The Gas Man did cometh; Plusnet answered my question about not connecting to iPlayer; someone came to paint the front of the flat; John Lewis delivered on time and with the goods I ordered (at a cost considerably lower for both product and service than IKEA, btw). I feel nervous about admitting to this run of good fortune as Britain’s service industries actually turned up and did a good/reasonable job. Nervous because there will no doubt be a price to pay for this good fortune.
Certainly all these transactions had consequences – a customer satisfaction questionnaire followed as a matter of routine. British Gas used an automated telephone call three days after the visit and the others used e-surveys triggered from emails. The only technical failure that made the questionnaire impossible to complete was, as you perhaps guessed, the one from the web/ internet specialist Plusnet.
This annoying little glitch aside, it is now a commonplace of modern customer service that many (most?) companies have now made the follow-up customer experience mini-survey an integral part of their service measurement and management processes. It was a tough sell and a very time-consuming exercise to despatch and analyse responses when I started trying to persuade companies to do this in the 80’s. Few operations had the means of creating and manipulating databases and even when they did, it was expensive and time-consuming. Technology has swept aside these barriers. But some still find it hard and mistakes – see Plusnet above – are still made. To do it right involves a degree of management focus to get it set up, the commitment of staff, the allocation of technical resources and the creation of a robust, reproducible and sustainable process which produces information that is used – to pay bonuses, win that customer service award, whatever. There are even professional organisations where customer service professionals and survey providers meet to discuss the merits of competing methodologies like Net Prom0ter and the various alternatives.
Still making a meal of it
Is it the issues around reproducible and sustainable that we might find the reason why the NHS still makes such a meal of its customer experience follow-up questionnaires? There are plenty of them floating around out there in the health services universe – paper ones at appointment desks, electronic survey monkey ones, national surveys about GP services, hand-held survey devices in the wards, people telling their stories on Patient Opinion. But it all seems disconnected, unpredictable and amateur demonstrating a perhaps a management vacuum where it is not someone’s job to measure and manage service. In the NHS, from what we see, it is an extra job for the nurse or clinician, receptionist, practice manager. The process is created from scratch each time and difficult to sustain; the data is not well analysed and the follow-up action and use unpredictable. As Val Moore found in her recent admission to hospital, she – the patient – was left to track down the means of giving their opinion.The person Val tracked down to point this out to after she had been discharged, cheerily admitted that this was something they should be turning their attention to and has never returned a call since. This institution shows the face of the cost-conscious NHS – a direct line that is never answered and with no voicemail. I attended a session at a (rather better organised) Kings College Hospital Community meeting last night which suggested another reason – research for clinicians means in the first instance clinical studies testing treatments and drugs etc. Perhaps customer experience research asking ‘were you seen on time?’ seems almost trivial by comparison.
There is not a hope in hell at this cost-constrained moment for customer experience and service management to be embedded in the NHS and recognised as an essential function. So we will be left with the situation where measuring customer views will be the province of the amateur with the process of gathering and using patient data left to the random enthusiasms of people who have quite enough to do already.This means that cost-effective and targeted service that is monitored and measured will remain impossible. This matters for lots of reasons – one of which is again prompted by the discussion about how to get users of Kings College Hospital more involved in research. Our answer is ‘get them more involved in research’. Get them used to a consistent, predictable and standardised process about their own experiences – ‘you have recently been seen here. Please tell us how you got on’ – where it is easy to understand why it is being done and easy to do with a short series of questions that are clear and simple to answer and results being fed back through websites, newsletters etc. You have now created a pool of research-ready participants who are pre-disposed to contribute and join in the more esoteric and ‘medical’ exercises. Both sorts of research are essential in a modern health service. Create a contract with the community whereby research participation at whatever level or reason is part of the deal with the hospital -the ‘we treat you, you help us’ relationship in action.