcome for staff morale, have created additional cost pressures that must be absorbed within fixed budgets. Consequently, the Trust has been required to make difficult prioritisation decisions, balancing investment in frontline patient care against essential infrastructure maintenance, digital transformation, and workforce development.
From a PESTLE analysis perspective, this economic influence intersects with the political dimension, as government fiscal policy directly determines NHS funding allocations, and the social dimension, as public expectations for healthcare quality continue to rise regardless of funding realities. The people practice team must navigate these tensions by developing creative, cost-effective approaches to attraction, retention, and engagement that do not rely solely on financial incentives. This aligns with the CIPD’s (2024b) emphasis on total reward strategies that leverage non-financial elements such as meaningful work, career development, flexible working, and organisational purpose to compensate for the limitations of public-sector pay scales.
1.2 External Influence Two: Technological Transformation and Digital Health Innovation
The second significant external influence is the accelerating pace of technological change within the healthcare sector. The COVID-19 pandemic catalysed a decade of digital transformation within approximately eighteen months, normalising remote consultations, digital triage systems, electronic health records, and AI-assisted diagnostics across the NHS. This technological momentum has continued into 2025 and beyond, driven by government investment in NHS digital infrastructure, the proliferation of health technology start-ups, and evolving patient expectations for digital service access (NHS England, 2024).
For the Trust, technological transformation creates both significant opportunities and substantial challenges. On the opportunity side, digital tools enable more efficient service delivery, improved patient outcomes through data-driven clinical decision-making, and greater flexibility for staff through remote and hybrid working models for non-clinical roles. The Trust has implemented a cloud-based electronic patient record system, introduced video consultation capabilities for community mental health services, and piloted AI-assisted triage tools in its urgent care pathway.
However, the challenges are equally considerable. Technological change demands continuous upskilling and reskilling of the workforce, creating substantial learning and development requirements that the Trust’s L&D team must plan and deliver within constrained budgets. Research by Topol (2023) on the digital future of the NHS emphasises that successful technological adoption depends not on the technology itself but on the organisation’s capacity to prepare, support, and engage its workforce through the transition. For many longer-serving clinical staff, the shift to digital working practices represents a fundamental change to established professional routines, creating resistance, anxiety, and, in some cases, active disengagement. The people practice team therefore plays a critical role in managing the human dimensions of digital transformation, including change communication, digital skills training, employee consultation, and the redesign of roles and processes to integrate new technologies effectively.
From an environmental scanning perspective, using PESTLE analysis, this technological influence intersects with the legal dimension, as digital health introduces complex data protection and information governance obligations under the UK GDPR and the Data Protection Act 2018, and the social dimension, as both patient demographics and workforce demographics influence the pace at which digital adoption is feasible and equitable (CIPD, 2024c).
- AC 1.2 Discuss the main business goal of the organisation that you work for (or an organisation with which you are familiar) and why it is important for that organisation to plan how they will achieve the goal.
The Trust’s overarching strategic goal, as articulated in its 2024–2029 organisational strategy, is to deliver outstanding, equitable, and sustainable community health and mental health services for the population it serves. This goal is operationalised through four strategic pillars: clinical excellence, workforce sustainability, digital innovation, and financial resilience. While the Trust is a public-sector organisation that does not pursue profit, its ‘business goal’ in the broadest sense is to maximise the quality and accessibility of care within the resources available, while building an engaged, skilled, and resilient workforce capable of meeting evolving health needs.
Planning how to achieve this goal is critically important for several interconnected reasons. First, the Trust operates within a tightly regulated environment where failure to meet quality standards set by the Care Quality Commission (CQC) can result in enforcement action, reputational damage, and, in extreme cases, special measures that restrict the Trust’s operational autonomy. Strategic planning ensures that resources, both financial and human, are allocated in a way that prioritises areas of highest clinical need and greatest regulatory risk.
Second, workforce planning is essential because the Trust faces structural workforce challenges that cannot be resolved through reactive, short-term measures. The NHS Long Term Workforce Plan (NHS England, 2023) identified that the NHS needed to train and recruit hundreds of thousands of additional staff over the following decade to meet projected demand. For the Trust, this means developing robust workforce plans that anticipate future staffing needs, build internal talent pipelines through apprenticeships and secondments, and reduce dependency on expensive agency staffing. Without proactive planning, the Trust risks a vicious cycle of understaffing, increased workload pressure, staff burnout, higher turnover, and further understaffing (Armstrong and Taylor, 2023).
Third, financial planning ensures that the Trust remains within its allocated budget while continuing to deliver safe, effective services. NHS trusts that repeatedly overspend face regulatory intervention and may lose commissioning contracts to alternative providers. Strategic financial planning, integrated with workforce and service delivery planning, enables the Trust to model different scenarios, identify efficiency savings, and invest in preventative programmes that reduce long-term costs.
Finally, planning provides organisational coherence and strategic alignment. The CIPD (2024d) emphasises that people strategies must be aligned with organisational strategy to create mutual value. Without deliberate planning, there is a risk of strategic drift, where different departments and teams pursue disconnected priorities, leading to duplication, waste, and confusion. For the Trust, planning ensures that workforce development, digital investment, service redesign, and financial management are coordinated components of a single, coherent strategy rather than competing demands.
- AC 1.3 Discuss the products and/or services of the organisation that you work for (or an organisation with which you are familiar) and discuss the organisation’s main customers.
3.1 The Trust’s Services
As a community and mental health NHS Trust, Greenfield Community NHS Trust does not produce physical products but delivers a comprehensive range of healthcare services funded primarily through NHS commissioning arrangements. The Trust’s service portfolio can be categorised into three principal areas.
First, the Trust provides community health services, including district nursing, health visiting, school nursing, community physiotherapy, occupational therapy, speech and language therapy, podiatry, and specialist continence services. These services are delivered in patients’ homes, community clinics, GP surgeries, and schools across the region, supporting people to manage long-term conditions, recover from illness or surgery, and maintain independence. Second, the Trust delivers mental health services across the lifespan, including child and adolescent mental health services (CAMHS), adult community mental health teams, crisis intervention services, psychological therapies, specialist perinatal mental health support, and older adults’ mental health services including dementia care. Third, the Trust operates specialist services including substance misuse treatment programmes, learning disability services, and veterans’ mental health support.
The Trust’s service model has evolved significantly in recent years, with an increasing emphasis on integrated care, prevention, and early intervention. The establishment of Integrated Care Systems (ICSs) across England has required the Trust to work more collaboratively with partner organisations, including acute hospital trusts, primary care networks, local authorities, and voluntary sector providers, to deliver seamless, person-centred care pathways (NHS England, 2024).
3.2 The Trust’s Main Customers
The concept of ‘customers’ in a public-sector healthcare context requires nuanced interpretation, as the Trust serves multiple stakeholder groups with different needs and expectations. The Trust’s primary customers are the patients and service users who directly receive its healthcare services. This population is diverse, spanning all age groups from newborns and children through working-age adults to older people, and encompassing individuals with a wide range of physical, mental, and social care needs. The demographic profile of the Trust’s catchment area includes a higher-than-average proportion of older adults and pockets of significant socioeconomic deprivation, both of which drive higher demand for community health and mental health services.
Beyond direct patients, the Trust’s customers also include NHS commissioning bodies, primarily the local Integrated Care Board (ICB), which commissions and funds the Trust’s services. The ICB expects the Trust to deliver services that meet contractually agreed quality standards, activity volumes, and outcome measures, effectively functioning as a purchaser of healthcare services. GPs and primary care networks are also important customers, as they refer patients into the Trust’s community and mental health services and rely on the Trust to deliver timely, effective interventions that support their broader patient management. Additionally, other NHS trusts, local authorities, social care providers, and voluntary organisations function as collaborative customers within the Integrated Care System, depending on the Trust to fulfil its role in joined-up care pathways. Finally, the Trust’s own workforce can be considered internal customers of the people practice team, which must deliver effective HR services including recruitment, payroll, learning and development, employee relations, and wellbeing support.
- AC 1.4 Review how file sharing technology and video conferencing can be used to improve working practices and collaboration within the people profession in your organisation (or an organisation with which you are familiar).
4.1 File Sharing Technology
File sharing technology, such as Microsoft SharePoint, Google Workspace, and specialist HR document management systems, enables people professionals to store, access, share, and collaboratively edit documents in a centralised, cloud-based environment. At the Trust, the people practice team has adopted Microsoft SharePoint as its primary file sharing platform, creating significant improvements in working practices and collaboration.
Prior to adopting cloud-based file sharing, the Trust’s people practice team relied on a combination of local network drives, email attachments, and physical filing systems. This created multiple versions of critical documents, difficulty locating the most current policy or template, delays in sharing information between team members working across different sites, and challenges in maintaining version control during collaborative policy development. SharePoint has addressed these issues by providing a single source of truth for all people practice documentation, including policies, procedures, templates, workforce data reports, and project files. Team members across all Trust sites can access the same documents simultaneously, with real-time version tracking ensuring that everyone works from the most current iteration.
For the people profession specifically, file sharing technology has improved several key working practices. Policy development and review has become more efficient, as multiple team members can contribute to a policy draft simultaneously, with tracked changes and commenting features enabling transparent, auditable collaboration. Recruitment administration has been streamlined, as candidate documentation, interview scoring matrices, and offer letters are stored in structured, searchable folders that all authorised team members can access. Workforce data and analytics reports are shared through centralised dashboards, enabling senior leaders and line managers to access real-time people data without relying on ad hoc email requests to the HR team. Furthermore, information governance has improved because SharePoint’s access controls ensure that sensitive employee data is only accessible to authorised personnel, supporting compliance with the UK GDPR and the Data Protection Act 2018 (CIPD, 2024c).
4.2 Video Conferencing
Video conferencing technology, principally Microsoft Teams at the Trust, has fundamentally transformed how the people practice team collaborates internally, engages with stakeholders, and delivers its services across a geographically dispersed organisation.
The Trust’s community and mental health services operate across more than 40 sites, including community clinics, inpatient units, GP surgeries, and administrative hubs. Prior to the widespread adoption of video conferencing, people practice professionals spent considerable time travelling between sites to attend meetings, deliver training, conduct disciplinary hearings, and meet with managers. This was both time-inefficient and carbon-intensive. Video conferencing has enabled the people practice team to conduct the majority of routine meetings, case conferences, and consultations remotely, freeing time that can be redirected to value-adding activities and reducing the Trust’s environmental footprint.
Specific improvements include the ability to conduct recruitment interviews and panel meetings remotely, which has accelerated time-to-hire by eliminating scheduling delays associated with physical meeting room availability and panellist travel. The L&D team has used video conferencing to deliver virtual training sessions, webinars, and CPD events to staff across all Trust sites simultaneously, dramatically increasing the reach and accessibility of learning interventions. Employee relations casework, including investigation meetings, disciplinary hearings (where appropriate and agreed by the employee), and grievance discussions, can be conducted via video conferencing, enabling faster resolution of cases. The CIPD (2024c) notes that the adoption of video conferencing in people practice has been one of the most significant shifts in professional working practices since the pandemic, enabling people professionals to operate as strategic business partners regardless of physical location.
However, both technologies require careful implementation. The Trust has established protocols to ensure that sensitive HR discussions conducted via video conferencing are held in private, secure environments and are not recorded without explicit consent. File sharing platforms require robust access management to prevent data breaches. Additionally, the Trust recognises that technology should complement rather than replace face-to-face interaction, particularly for sensitive matters such as delivering redundancy news, conducting welfare meetings, or supporting employees through personal crises, where the human connection of physical presence remains important (Torrington et al., 2024).
- AC 2.1 Define organisational culture and explain why it is important to foster an appropriate and effective workplace culture in your organisation (or an organisation with which you are familiar).
5.1 Defining Organisational Culture
Organisational culture can be defined as the shared values, beliefs, assumptions, norms, and behaviours that characterise how people interact, make decisions, and experience work within an organisation. Schein (2024), one of the most influential theorists on organisational culture, describes it as operating on three levels: visible artefacts, such as the physical environment, dress codes, and published values; espoused values, such as strategies, goals, and stated philosophies; and underlying assumptions, the deeply embedded, often unconscious beliefs that fundamentally shape organisational behaviour. Culture is often described as ‘how things are done around here’, capturing the unwritten rules and shared expectations that guide daily conduct beyond what is formally documented in policies and procedures (Armstrong and Taylor, 2023).
Handy’s (1993) typology of organisational cultures provides a useful analytical framework. It identifies four cultural types: power culture, where authority is concentrated in a few individuals; role culture, where authority derives from formal positions and bureaucratic structures; task culture, where teams form around specific projects and expertise is valued over hierarchy; and person culture, where the organisation exists to serve the individuals within it. Most organisations, including the Trust, exhibit elements of multiple cultural types, though one typically predominates.
5.2 The Importance of Fostering Appropriate Culture at the Trust
Fostering an appropriate and effective workplace culture at the Trust is important for several critical reasons that directly impact patient care, workforce sustainability, and organisational performance.
First, in a healthcare setting, organisational culture directly influences patient safety and care quality. Research by West and Dawson (2022), conducted specifically within the NHS, demonstrated a statistically significant relationship between staff engagement, which is shaped by organisational culture, and patient outcomes including mortality rates, infection rates, and patient satisfaction scores. A culture that encourages open communication, psychological safety, and willingness to report errors without fear of blame is essential for maintaining patient safety. Conversely, a culture of fear, hierarchy, or blame suppression, as identified in several high-profile NHS failings, can lead to catastrophic patient harm.
Second, culture is a primary driver of staff engagement, wellbeing, and retention. The NHS Staff Survey (NHS England, 2024) consistently identifies organisational culture, including factors such as team working, line management quality, and feeling valued, as a stronger predictor of staff retention than pay alone. For the Trust, which competes for scarce clinical talent in a challenging labour market, a positive, inclusive, and compassionate culture is a critical differentiator that supports both attraction and retention. The CIPD (2024e) emphasises that culture shapes the employee experience at every stage of the employee lifecycle, from the first impression formed during recruitment to the lasting impression left at exit.
Third, culture determines the organisation’s capacity for adaptation and innovation. The Trust operates in an environment of continuous change, driven by policy reforms, technological innovation, demographic shifts, and evolving patient expectations. A culture that embraces learning, experimentation, and constructive challenge is better equipped to navigate change successfully than one characterised by rigidity, risk aversion, and resistance. For the people practice team, fostering an adaptive culture is essential for supporting the Trust’s digital transformation agenda and its transition to integrated care models.
Finally, culture is integral to the Trust’s compliance with its regulatory obligations. The Care Quality Commission’s inspection framework explicitly assesses organisational culture under its ‘Well-Led’ domain, evaluating whether the organisation promotes an open, learning culture that supports high-quality care. A positive CQC assessment depends, in significant part, on evidence of an effective, values-driven organisational culture.
- AC 2.2 Explain how culture is part of a whole system and explain how people professionals’ work and actions could impact elsewhere in your organisation (or an organisation with which you are familiar).
6.1 Culture Within the Organisational System
Organisational culture does not exist in isolation but is an integral component of a complex, interconnected organisational system. Systems thinking, as applied to organisations, recognises that any change in one element of the system produces ripple effects throughout other elements. Culture both shapes and is shaped by the organisation’s strategy, structure, processes, technology, leadership, and external environment in a continuous, dynamic interaction (Senge, 2023).
At the Trust, culture is embedded within a system that includes the formal organisational structure, with its clinical divisions, corporate functions, and governance hierarchies; the operational processes through which care is delivered, staff are managed, and resources are allocated; the technological infrastructure that increasingly mediates how work is performed and how people interact; the leadership behaviours that model and reinforce cultural norms; and the external regulatory, political, and economic context within which the Trust operates. A change in any one of these elements has the potential to influence culture, just as cultural characteristics influence the effectiveness of each element.
For example, the Trust’s recent implementation of a new electronic patient record system was a technological change, but its success depended on cultural factors such as staff openness to learning new skills, willingness to change established workflows, and trust in management’s motives for introducing the system. Conversely, the way the implementation was managed, whether staff were consulted, supported, and given adequate training, influenced the broader organisational culture by signalling whether the Trust genuinely values its workforce or merely imposes change from the top down.
6.2 How People Professionals’ Work Impacts Elsewhere in the Organisation
The work and actions of people professionals at the Trust have far-reaching impacts across the organisational system, often in ways that extend well beyond the immediate scope of a specific HR initiative.
Recruitment and selection decisions made by the people practice team directly impact team composition, service delivery capacity, and, ultimately, patient care quality. A decision to relax selection criteria to fill vacancies more quickly, for example, might solve an immediate staffing problem but could introduce competence issues that manifest as clinical errors, increased complaints, or team dysfunction months later. Conversely, a rigorous but supportive recruitment process that prioritises cultural fit alongside clinical competence builds teams that work effectively together, contributing to both patient safety and staff satisfaction.
People professionals’ approach to learning and development shapes the organisation’s skill base and innovation capacity. Investment in leadership development for ward managers and team leaders, for instance, has cascading effects on team culture, staff engagement, sickness absence, and retention across the teams those managers lead. West and Dawson•s (2022) NHS-specific research found that the quality of immediate line management was the single strongest predictor of staff engagement, underlining the system-wide impact of L&D interventions targeted at managers.
Employee relations activities undertaken by the people practice team shape perceptions of organisational fairness, which in turn influence trust, engagement, and psychological safety across the workforce. If disciplinary processes are perceived as inconsistent or biased, the cultural impact extends far beyond the individuals directly involved, creating a climate of anxiety and self-protection that inhibits open communication and learning. Similarly, wellbeing initiatives designed by people professionals can shift the organisation’s broader culture from one where presenteeism is normalised to one where sustainable performance and work-life balance are genuinely supported (CIPD, 2024e).
Reward and recognition practices established by the people practice team communicate powerful cultural messages about what the organisation values. If the Trust’s reward framework recognises only quantitative outputs, such as patient throughput targets, while neglecting qualitative contributions such as compassionate care, mentoring, or innovation, it signals a cultural priority that may not align with the Trust’s stated values. People professionals must therefore design reward and recognition systems that consciously reinforce the culture the Trust aspires to create, not inadvertently undermine it (Armstrong and Taylor, 2023).
In essence, every action taken by the people practice team, from the design of a job advertisement to the conduct of a disciplinary investigation, sends a signal that is interpreted by the wider workforce and assimilated into the collective understanding of ‘how things work here’. This systemic influence means that people professionals carry a profound responsibility to ensure that their work is not only technically competent but culturally conscious, aligned with organisational values, and sensitive to the unintended consequences that may ripple through the system.
- AC 3.1 Explain why it is important that organisational change driven by economic downturn and challenging trading conditions is planned, and effectively managed in your organisation (or an organisation with which you are familiar).
Organisational change driven by economic downturn and challenging trading conditions is an increasingly likely scenario for the Trust, given the sustained pressures on public-sector funding, rising operational costs, and the ongoing gap between NHS demand and available resources. Should the Trust face a period of enforced cost reduction, service reconfiguration, or workforce restructuring in response to economic pressures, it is critically important that such change is planned and effectively managed rather than implemented reactively.
First, planned change protects patient safety and service quality. Unplanned, reactive cost-cutting measures, such as abrupt recruitment freezes, blanket overtime bans, or hasty service closures, risk creating unsafe staffing levels, disrupting continuity of care, and transferring demand to other already-pressured services. By contrast, a planned approach enables the Trust to model the impact of proposed changes on service delivery, identify risks to patient safety, and design mitigations before changes are implemented. The Francis Report (2013), which investigated the Mid Staffordshire NHS Foundation Trust scandal, remains a powerful reminder that organisational responses to financial pressures that neglect the patient safety dimension can lead to catastrophic outcomes.
Second, planned change supports legal compliance. If economic downturn necessitates workforce reductions, the Trust has significant legal obligations under the Trade Union and Labour Relations (Consolidation) Act 1992, which requires collective consultation where 20 or more redundancies are proposed within a 90-day period, and the Employment Rights Act 1996, which governs individual redundancy rights including fair selection, consultation, and statutory redundancy pay. Failure to plan and comply with these requirements exposes the Trust to employment tribunal claims for unfair dismissal and protective awards for failure to collectively consult. The financial and reputational cost of such claims can far exceed the savings intended by the restructuring (Lewis and Sargeant, 2023).
Third, planned change minimises the negative impact on employee morale, engagement, and psychological wellbeing. Research by Kotter (2023) emphasises that successful change management requires a structured approach that includes establishing urgency, building a guiding coalition, communicating the vision, empowering action, generating short-term wins, consolidating gains, and anchoring change in culture. Without this structured approach, economic downturn-driven change is likely to generate fear, uncertainty, rumour, and resistance among the workforce, leading to increased sickness absence, reduced productivity, higher voluntary turnover of the most talented staff who can secure employment elsewhere, and a deterioration in the organisational culture that the Trust has worked to build.
Fourth, planned change enables the Trust to explore alternatives to compulsory redundancy, such as voluntary redundancy schemes, redeployment to other roles, natural attrition, reduced use of agency staffing, and renegotiation of service contracts. These alternatives, which typically generate less workforce disruption and reputational damage than compulsory redundancy, require lead time, consultation, and careful planning to implement effectively (CIPD, 2024f).
Finally, effective change management preserves organisational capability for recovery. Economic downturns are cyclical, and organisations that manage contraction poorly, losing key skills, institutional knowledge, and workforce goodwill, find themselves poorly positioned to capitalise when conditions improve. Planned change ensures that the Trust retains its most critical capabilities and relationships, enabling it to recover more quickly when economic conditions stabilise.
- AC 3.2 Explain the importance and role that could be played by people professionals in your organisation (or an organisation with which you are familiar) within change driven by economic downturn.
People professionals at the Trust play a multifaceted and critically important role in organisational change driven by economic downturn. Their contribution spans the full lifecycle of the change process, from initial planning and legal compliance through implementation and post-change recovery.
8.1 Strategic Advisory Role
People professionals serve as strategic advisors to the Trust’s leadership team, providing expert guidance on the workforce implications of proposed changes. This includes modelling the impact of different cost-reduction scenarios on staffing levels, service capacity, and skills mix; advising on the legal framework governing redundancy, consultation, and restructuring; presenting workforce data to inform evidence-based decision-making; and challenging proposals that may achieve short-term savings at the cost of long-term organisational capability. The CIPD (2024f) emphasises that people professionals must be ‘at the table’ when strategic decisions are made during economic downturn, ensuring that the human dimension is considered alongside financial and operational imperatives.
8.2 Legal Compliance and Process Management
People professionals are responsible for ensuring that all change processes comply with employment legislation and organisational policies. In a redundancy scenario, this includes designing fair and objective selection criteria, managing collective and individual consultation processes within statutory timeframes, calculating redundancy entitlements accurately, administering notice periods, and ensuring that all documentation is legally defensible. At the Trust, where a significant proportion of the workforce is represented by trade unions, people professionals also lead or support formal negotiations with union representatives, seeking to reach agreements that balance organisational needs with employee interests. Their expertise in employment law and procedural fairness is essential for protecting the Trust from costly and reputation-damaging legal challenges (Lewis and Sargeant, 2023).
8.3 Communication and Employee Support
During periods of economic downturn-driven change, effective communication becomes one of the most important determinants of employee experience and organisational resilience. People professionals at the Trust play a leading role in designing and delivering the communication strategy for change, ensuring that messages are honest, timely, consistent, and empathetic. This includes advising senior leaders on how to communicate difficult messages, preparing frequently asked questions documents, organising town hall meetings and drop-in sessions, and establishing channels for employees to ask questions and raise concerns.
People professionals also coordinate employee support services, including access to the Employee Assistance Programme (EAP), occupational health referrals for staff experiencing stress or anxiety, career transition support for those facing redundancy, and signposting to external resources such as financial advice services and jobsearch support. Bridges’ (2023) transition model highlights that the psychological experience of change, the internal transition from ending through a neutral zone to a new beginning, requires dedicated emotional support that goes beyond procedural compliance. People professionals are uniquely positioned to provide this support, acting as a bridge between organisational imperatives and individual human experiences.
8.4 Protecting Organisational Culture
Perhaps most importantly, people professionals serve as guardians of the Trust’s organisational culture during periods of destabilising change. Economic downturn-driven change can erode trust, psychological safety, and collaborative norms that have taken years to build. People professionals can mitigate this erosion by ensuring that the change process reflects the Trust’s values of compassion, fairness, and respect; by monitoring employee engagement and wellbeing indicators throughout the change period; by advocating for survivors of restructuring, those who remain but are often overlooked in the focus on those departing; and by supporting managers to maintain team morale and performance during periods of uncertainty. Research by Sahdev (2023) on survivor syndrome highlights that employees who remain after a restructuring often experience guilt, anxiety, increased workload, and diminished trust, all of which people professionals can help to address through proactive engagement and support interventions.
- AC 3.3 Discuss how organisational change, driven by economic downturn, could impact people in your organisation (or an organisation with which you are familiar) in different ways.
Organisational change driven by economic downturn does not impact all employees equally. The differential impact of such change is determined by a complex interaction of factors including role, seniority, employment status, personal circumstances, protected characteristics, and individual psychological resilience. Understanding these differential impacts is essential for designing change processes that are fair, legally compliant, and sensitive to the diverse experiences of the workforce.
9.1 Impact by Role and Function
Employees in roles directly affected by cost-reduction measures, such as those in administrative, support, or corporate functions that are typically targeted first in restructuring exercises, will experience the most immediate and acute impact. These employees face the prospect of redundancy, role changes, or redeployment, with all the associated anxiety, uncertainty, and disruption that these entail. By contrast, employees in frontline clinical roles that are protected from headcount reductions may experience the change differently: while their own roles may be secure, they are likely to face increased workloads as support functions are reduced, diminished access to resources and infrastructure, and the emotional burden of witnessing colleagues lose their jobs. At the Trust, this differential impact is particularly sensitive because administrative and support staff, who often have lower pay and fewer alternative employment options, may feel that they bear a disproportionate burden of cost-cutting measures while higher-paid clinical and management roles remain protected (CIPD, 2024f).
9.2 Impact by Employment Status
Employees on different contractual arrangements will experience downturn-driven change in distinct ways. Permanent, full-time employees with substantial continuous service have the greatest statutory protection, including redundancy consultation rights, statutory redundancy pay, and the right to claim unfair dismissal. Part-time employees share these rights on a pro-rata basis, but may feel more vulnerable if they perceive that reduced-hours roles are more easily eliminated. Fixed-term contract employees face the non-renewal of their contracts, which, while legally constituting a dismissal for redundancy purposes, may be experienced as more abrupt and less supported than a formal redundancy process. Bank and agency staff, who may have been providing essential services at the Trust, typically have the least contractual protection and may find their assignments terminated immediately as one of the first cost-saving measures, often without the support, consultation, or financial compensation available to permanent employees (Taylor, 2022).
9.3 Impact by Personal Circumstances and Protected Characteristics
Economic downturn-driven change can have disproportionate impacts on employees with particular personal circumstances or protected characteristics, raising important equality considerations. Employees with caring responsibilities, who are disproportionately women, may find that restructuring reduces the flexible working arrangements they depend on, or that redeployment opportunities are only available in locations or shift patterns incompatible with their caring commitments. Disabled employees may face particular challenges if reasonable adjustments previously in place are disrupted by role changes or relocations, and may require additional support to navigate the change process itself. Older employees, who may have longer service but fewer years remaining before retirement, may experience redundancy as particularly devastating, given the well-documented challenges of securing re-employment in later career stages (Lewis and Sargeant, 2023).
The Equality Act 2010 requires the Trust to consider the impact of proposed changes on employees with protected characteristics and to take steps to avoid indirect discrimination. For example, if a restructuring proposal would disproportionately affect part-time workers, and the majority of part-time workers at the Trust are women, this could constitute indirect sex discrimination unless the Trust can demonstrate that the proposal is a proportionate means of achieving a legitimate aim. People professionals at the Trust must therefore conduct equality impact assessments as an integral part of the change planning process, identifying and mitigating any disproportionate impacts on protected groups before changes are finalised.
9.4 Psychological and Emotional Impact
Beyond the structural and legal dimensions, economic downturn-driven change impacts people at a deeply personal, psychological level, and individuals respond to this impact in different ways depending on their personality, resilience, financial circumstances, and social support networks. Kübler-Ross’s (1969) change curve, adapted for organisational contexts, suggests that individuals typically move through stages of shock, denial, anger, depression, and eventual acceptance when confronted with significant change, but the pace and intensity of this journey varies enormously between individuals.
Some employees at the Trust may respond to downturn-driven change with pragmatic acceptance, viewing it as an inevitable consequence of economic conditions and focusing their energy on securing the best possible outcome for themselves. Others may experience profound anxiety, grief, and loss, particularly if their professional identity is closely tied to their role or if they have limited financial reserves to cushion the transition. Still others may respond with anger directed at management, the government, or the system, which may manifest as conflict, disengagement, or resistance. People professionals must be attuned to this diversity of emotional responses and ensure that the support offered, from EAP referrals to one-to-one conversations with HR advisors, is tailored to individual needs rather than delivered through a one-size-fits-all approach (Bridges, 2023).
Furthermore, the concept of ‘survivor syndrome’ highlights that employees who remain in the organisation after downsizing often experience negative psychological effects including guilt, increased job insecurity, reduced trust in management, and diminished organisational commitment. For the Trust, where the quality of patient care depends on an engaged and psychologically healthy workforce, managing the impact of change on survivors is just as important as supporting those who leave. People professionals can address survivor syndrome through transparent post-restructuring communication, opportunities for remaining staff to contribute to reshaping the organisation, recognition of increased workloads, and ongoing investment in team-building and wellbeing support (Sahdev, 2023).
References
Armstrong, M. and Taylor, S. (2023) Armstrong’s Handbook of Human Resource Management Practice. 16th edn. London: Kogan Page.
Bridges, W. (2023) Managing Transitions: Making the Most of Change. 5th edn. London: Nicholas Brealey Publishing.
CIPD (2024a) Labour Market Outlook. London: Chartered Institute of Personnel and Development.
CIPD (2024b) Strategic Reward and Total Reward. Factsheet. London: Chartered Institute of Personnel and Development.
CIPD (2024c) Technology and People Practice. Factsheet. London: Chartered Institute of Personnel and Development.
CIPD (2024d) People Strategy and Planning. Factsheet. London: Chartered Institute of Personnel and Development.
CIPD (2024e) Organisational Culture and Engagement. Factsheet. London: Chartered Institute of Personnel and Development.
CIPD (2024f) Managing Redundancy and Restructuring. Factsheet. London: Chartered Institute of Personnel and Development.
Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. London: The Stationery Office.
Handy, C. (1993) Understanding Organizations. 4th edn. London: Penguin.
Kotter, J.P. (2023) Leading Change. 2nd edn. Boston: Harvard Business Review Press.
Kübler-Ross, E. (1969) On Death and Dying. New York: Macmillan.
Lewis, D. and Sargeant, M. (2023) Employment Law: The Essentials. 17th edn. London: CIPD Kogan Page.
NHS England (2023) NHS Long Term Workforce Plan. London: NHS England.
NHS England (2024) NHS Staff Survey Results 2024. London: NHS England.
Sahdev, K. (2023) ‘Surviving downsizing: The experience of survivor syndrome’, Human Resource Management International Digest, 31(2), pp. 28–32.
Schein, E.H. (2024) Organizational Culture and Leadership. 6th edn. Hoboken, NJ: Wiley.
Senge, P. (2023) The Fifth Discipline: The Art and Practice of the Learning Organization. 3rd edn. London: Random House Business.
Taylor, S. (2022) Resourcing and Talent Management. 8th edn. London: CIPD Kogan Page.
Topol, E. (2023) The Topol Review: Preparing the Healthcare Workforce to Deliver the Digital Future. Updated edn. London: Health Education England.
Torrington, D., Hall, L., Taylor, S. and Atkinson, C. (2024) Human Resource Management. 12th edn. Harlow: Pearson Education.
West, M. and Dawson, J. (2022) Employee Engagement and NHS Performance. London: The King’s Fund.