1.0 Introduction

1.1 Aim

The aim is to conduct an in depth analyses of the Role of Human Resources in Organizational Performance while analysing case studies of the Global Significance of Human Resources in Health Care Sector

1.2 Research Objective

• Identify the significant roles of HRM within an organizations
• Recommend applicable HR strategies to manage workforce
• Evaluate the impact of HR strategies within an organization
• Identify issues in employee management which HR faces
1.3 Research Questions

• Has HR changes the way people are seen in the Health sector globally
• Are the issues raised still present in the health sector
• Has the roles of HR changed over the years
• To what extend can HRM improve the performance of the health sector
1.4 Rationale

• To identify and analyse how major trends in health care sector influence the nature of HRM
• To explain the importance of aligning an organization’s HRM and business strategy
• To evaluate the importance of HRM strategies
• To apply HRM models and theories
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1.5 Overview

There is a changing trend in the impact of HRM where employees are now seen are an integral part of the organisation. There is now effective strategy in HRM created to align with the organisational strategy. HRM strategy about creating long term goal, objective and mission that is suitable for the organisation. In HRM there are several books that define the concept differently
Torrington, Derek and Hall Laura (2014) define “HRM is concerned with all aspect of how people are employed and managed in organisation”. It important organisations are employs the right staff and these staffs are treated well through effective management strategy which can lead to organization growth.
HRM performance provides platform for organisation to grow financially, enhances their skills, and motivate staff. This is where organisation retain the right staff by recruit the staff fit the organisation culture and strategy. Most organisations have skill based system normally called talent management. Organisations have to deploy a job to staff that meet the strategy requirement of that role. In cases where this is not meet there should be training in place to improve productivity and increase staff retention.
There are different functions/roles that deploy in HRM according to the Torrington Derek and Hall Laura (2014) that includes: strategic HRM, human capital management, knowledge, organisation development, resourcing, performance management, learning and management, reward management, employee relations and employee well-being”.
There are different roles that HRM plays as discussed previously, this will now be discussed in details briefly and then reviewed later in the chapter, firstly we need to define and describe each HRM function are:
1. Strategic HRM: Torrington, Derek and Hall Laura (2014) “This is an approach that defines how the organisation’s goals will be achieved through people by means of Hr strategies and integrated HR policies and practices”. Strategic HRM is about continues planning, better values, committed and motivation that can lead to competitive edge.
2. Human capital management: Torrington, Derek and Hall Laura (2014)”is concerned with obtaining analysing and reporting on data which informs the director of value-adding people management strategic investment and operational decisions at corporate level and at the level of Front-line management”. Organisation can be informed on where the assets are and how it can lead to a competitive edge. The asset can be social, organisation and intellectual.
3. Knowledge management: Torrington, Derek and Hall Laura(2014) “is any process or practice of creating, acquiring, sharing and using knowledge, wherever it resides, to enhance learning and performance in organisation”. It about making sure that information flow effectively and efficient to the right personnel.
4. Resourcing(Human planning recruitment and selection and talent management):
Focus on improving employee recruitment, retention, performance, and potential. It’s all about making sure that employees are committed.
5. Performance management:
It’s the communication about management and employee with regards to ensuring that the organisation’s goals set are meet by the employee.
6. learning and management:
It about ensuring that skill and knowledge is improved within the organisation through the use of the term called procurement, which involves training and cost-effective approach.
7. Reward management:
It an approach that focus on rewards strategy and practice which results in acknowledge of employee for the exceptional performance through pay increase and fair treatment.
8. Employee relations and employee well-being:
The focus is to create a positive relationship between the employee and employer through advice and knowledge sharing within the relationship which can lead to employee commitment and engagement
1.6 Identify issues in employee management which HR faces

The issues will be discussed in the literature review in more details, as for now the facts have to describe. There are different issues in Hr employee management globally that includes the following below:
• Recruiting new staff: It is important that the right employees are recruited and trained to adapt to the roles quickly. It is not just about one aspect when recruiting.
• Retention: Staff can be retained by providing them with different HR scheme such as reward system and effective training.
• Training: It is important that staffs are trained well so they can increase the productivity of the organisation. If staff are not well trained this cause slow down in productivity.
• Health and safety: Staff must be kept informed about the health and safety in the organisation. It is an important aspect of the staff commitment.
• Work diversity: There must be rules in place to ensure that staff are not treated badly and are respected.
• Globalization: It is where organisation are set up multi-nationally and should operate to deal with different issues such as laws and tradition
• Advancement in technology: Organisation needs to keep up with the changing trend in technology such as HRM system and payroll system.
• Management of information: information need to updated, reliable and should be useful for the particular purpose within the organisation.
The chapter below that we will covered includes the following-
1. Literature Review
2. Methodology
3. Results / Findings / Discussion
4. Conclusions and Recommendations?
2.0 Literature review

After reviewing few literatures this is the points that was made. Firstly all of the literature that was read said and made the point about motivation, which is useful in employee retention.
Motivation as an enabler
In the past motivation was not well appreciated in hr within the health sector according human resources and the success of health sector written by Tim Martineau. He adds that health sector did not understand how HR would improve productivity and therefore hr was ignored as resources by the management. Human resources management in Health care sector a conceptual study written by K.Naga Sundari1 , Prof. V. Narasimha Rao2 argue further that there is a problem with staff engagement and top management support in HR planning. Human resources in the health sector: an international perspective Javier Martínez ; Tim Martineau argues that planning and managing staff resources is an important tool to effective hr in the health sector globally. Poor motivation is seen as the cause of the problem faced by management not taking the process seriously. Motivation can be achieved where the management roles can be changed or adjusted to fit in the hr roles that can be useful while dealing with HR queries from staffs. It should be reflected in the job description. Javier Martínez ; Tim Martineau in the Human resources in the health sector: an international perspective adds that the job description should show skills and competencies that includes proper training and effective Hr development in the health sector.
Also technology will play a part in the management of staff by the manager in the health sector where hr software are integrated to assess the need of staff and assess how they can be enabler to do better at their roles. It is important that management motivate their staff which can lead to job satisfaction which in turn ensures there is high staff retention in the health sector. Most of the Literature that was reviewed covered the motivation and they argue that a health sector without highly motivated staff will end with poor quality of work which would lead to performance issues. It talked about ways of overcoming performance issues such as creating performance appraisal, better pay rate and increase in the recruitment of quality staffs that are willing to stay. Although they talked about motivation in the literature reviewed it did not go into detail about what motivation was and the impact on the health sector. Based on the review it has not changed the way staff are treated in the health sector, it is still a problem, for example looking at NHS, we can see that it struggle to recruit staffs that are right for the roles and even staff that are recruited struggle to cope or stay in the health sector. Motivation will always be a problem in the health sector as seen in the literature reviewed covered. HRM is an important way of managing staffs and the future is bright if this resource is well integrated into the health sector.
Poor investment in HR
There were poor investment in HR due to complexity of the health sector and hr combined together. Both hr is a complex on its own and health sector is same; combing both makes it difficult to see the impact of hr in the health sector. Some of the literatures covered saw this as a problem with hr and health sector. None of the literature said that hr professional (expert) can sort these problems out. It was a problem with the literature that was covered. One thing that was mentioned in the literature was that hr investment is the future. There is not enough said about investment in hr and how this can change hr in the literature in the health sector that was covered this is loop hole in this sector. Human resource management in sector a conceptual study written by K.Naga Sundari1 , Prof. V. Narasimha Rao2 and Javier Martínez ; Tim Martineau in the Human resources in the health sector: an international perspective also says that lack of time and resources is a major issue in HR as management. This is due to the fact that management find the process complex as mentioned earlier in the review and they feel that they can be doing other management roles rather than HR Duties. The importance of human resources management in health care: a global context Stefane M Kabene and Carole Orchard, John M Howard, Mark A Soriano and Raymond Leduc further adds it is a complex relationship between HR and health sector. It further argues that cost of hr is due to the complexity of area and the combination of health sector and hr together. Staff performance issue was mentioned in most of the literature covered during the review. In review the literatures the conclusion is that staffs don’t performance well because there is not enough investment in the hr in terms of training the staff, performance review and recruitment of the right staffs that can do the job effectively and efficiently. Low Pay by health sector is seen by Javier Martínez & Tim Martineau in the Human resources in the health sector: an international perspective as the main investment issues that health sector need to address and overcome to retain and attract the right type of staff. Staffs are more likely to move away from their existing job in one health sector for a better job as covered by Javier Martínez & Tim Martineau in the Human resources in the health sector: an international perspective. There are loop-hole in the literature review covered this includes the lack of discussion of the Strategic HRM. It is due to the fact that this alone is a complex issue and aligning the Strategic HRM to the organisational strategy is a very complex activity and takes time and effort. When we look at the literature review, there is a lot of discussion on the issues of investment, but it did not take it in depth. It lacks discussion on technology and how it can improve the HRM with the health sector. From the review of textbook covered it mentioned technology as an enabler of change in the organisation. When it compare to literature review, there is a problem because all the literature reviewed. It did not mention the rewards system and better training facilities. Investment in the HRM is a slow process and it will take time to take off, it just requires encouraging and gaining the support management to embrace the impact that technology in the health sector. As investment in hr increases so does that the performance existing staff and recruitment of the right staff in the health sector. When reviewing the literature there is evidence that there are clear changes taking in term of investment, more need to be done to facilitate this change. Health sector need to recognize the impact of HRM and what investment can do in this sector. There need to be more literature written on this area and how investment can help. Technology and staff should be at the heart of everything health sector do. If this can be achieved than health sector will do better at staff retention.
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Knowledge staff
Human resources management in Health care sector a conceptual study written by K.Naga Sundari1 , Prof. V. Narasimha Rao2 argue that knowledge staff, skilled staff are key to the organisational or growth. If you recruit the right stuff that are well trained and knowledge it likely to improve performance of the health sector according to this literature review covered. This literature was the only one that covered the concept of flexibility in the hr and how important is the health sector. It mentioned that staff flexibility can lead to high staff retention. Human resources management in Health care sector a conceptual study written by K.Naga Sundari1 , Prof. V. Narasimha Rao2 also argues that valuable works force and manageable work force is key to hr success in the health sector within the global sector. Most the literature reviewed talked about the keeping staff to who can be trained and also retrain other staff. It is a challenge as this is why we need HR as a tool to deal with this issue. Globally finding the right staff is an issue as demonstrated in the case study which covered NHS, health sector in African and Other part of the world according to case study covered in the literature. There are issues of size, health care distribution, training, migration and Demographic which focus on ages as a major reason according to the importance of human resources management in health care: a global context Stefane M Kabene and Carole Orchard, John M Howard2, Mark A Soriano and Raymond Leduc. Most of the literature discussed the issue of recruiting the right staff that are knowledgeable and well trained to do the job within the health sector. HRM plays an important role in the heath sector which can lead to better results in the performance of staff in their roles. One thing that was mentioned was the important of knowledge management and transfer of this knowledge from across the board. Most of the literature reviewed talked about the power of knowledge in the health sector. With an effective knowledge, we can find the right staff and have HRM strategy that can be useful in the health sector. It is not always easy to find the right staff according to the literature Reviewed and something we need expert to delivered this approach and so doing integrate this with the HRM strategy. Not much has changed in the use of knowledge management in the health sector according the literature reviewed. Management do not have time to assimilate knowledge, they would prefer spending their time doing other management roles.
Commitment
But there was point made in human resources issues and implications for health sector issue which argue that having the right no of staff may not lead to success right away. It said that the key is commitment and right staff quality and that skill and commitment was an important asset to the health sector. The literature continues with the point that lack of training, care worker to do the job and behaviours of staff was a drawn back to the commitment of staff in the health sector. It could lead to staff lose and low staff morale. This point is further strengthened in the literature entitled “Human resources in the health sector: an international perspective Javier & Tim Martineau” add that It is the staff behaviour which includes staff not turn up for work on time, increased work load which is as result of lack of staff and finally bad attitude which reside from staff not able to deal with the job. Therefore commitment is a key aspect of staff retention. It was the only literature covered, that add that committed model organisational involvement, emotional identity, staff considering leaving cost and staff staying benefit was key to high staff retention and staff commitment to the health sector when hr is integrated. One of the areas it covered finally was the HRM practice was includes socialization among staff that have personality trait that match and can works well together, It also mentioned performance management as a key asset that will allow staff work well together and finally point was the job staff practice. Reward system and performance appraisal can keep the best staff and improve underperforming staff. It mentioned that staff can stay if there is promotion and effective training. This leads to commitment from staffs. Human resources management in Health care sector a conceptual study written by K.Naga Sundari1 , Prof. V. Narasimha Rao2, and Argue that there should be a hr strategy that is clear and defined this means that the facts need to be laid out effectively. It also talks about the issues of having hr department that staffs can queries for hr effectively and efficiently. Furthermore human resources in the health sector: an international perspective Javier Martínez & Tim Martineau talks of the main problems with hr in the health sector as the delivery of services and care planning issue. The importance of human resources management in health care: a global context Stefane M Kabene and Carole Orchard, John M Howard, Mark A Soriano and Raymond Leduc further adds that knowledge, skills and motivation are key to staff delivery of service. Having review different literatures the assumption is that the only way that this issues can be controlled to find the committed staffs who believe HR has a role to play in the health sector. Human resources in the health sector: an international perspective Javier Martínez & Tim Martineau that an effective staff objective that is well defined and well organised lead to an increased staff performance. Most of the literature reviewed talked about commitment as an enabler of change and it argue that that with committed staff, health sector can have high staff retention. It would need the support of committed management who know how to motivate staffs. The main loophole with the literature review covered, is it did not look in depth at motivation. This is still a problem with the management and staff as a whole. This is because staff morale is down and staffs do not stay on in the health sector due to poor management. NHS is one case study reviewed and the findings are clear, it has low staff retention. The roles of management has changed over the year in the health sector, It is not clear from the literature reviewed how it has changed but in the textbook, covered there were changes that need to be made by the health sector. The following includes the changes that need to be made: It needs a reward system to encourage staff to stay, performance review, better more trained staff that are committed and are willing to stay the case. Commitment would always a problem for staff and management. There is no quick fix to the problem and it takes time to implement the process.
Review of case study
There were case studies explored by the literatures, preferred human resources and the success of health sector written by Tim Martineau because it look in details at how HR is deployed in health sector in that particular organisation. The first point on the case study was the issues of retraining staff, adjusting the staff roles to suit the need of health sector was also mentioned and finally the fact quality staffs needs to be recruited. The second case study made the point that structure changes need to be made to suit the health sector, staff also need to be re profiled and a database be to be created to suit this process and would cost a lot in integrate this changes. Finally case study about NHS said that staff performance be need addressed, new pay structure need to review and integrated into the organisation and the finally point was the fact that skilled staff need to deployed correctly to bring about increased performance.

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3.0 Research Methodology

3.1 Why Research Methodology

Methodology allows the collection, analyses and presentation of data using a particular research method. This is of great important during the research process, it allow the researcher to look at the data that is on display by using a target audience to create the finding which will be discussed later in the finding chapter.
3.2 Research purpose

The goal of the research is to assess the roles of human resources in organisational performance using different research approach. It would involve using case study, and other resources to assess the global significance of human resource in health care sector.
3.3 Outline of intended research activities

In the research methodology there are activities that would be covered as we carry out the research and this includes the following:
• Data Collection
• Research approach
• Research justification methodology
• Sample approach
• Analytical tools
• Difficult faced in research design
• Ethical issues faced
• Ethical issues overcome
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3.4 Data collection

There has to be a way that we can collect data from the relevant sources, it important that we consider the target audience for this particular research. The target audience for this research is mainly health care personnel and their performance. Due to the complexity of the subject area we need to keep the target audience easy to assess.
There are two ways of collecting data that includes primary and secondary data collection. Primary data collection uses research resources such as interview and questionnaire while secondary data collection includes case study, e-book, books, journal, project and other sources. For the purpose of this research the focus will be on secondary data collection not primary data collection and this is due to limited resources to carry out this research. Interpreting the data will require detailed analysis of different sources to ensure that it matches, can be used generate new ideas, relevant, useful, and timely and there is consistent in during the research process.
There is an issue of accessing the data this is due to the fact that gathering health sector data within the hr is not an easy task. It is a very specific and complex area to find data and write about. Validity of data may not always be accurate as the data may change over time and it may means adopting a new research to find that data that is required. It may mean doing more research and making sure the data matches and this is less inconsistent. The Generalizability of finding should focus on the making sure that data found is clear, useful and can be integrated into another setting in different organisation in the health sector. It must focus on the areas in questions and embedded into a new or existing environment.
3.5 Limitation of research design

Time restriction: Due the complexity of area it takes time to find the data that is required to present the finding. It is important that we find data through the use of secondary data collection in this context. Having the correct research strategy are key in finding the right data. It is important that we reduce and be more specific in the research area we are investigating as time is of essence.
Deadline restriction: As the deadline is short, it requires particular attention to the right type of information. As mentioned earlier information collected must be up to date and relevant. This will allow the researcher to gather information easily and present it with ease.
Data analysis: This could be a problem as finding the right data to analysis requires a lot of checklist to make the right decision. It requires the use of data that are relevant, useful and allow you to make a conclusion. Sometime researchers do not always find the right data and make end up finding the wrong data and analysing this data, it may be because the research design is not fit for the purpose.
Sources of information: In this research, there will need to collect and analyse data using he secondary sources of data. The primary sources may not be used due to the time restriction and complexity of data. The major problem with using data collection that involves primary approach is that its time consuming, expensive and need permission to collect the data. In the complexity the best option would be secondary data collection. This is due to the fact that it’s cost effective and does not require permission to access data.
Analytical tool: In the research design for the purpose, there will be no tool use to analyses the data, due to the type of research in question. This is limits the process of finding data as the focus would be only collecting and analysing data without using analytical tools. Instead the use of data collection would involve using different research tools such as Google, e-book and e-journal.
There are few difficult faced while designing research process as this affects, this includes the following:
• It is hard to make sure that topic align to the research design as its takes time to do this.
• It takes time to conduct an effective research process and this requires patience and right data.
• It hard to use choose which research group are as it requires continue effort to gather this information from group.

3.6 Sample Approach

The motivation for choosing the target sample or population mentioned earlier is due to the fact that health sector personnel is simple to research, find information. If the focus was general and was more on all the sectors, it could take a while to find the information as it a complex area. It being specific makes it better to find data. Most health sector keep their information securely and safe. This is why data is hard to find online and it cost money to find this data. The sample approach depends on the time and access to the resources.
3.7 Ethical issues faced

There are different ethical issues faced while researching for information, which will affect the outcome of the research. It is important that these ethical issues are dealt with and placed under control to avoid further issues from taking place. The following are issues that may arise which include:
• The dissertation and university guidelines must be following so the right requirements are meet while writing the dissertation. It is important that the process is effectively and efficiently carried out so the research guidelines are met.
• Getting signature for writing the dissertation and carry out the primary data collection was a problem as the time restriction was a problems.
• Some data may be difficult to get using secondary data collection, this data due to the effect on the other research. This is because the data collection may conflict with the other research view.
• Because data is not carried using primary data collection its does not affect the privacy of the data.
• There was an issue with making sure that data is right and relevant. It is problem as this takes time and need for proper investigation.
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3.8 Ethical issues overcome

• Overcome the ethical issues are not straightforward, as it ensuring that the guidelines set by the university are met fully. It includes ensuring that data is properly presented in the correct way.
• Planning must be implemented effectively and efficiently as this allows the ethical issues to be dealt with.
• Permission must be taken to ensure that data collected is carried out the correct way
3.9 Summary

Methodology is an important aspect of writing a dissertation. It all about saving time and making the process easy for the decision making process. It involves different process from the Data Collection to presentation of data to create relevant information. To gather more information, there is a need to use different method such as primary and secondary information. Ethical issues need to be considered while writing the dissertation as it allows the research to follow the guideline.
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4.0 Results / Findings / Discussion

In the finding, there will be a look at the following areas:
• Findings and Result is includes experiment, outcome and case study summary
• Discussion looks at an overview of what happening in developed country and why there is a requirement for experienced staff from developed country.
• Summary try align the HRM finding to literature review and draws its conclusion based on that.
4.1 Finding 1

In the finding written by Philipos Petros Gile, Martina Buljac-Samardzic and Joris Van De Klundert(2018), conducted a research on HRM practice and concluded the following about this practice:
Training and education: There were ten studies carried out by the researcher on the relationship between training and outcome. The following the discovery of the studies:
• Six considered employee outcome
• Two considered job satisfaction and retention
• Four considered negative relationships between training and employee outcome.
There were indications from two studies that improved team performance was as a result of effective training within the team and the evidence was discounted and considered weak. Three of the four studies focus on organisational outcome reported improved quality of care.
Salary and compensation: Research was carried out on salary and compensation there was evidences that higher pay results in better performance and high staff retention.
Rostering and scheduling: Research was carried out on four studies and scheduling, there were evidence that one of the study showed failure of HRM involvement to reduce turnover intention.
Task shifting: The six studies that research task shifting/task goal reported organisational outcomes. There was improvement in efficiency in that study, reduction in employee shortage.
Managing staff through leadership support and mentoring: The studies which involved leadership and mentoring practices both say that better job satisfaction by staff.
4.2 Finding 2

In the finding written by Jemmy Mumbua Mutua, Jacinta Kinyili and Robert Arasa(2018) conducted a research using variation of employee performance due to the manpower planning, recruitment and selection, training and development, reward and compensation. In the report it concluded the following outcome:
• 62.9% variation employee performance due to the manpower planning, recruitment and selection, training and development, reward and compensation.
• 37.1% imply that there are other factors that lead to employee performance which were not discussed in the study.
It breaks down the roles that this impacts on the organisation and concluded the following:
• As for manpower planning and employee performance concluded that more manpower planning will result in increased employee performance.
• Recruitment and selection and employee performance concluded that more Recruitment and selection will result in increased employee performance.
• Training and development and employee performance concluded that more Training and development will result in increased employee performance.
• Reward and compensation and employee performance concluded that more T Reward and compensation will result in increased employee performance.

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4.3 Finding 3

In the finding written by Stefane M Kabene, Carole Orchard, John M Howard, Mark A Soriano and Raymond Leduc conducted a research using case studies this was the conclusion:
Case study 1
• HRM can bring about change and can facilitate the growth of organisation via steps taken to understand and implement them to the existing culture.
• HRM can act as tool to encourage employee to be more creative and innovation through the use of team-based approach.
• HRM plays an important role in investing in staff development through the use of internal position and ensure they can pursue external staff roles and can ensure organisational changes.
Case study 2
• HRM issues where raised in the University of Nebraska Medical Center, this HRM issues includes intense Price competition, payment reform in health, reduced state, research, changing workforce, population demographics and funding issues which prompt the organisational changes to meet the new challenges.
• The goal was to find a HRM strategy that aligns with the organisational strategy. It looks at staffing as a key issue and say that the best way to have the skills and quality within the job roles while recruitment of staff.
• The next goals to have a system where performance management was useful in rewards process and manager was use feedback to make improve staff effectively.
• The third goal was the development and learning was useful as staff can learn and develop their own learning.
• The Next point in the case study was to value staff through staff retention and attracting the right staff.
• The finally organisational effectiveness have better vision that includes flexible, innovation and reactive.
4.4 Discussion

There are different points that were picked out in the discussion this includes the following:
• Different health care system where examined and it was evidenced that the HRM and health care found to be significant different in the countries within the organisation. What made it different was the legislation which affects the HRM in country such as Canada.
• There was a problem with trained staff and therefore country such as Canada, Germany and United state tend to recruit staff from developing country in the Health sector.
• There was big problem in united state HRM and health sector with the following issue such as care cost, care coverage and care standard which lead to poor care treatment from employee responsible.

Figure 1- – Stefane M Kabene, Carole Orchard, John M Howard, Mark A Soriano and Raymond Leduc(2006)
• The Average Annual premiums for employer sponsored family health coverage shows that Health insurance premium goes up as the year progresses. This means that it becomes more and more expensive to cope financially and show that health care cost is not affordable to everyone.
• Assessing the case studies in Finding three, found that HRM can play an important role within the health sector as it can allow researcher to implement their policies and carry out more research within the health sector that can be useful to the organisation.
• There is a need to recruit globally which coined the term globalization, resources sharing and quality distribution.
• There are other reasons why developed country cannot retain staff that includes cost of health sector.
• The economics of developed country is not a problem as people are better in that economic.
• Human resources input plays roles in develop, manage, motivate and retain staff this is where the HRM researcher or professional must make a different.
• There is a need for integrating the HRM in the organisation as those who are responsible for implementation HRM know that the process works and can change the way organisation treats its staff and recruits and retain staff.
• HRM expert should be part of the higher level planning so as to raised, considered, properly addressed and deal with the issues within HRM and align the HRM strategy with the organisational strategy.
• There should knowledge management and sharing within the organisation, this is HRM should be encourage to learn about other areas within the organisation one way to do this is by work experience.
• Below is a summary of the wage differences in the organisation in different countries showing the sources of wages and destination for recruiting staff such as physician.

Fig 2- Stefane M Kabene, Carole Orchard, John M Howard, Mark A Soriano and Raymond Leduc(2006)

Fig 3: Stefane M Kabene, Carole Orchard, John M Howard, Mark A Soriano and Raymond Leduc(2006)
The above table about the Factor influencing health care professional’s intent to mitigate reason for migrating and willingness to remain in their home country. It explains why people migrate from developing county to developed country. The major reasons are because get experience, better pay, living condition are improved. This is the reasons why more people with great qualification migrate.
4.5 Summary

For organisation to do better it need HRM at the heart of their business and therefore aligned to the organisation strategy. The HRM is an important tool in the health sector from the findings and discussion as it will improve performance through effective training of staff and knowledge distribution. It is important that management and HRM expert work together to achieve this goal through effective discussion of issues. As mention earlier in the literature review, the use of HRM is Important, as it can find committed staff, trained staff, more investment in the organisational resources, motivated staff and knowledge staff. It is an asset that organisation must embrace in order for them to grow and increase the performance of staff. As we can see there is a link between the literature review and secondary Finding. The issues such as commitment in the literature review are still present, as are always a issue and the only thing that may change is the roles of HRM expert in the health sector within the organisation. When you compare the following roles, Strategic HRM, Human capital management, Knowledge management, Resourcing(Human planning recruitment and selection and talent management, Performance management, learning and management, Reward management and Employee relations and employee well-being that are mentioned in the introduction, the finding talks about the HRM changing roles and talk about this in details in the finding. ?
5.0 Conclusion /Evaluation/recommendation

Things are changing for the better as employees are now seen as an important asset in the organisation. HRM strategies are seen as integral part of the organisation and HRM is about employee management and recruitment. HRM acts as a way of retraining and improving staff through performance management. The role of HRM includes the following:
• Strategic HRM focus on continues planning
• Human capital is about asset and its impact on the organisation
• Knowledge management is focus on sharing knowledge
• Resourcing is about employee management maximum
• Performance management focus on employee goal being met.
• learning and management is about procurement
• reward management focus on giving staff reward for their performance
• Employee relations and employee well-being is about strength relationship in the organisation

The Issues in employee management HR that was discussed focused on using HRM expert to recruit the right staff that can adapt in the organisation through effective training and retention staff by motivating staff and using technology to management information using globalization. In the literature review different literature was used and the main concern raised includes:
Motivation acts as a tool for increasing productivity but this was not appreciate by top level management due to lack of understanding the concept. There are different ways that staff can be motivated to work in a organisation that include better job description, better pay rate, performance appraisal and proper training of staff. The approach can lead to higher productivity, Investment in HRM is not an easy thing as its complex, talk less of combining it with health sector. There needs to be more said about the impact of HRM investment as this is ignored by management as there is no time and resources to invest in training and retaining staff. Knowledgeable staff was another concern as not all the literature covered this concern. It was seen as way to retain staff, knowledge transfer and management. Management do not have for knowledge sharing. Commitment is about getting right staff (i.e. personality trait, reward system) to stay in the health sector. It mentioned in the literature that the major problems includes lack of training, care workers lacking and staff behaviour which to staff retaining issues. The case study covered in the literature covered staff retaining through effective training and recruitment of quality staff. It about organisation structure, reprofiling, cost a lot to integrate, new pay structure and performance review.
Within the Methodology the focus was to use secondary approach where the collection of data focus on health care and complexity mean keeping it easy to assess. It is important that focus is on useful, relevant and key data that can help create a useful finding. There are different limitation that includes time restriction, deadline, data analysis, source problem and analytical tool. Finally the ethical issues include such as guideline and signature, one way to overcome this are to follow the guideline.
Finally the finding 1 analysed HRM carried out by researcher and concluded there were good result in using the HRM in the training, salary, rostering, task shifting and leadership support. Finding 2 analyse and concluded that planning, recruitment, training and reward resulted in good employee performance and Finally finding 3 concluded that using a case study that HRM is key to better team based approach, staff development, better culture, address of issues, In the discussion there were such as legislation, poor staff training, cost of health care, and so on as a major issues in the developed country.
5.1 Recommendation of HR Strategy to the work force

HR strategy must focus on the long term which should be easy to implement and process without employee being confused by the strategy.
• The Health sector HR strategy can satisfy organisational needs, it’s all about analysis, action, clear vision, deliverable and works.
• Make sure the strategy is diverse and relevant to the health sector and can suit need of the health sector.
• Make sure the strategy is useful for everyone involved including health sector.
• Keep the strategy and process relevant, easy to understand and implement within the health sector.
• Changes must be implemented slow and must not affect the health sector hr and staff roles heavily.
• Make sure that employee can trust the new strategy implemented that it make sense and can suit the need of the employee.
• Health sector strategy must be aligned with the organisational strategy within the organisation.
• The hr strategy must fit in with the organisational culture of the health sector and must align to the culture.
• The chosen hr strategy must be cost-effective and must not be take too long to implement the HR.
The HR strategies below can be useful and aligned to the organisational strategy in order to improve organisational performance:
1. High performance management
2. High commitment management
3. High involvement management
High performance management
• Health sector can use this type of strategy to increase the performance of the organisation.
• It can improve productivity, customer service, growth and profits.
• Health sector can use this strategy to carry out detailed analyses of the training, appraisal, performance, management recruitment and selection.
• This plans encourage and facilities, problem solving, employee involvement, skill development and motivation.
• This is openness, action based, quality of work will be better with the hr strategy.
• There is Team spirit, there is leadership between staff and employee, there is better vision, It result in profitability and higher performance,.
High commitment management
• Health sector can benefit from the strategy as it get employee voluntary committed.
• This approach gives the employee the licence to free to behaviour in a way that shows commitment and ensure that trust is still present.
• It encourages team working where they can share information and structure work, flexible, problem solving, and job redesign.
• Health sector can use this strategy to ensure that staff can grow in the organisation and job description.
• It can reward staff for their effort, its high involvement term of quality and can provide competitive advantage
High involvement management
• Health sector can use the strategy assess staff decision making, power, information access, training and incentives. It can commit and involve staff through sharing mission and information.
• It can allow employee appreciate their work through more control of their work and treat them as important part of the health sector.
• This approach can lead to Ideas sharing within the team setting and pro-activity.
• Within the Health sector, this approach can ensure job satisfaction and commitment in the organisation.
5.2 Evaluation of the impact of HR strategy in the Health sector

Health sector can do well with aligning the HR Strategy with business strategy as it provide organisation with competitive advantage and high staff retention. HR Strategy is an important asset to an organisation as it allow employee to improve its performance. There are different impacts that HR Strategise can have in an organisation that includes:
1. Health sector can allow unearthing of talented staff and this can lead to motivated employee who can grow in the organisation and can lead management of employee who are committed to the organisation.
2. Health sector can allow management to develop, hold onto high quality employee. It is important that the employees are aligned to correctly to business needs which can lead to better performance, better idea sharing, flexibility, commitment, more acceptances of the strategy and better fit for the organisation.
3. Health sector hr strategy can provide the organisation with secured employment, this can act as a tool for providing a vision for organisation do better in term of performance and employ can accept the process. It can keep the organisation values going as it makes it a good place to do your work.
4. Health sector hr strategy can act as a tool where employee can see their roles and responsibility as important, flexibility, job satisfaction, productivity and acceptable.
5. It can a tool to enhance high performance within the organisation, which can lead to better quality of work, likely to increase the organisational profitability and increased commitment from the top management. It can change the way the employee act in the organisation which can lead to more commitment and trust.
6. It can act as a strategy for knowledge management where is developed and grows. It can allow health sector to develop their skills as employee are committed and willing learn. Health sector allow hr strategy aim and objective to be achieved through effective, efficient learning and sharing of knowledge within the organisation.
7. Health sector can benefit from reward employee for what they do in the organisation. It can lead to high staff retention which can lead to commitment and better attitude within the organisation.
8. Health sector can see an improvement in the way staff work in the organisation through motivation, commitment and involvement in the business objective. It can give employee a goal in the organisation which ensures that they can feel more willing to commit to the organisation.
5.3 Limitations of the research considered

There are limitations that we face but there was no way this could not avoid this, all that could be done was to find ways to deal with this concern. This would allow the delivery of the dissertation within the required time and with the deadline met. These are the limitation that was faced while writing the dissertation:
• Time restriction: This was a concern as the dissertation need more time. Due to the restriction there were areas in the dissertation process that took so long to complete. For example in researching the information it took longer to find information and organisation this information. There were delays during the dissertation due fact that university decision making.
• Research Complexity: It was one area that slowed down the dissertation process, it made the write up difficult as the subject areas was complex and required the researcher being specific. To specific means that terms used to find the information had to be relevant and useful. Due the complexity of the task it required a lot of reading and analyses of information, this took time.
• Secondary data collection: In the areas there was a concern as the duration to write the dissertation was not long enough, so we could not carry out a secondary data collection. It was also difficult to find information using only the primary data collection. Due the restriction, there were difficulties finding the information with only one data sources.
• Locating information: The only issue here, is there were problems with locating information that was required . This is because this required the Researcher to sign up or make a payment. As a result researcher did not get the information that was required.
• Target audience: To assess this, there was a need to find the correct audience and to ensure that the information is effectively located and presented in the correct way. Some information were general not specific to the audience as there was heavily use of Google and there was no access the good e-journal.
5.4 Future Research in HR within Health sector

1. Technology and new approach to treatment is acting as an enable of change. It allows the use of the technology to store and manage knowledge that the health employee will need to carry out their duties. This will in develop the skill that the management in the health sector will need. Example mobile phone can be used to save time and gather knowledge. The future is mobile technology and the use of HR to support staff. This is still a work in progress and make a big different in the organisation.
2. Due to the reduced staff in the skilled areas there is a problem of finding the right staff and training them. This area can be further developed through effective and efficient use of the talent management software. This need to be further explored and more research to better way of finding talent.
3. Investment in the HR is a major problem and need further reading, there need to be more done in the areas to motivate and commit employee and get involved in the process and ensure investment.
More need to Researched in the areas, as more investment the right way can lead to better performance.