SWOT AND COST ANALYSIS

SWOT: What’s it all about and how to use it?

David Stonehouse is a Lecturer in Children and Young People’s Nursing with the

School of Health and Society at the University of Salford, Manchester.

Abstract.

This article examines the Strengths, Weaknesses, Opportunities and Threats

analysis tool commonly known as SWOT and how support workers can utilise this in

decision making, problem-solving and in identifying where changes in clinical

practice are needed. The importance of this will be highlighted in the relevant

sections of The Code of Conduct for Healthcare Support Workers and Adult Social

Care Workers in England (Skills for Care and Skills for Health, 2013) and for nursing

associates in the recently amended NMC (2018) code. The article will start with an

overview of the SWOT analysis tool before examining the four separate parts. The

importance of the analysis stage will be highlighted.

Key Words: Analysis, Opportunities, Strengths, Support Workers, SWOT, Threats,

Weaknesses.

Introduction

Support workers are key to the delivery of high quality care to patients. They are

closest to patient care and therefore know the needs of their patient’s best and how

their organisations operate from the ground up. They are best placed to identify

where change is needed and where decisions need to be made. One way in which to

ensure that the right decisions and changes are being implemented is in utilising a

decision making tool such as SWOT. There are other tools available, for example

PESTLE (Taylor et al, 2015), or SPECTACLES (Pettinger, 2012), however SWOT

analysis has been chosen as being simpler, having only four components, and as

Marquis and Huston (2017) state, it is recognised as being both effective and

commonly used in healthcare organisations. The SWOT analysis tool can be used

for a whole range of applications. For managers “to scan their external environment

to identify opportunities and threats so that their internal strengths and weaknesses

are aligned accordingly” (Sola et al, 2018:136), to assisting support workers in

writing their Professional Development Plans by identifying “areas in which

development is required or desired” (Jackson & Thurgate, 2011:293) and by a

learner within the workplace to identify opportunities within their environment

(Wareing, 2016).

Code Words.

The Code of Conduct for Healthcare Support Workers and Adult Social Care

Workers in England (Skills for Care and Skills for Health, 2013), section 2.1 states

that you must “always act in the best interests of people who use health and care

services.” To act in your patients best interests means always delivering care which

is of the highest possible standard. To do this your care and practice must be

evidence based and be open to regular scrutiny. Evidence based practice is defined

as practice which is “based on the best available evidence, patient preferences and

clinical judgement” (Schmidt & Brown, 2015:4). Section 6 is focused upon striving to

“improve the quality of healthcare, care and support through continuing professional

development. This is achieved through, section 6.2, participating in “continuing

professional development to achieve competencies required for your role.” Section

6.4 urges you to “improve the quality and safety of the care you provide” and 6.6, to

“contribute to the learning and development of others as appropriate.” For nursing

associates, the NMC (2018) code also states in Section 25.1 that you must “identify

priorities, manage time, staff and resources effectively and deal with risk to make

sure that the quality of care or service you deliver is maintained and improved.

Through analysing proposed changes to working practices using tools such as the

SWOT analysis tool, support workers and nursing associates will be assisted to

make good, well founded decisions in how care and services can be improved.

Knowing the strengths of that decision and the opportunities it will present. They will

also be empowered to voice their concerns when a change is not in their patient’s

best interests, recognising the weaknesses, and by recognising the external threats

they will be better placed to overcome them.

Undertaking a SWOT Analysis

Before you start you need to identify what it is you are going to analyse. Sale (2005)

states that first of all you need to assess the current situation. What are the drivers

and levers for change? Has something occurred to prompt you or your department to

consider change or to make a decision? This may be a whole range of things, such

as incidents, complaints, new research, or a development in best practice.

The whole department, including support workers and nursing associates, should

meet to perform a SWOT analysis. This is done by examining the four categories,

strengths, weaknesses, opportunities and threats. The order and positioning of the

four categories in the grid is deliberate (See fig. one). The top two categories of

strengths and weaknesses are directed internally at the individual, team, department

or organisation. Wherever, or whoever, the change or decision is aimed at. The

bottom two categories of opportunities and threats are aimed at the external

environment (Phillips, 2009). Together with this, the left hand two categories of

strengths and opportunities are positives whereas the right hand two of weaknesses

and threats are negatives. As Thompson (2012:216) states this is useful as it “helps

us to provide a balanced overview of the situation we are analysing,” and not just to

focus on the negatives.

Fig One. SWOT Analysis Tool.

Strengths

This is the first of the two positive areas and is looking internally. Strengths could be

the things that make you or your team stand out from other areas. What do you do

well and excel at? Are your skills, knowledge and experience you have a strength?

The training you have received to support you in fulfilling your role and in meeting

the organisations objectives. These strengths could be identified from good

evaluations received or patient feedback.

Weaknesses

The first negative area and again internally looking is weaknesses. Are there areas

of your organisation, team or even on the individual level which you can recognise as

being weak? Are there things missing? This could even be around reputation or

image, or deficiencies in accommodation or outdated technology (Mullins, 2013). It

could also be on a more practical level of staff shortages, positions not filled, work

load, morale of the team, or actual working conditions.

Opportunities

This is the second positive area but now is outward facing. What opportunities are

there outside of your team or organisation? Is there a need being generated by

patient expectations, or new guidelines which you could adopt? Is there something

new that you could start doing? Could new funding be accessed that has previously

been unavailable (Phillips, 2009)? This is your chance to identify a new direction, or

new service you could be delivering to meet a previously unmet need. Maybe a new

technique has been identified to provide care in an improved way? Opportunities

could also be experiences gained outside of the current team, which as yet have

been unused (Jackson & Thurgate, 2011). Have team member’s talents been

unrecognised and unused until now?

Threats

The last area is negative and outward facing. This is more serious. It is about

identifying things which could actually threaten your practice, service or organisation.

Are there things out there, external, which could impact negatively on how you

provide your service or care? Threats to the organisation or team could be a loss or

decrease in budget, or a change in political or societal drivers which may threaten

commissioning of the service in the future (Phillips, 2009). Is another organisation

providing care in a more productive way?

Analysis

This is the most important part of the process. For the analysis to be worthwhile, time

needs to be given to complete the four sections above as fully as possible. As

Pettinger (2012:24) states nothing should be off limits, only “once everything is in

front of people, evaluations and judgements can then be made.” Once recorded you

need to be able to tell what the strengths, weaknesses, opportunities and threats are

telling you. If done too quickly or as a tick box exercise, there is a risk that SWOT

may have been performed, but without the analysis (Thompson, 2012), making the

exercise worthless. Thompson (2012) goes on to say that once words have been

inputted into the four areas, you are then able to see if there are any patterns or

themes emerging. Issues previously unrecognised can be acknowledged and

discussed, making the decision making process easier and highlighting the drivers

for change.

Conclusion.

So to conclude, this article has highlighted the usefulness of the SWOT analysis tool,

in supporting an individual, team or department to identify opportunities for change.

Support workers and nursing associates will often know more about how a team and

department is performing, being the key staff members delivering the most hands on

care. They are therefore well placed to contribute the most to a SWOT analysis of

the clinical area, suggesting how strengths can be maximised, weaknesses

improved upon, opportunities grasped and threats neutralised. All this will help to

deliver quality care and services to the patients and families that we serve and

support.

Key Points:

1. Support workers are key to identifying the strengths, weaknesses,

opportunities and threats within their own working environments.

2. Time needs to be devoted to completing the four areas so that it does not

become a tick box exercise.

3. Thinking about an area using SWOT allows you to have a balanced view of

both the positives and negatives, looking both inward and outward.

4. The most important stage is the analysis of the four categories, without which

the tool is useless.

5. Once your analysis of the SWOT has taken place, you can then make better

decisions and changes to benefit both staff and patient care.

Reflective Questions For Your Continuing Professional Development

• In a small group of your peers, conduct a SWOT analysis of your team or

department.

• Identify possible changes you can make to build upon your strengths, or to

remove or diminish any weaknesses.

• As an individual perform a SWOT analysis examining your own personal

learning and development.

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