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Thefailings of the operations at Mid Stafford Hospital was as a result of poormanagement and leadership. The Hospital trust’s board were negligent in theirsupposed duties. They neglected the employees; the clinicians, especially thenursing staff in providing them sufficient entitlements all because they wantedto gain the NHS foundation trust status and had to do this by investing a lotof money close to 10 million pounds that would have been used to pay thestaffs, to buy enough drugs, to be level with the modern day innovation formedical equipment and stay in line with the medical standards, But Because ofthis negligence and nuisance, many patients suffered and died(about 400 to 1200patients were victims) from the hands of some of the nursing staffs(who werelater suspended)who became non caring on the patients because of non-payment oftheir salaries and wages.

These failings at Mid Stafford could have been curedif appropriate performance measures were taken. This performance measures wouldhave been used to contain the inefficiencies of the health organization, bycontrolling and monitoring the activities of the employees or staffs (thedoctors and nurses) and also getting feedback from them using quality controlmeasures (Mintzberg 1995). The performance measures are taken on the totality ofan organization. Every stakeholder is usually involved in the performancemeasurement of an organization.

The financial measurements can either befinancial or non-financial. There are different financial and non-financialperformance measurements that could be used alone or combined together toidentify the failings at Mid Stafford. For the financial performance of thetrust to be measured, financial ratios would be used. For the non-financialperformance to be measured, there would be an analysis of customersatisfaction, employee satisfaction, quality control, setting performancetargets, using key performance indicators, the use of strategy maps andbalanced scorecard and a host of other resource applications would be used.Thefinancial performance of an organization is judged from the financialundertakings of the organization, It is from the assets, liabilities and thefinancial statements, that the financial ratios are computed from, thefinancial ratios are very useful in that they serve as a financial level forcomparing industry standards and also benchmarking analyzing the financialperformance of the organization (Olowe 1998). The financial performance arejudged from revenue and expenditure of the health organization; cash flowoperations, net sales, net income, investment activities and all these can thenbe measured more accurately by the use of the financial ratios which the abovementioned elements form.

The following are the primary category of ratios thatare used in measuring the financial performance of an organization: liquidityratios, profitability ratios, activity ratios, efficiency ratios, stabilityratios and leverage ratios.This financial and non-financialmeasures could have been applied to reduce or eliminate the failings at MidStafford, As part of the public inquiry report into the failings, it was seenthat the poor care and treatment of the patients was as a result of inadequatestaffs, that is inadequate doctors and nurses. It was even seen in the onesthat were available, that only a few were fully trained and at some point thejunior doctors were left alone at night to attend to patients that needed moreexperienced hands to be taken care of. Looking at this scenario, what the trust’sboard would have done would be to ensure that there is an effective HumanResource Management Team that will be in charge of the employees relations;care for the employees, oversee the recruitment and training of caring nurses,make sure that the staffs receive their entitlements and are not lacking in anyarea whatsoever in the organization.  Theorganization board should have employed the use of strategic tools like a strategicmap, balanced scorecard or six sigmas to ensure that the objectives, vision,mission and goals of the organization were being followed in line by the staffs.                                                                There was also the issue of poor leadership inthe hospital management.

It was seen that the leadership of the foundationtrust was in the trust’s board and that they were the major factor to blame forthe failings at the hospital. They were very poor in management of the organization’sresources, in that they engaged in projects that could only benefit the externalview of the organization and demotivate its employees. They embarked in aninvestment to get the NHS Foundation Trust Status, putting the major resourcesthat were meant to give employees and customers (patients) satisfaction intouse for their own benefit. Also the actions they took to investigate thechallenges and the problems the organization was facing were inadequate. Therewas no effective or quality internal assessment of the staff and the organizationas a whole. There was also a problem with the national overseers of thehospital; the Department of Health, the Ministers, the Health Care commission,the senior civil servants and many others that had a national duty relating tothe provision of health care in the country.

 The financial measurement that should have been applied in this case bythe health manager or the board would have been to look at the return or profitthat would have been gained on getting the foundation trust status and see toit, how it would have been used well for the totality of the organization andhow it would have benefitted the stakeholders especially the patients who werevictims of the health organization’s negligence. It was also seen that the organization lackedefficient and effective strategies in place to curtail the failings. Strategyis a way an organization plans and processes its actions and activities over a longperiod of time. It is a pattern in a stream of decisions (Mintzberg, 1995).

Where there is no strategy in place in any organization, whether big or small,there will be a corporate failure because whoever fails to plan, plans to fail.The Hospital management should have employed a strategy plan in place, using astrategy map or a balanced scorecard that will show the organization’s goals,its objectives and its performance targets that are to be achieved within aperiod of time. By doing this, the health organization would have had a foresightof where they are going to and produce a vision well communicated to itsemployees and all stakeholders Looking at the financial and non-financialperformance measures, we would be able to see that the financial measurementshad a limited capability in ensuring that the failings at the hospital wereeliminated, the financial aspects which dealt with an assessment of the organization’sassets, liabilities, and the financial statements could not have beensufficient enough in curtailing the inefficiencies of the organization.

Whatwas more important was the state of the employees: the nurses, the doctors andother, clinical staffs; what could have made them neglect and treat thepatients in the way they did. Then this is where the essence of non-financialmeasurement comes in. By this the inefficiencies could have been prevented byemploying certain resource management tools such as quality control, the use ofkey performance indicators, continuous quality improvement, total qualitymanagement, benchmarking, use of motivational theories such as Maslow, Needsand Expectancy theories (Drucker, 2005); all of this that would help motivatethe employees and become better at the work they do; at treating and takingcare of the patients well.Havingseen how the financial and non-financial performance measures could be used inensuring the failings at the hospital were averted, we can come into a conclusionthat the hospital could have done their best to ensure that the incidents; thehigh mortality rates, the deliberate and negligent acts of the nurses leavingthe patients to die could have been averted if all the components of a goodmanagement and performance system were considered.


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