This article in The Guardian about how the NHS has much to learn from the retail sector in the way it designs and uses patient questionnaires has prompted a lot of angry comment.
To be fair, it makes one or two good points. These include the fact that we are too slow in incorporating patient feedback into the way health care is delivered. Also, that it is not clear why we ask the questions we do of patients.
Where it completely and utterly falls flat on its face is in comparing shopper behaviour in Argos to the way people use the health service. Companies like to delude themselves and others about the ‘rich’ relationship they have with their customers . Yet, in the final analysis, there is nothing more to it than an exchange of money for goods.
I have some sympathy for the arguments Sir Ian Kennedy and others have set out for better customer service in the NHS a la John Lewis. But heaven help us all if we begin to model the whole system on what happens in the high street.
The author of the article hails from an organisation called ‘Patient Focus‘ that celebrates its expertise in tools for gathering patient experience. An example of their work is here.
Personally I’d like to know a bit more how it involves patients in what it does. For, in my experience, the best patient surveys are those not just designed with patients in mind, but put together and conducted by patients themselves. I think they call it ‘putting the customer first’ in the retail business.
Simon Denegri's Lay Review 
You are right, you can’t compare the behaviour of a shopper on the high street to the way people use hospitals, there are essential differences.
The key difference is of course that patients don’t choose to need the services of their local NHS trust. And when they do, good ‘customer service’ can mean the difference between life and death. Not just what store you buy your toaster from next time.
But on a par with retail, is that whether service is ‘good’ or ‘bad’ is best measured by the person receiving it. One of the best ways to do this is in a responsive and systematic way that allows changes to be driven from the eye-view of the patient.
On this point, you talk about patient surveys being designed ‘for the patient by the patient’. However, surveys that are just responsive to patients’ needs miss out on being useful to the trust as a whole. The surveys need to capture information that is relevant to all sides – clinicians, management and patients. This is why, at the outset of working with any new trust, the first thing we do is create a project group that includes representatives from clinicians, patient representative groups e.g LINKS and senior management.
This multi-disciplined approach ensures that surveys highlight a full range of actions needed to improve ‘customer service’ in the trust. There are simple changes that can be made to the wellbeing of the patient and can be easily addressed by the ward manager, such as a patient telling us that bins being too close to their bed made them feel uncomfortable. This was rectified simply by instructing the cleaning supervisor to ensure bins were moved to the other side of cabinets. Then there are deeper issues of staffing levels or dignity that need to be addressed by the trust at a higher level.
We certainly didn’t intend to imply that you can compare the behaviour of a high street consumer to a hospital patient. But what you can compare is the systematic and considered approach to engage both audiences. An approach that involves including both audiences and all those who they depend on for good service from the start. Then systematically ensuring that their feedback feeds into everything that the people providing the ‘customer service’ do.
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Helen, thanks for this really helpful response on the approach taken by patientfocus. I am sure people will find it helpful and reassuring. A 360 degree appraisal of patient experience, gathering input from all those who have some part to play in their environment, must be the right course. I know that people who visit this blog would find it interesting and helpful to see any of the results of your future surveys if possible so please do pass it on. Best wishes, Simon
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