Due to the nature of the service the NHS must design their processes on a Total Quality Management basis (Palmer, 2001), allowing minimal room for errors. Critical incidents within the NHS truly are critical, making adequate and timely service recovery essential. Critical incidents must be identified and recovery strategies put in place. Empowerment of staff is a crucial part of this service recovery process. Customer participation is extremely high within the NHS as services are performed directly on the customer.
The NHS do not actively seek sick people, it is up to the customer to initiate the service process. Customers must also participate throughout the process, for example sticking to diets and medication. There is no standardised service so no process is ever identical. The high levels of customer participation mean it is very much dependant on the beliefs and behaviour of the patient. If they do not want, say, a blood transfusion because of their religion, the normal process must be altered. Procedures and policies are, however, in place to guide employees and provide structure and support.
“In the public sector, the primary benefit of business process management is the increased effectiveness and efficiency achieved from restructuring the organization along cross-functional processes. ” This is evident by the fact that NHS processes have recently been made less bureaucratic and more flexible and adaptable by the shift of power to front-line employees. “Blueprinting attempts to draw a map of the service process. ” (Palmer, 2001, pg. 66) It helps standardise the service, increase consistency, improve efficiency, identify potential failure points, facilitate staff training and can be used as a useful evaluation technique.
(Palmer, 2001) Due to the wide range of services available through the NHS, blueprinting every procedure would be impractical, but this process is sometimes used. “A service is performed rather than handed over” (Woodruffe, 1995, pg. 187) meaning more risk is incurred. You cannot determine whether you are satisfied with the service on offer until you have actually consumed it.
“Because services are intangible, customers’ perceptions of value are enhanced when tangible elements are added or better managed. ” (Martin. C. L., 1999) Hence the importance of physical evidence, such as facilitating goods, di?? cor and comfort. (Palmer, 2001) “Corporate Identity tangibilises corporate image by linking the values, benefits and qualities of the organisation’s image with identifiable physical attributes such as brand names, logos, staff uniforms, house-styles and consistent standards. ” (Woodruffe, 1995, pg. 188) This is a crucial factor in the NHS’s marketing strategy due to its high-contact nature. Customers will form an initial opinion of a service within minutes of entering the servicescape.
(Woodruffe, 1995) Therefore it is essential that the design and appearance immediately create a favourable image. If the consumer forms a bad opinion from the beginning, they may be more critical of minor service failures later on. (Palmer, 2001) Therefore it is essential for hospitals to be kept clean, buildings to be kept in good condition and receptionists to always look smart and professional. All employees who come into direct contact with consumers throughout their service experience must also portray the correct image. For example nurses and doctors
should always look clean, friendly and professional. Atmospherics is “the way in which marketers can plan for and provide an atmosphere. ” (Woodruffe, 1995, pg. 196) Many NHS consumers will be nervous, so waiting rooms often play calming music and provide comfortable seating to make them feel more at ease. Toys are also available for children and magazines for adults to make waiting times (queuing) less aggravating. “At its most basic, quality has been defined as, ‘conforming to requirements'” (Crosby, 1984, cited in Palmer, 2001, pg 208).
In contrast to this statement however, it has been suggested by Juran (1982) that quality concerns, “fitness for purpose” (Palmer, 2001, pg 208). Devices have to be constructed to measure whether a service, such as the NHS, is ‘conforming to requirements’ and ‘meeting its fitness for purpose’. In reality it is clear to see that it is the needs and demands of the consumer that dictate how a service measures itself in terms of ‘requirements’ and ‘purpose’ (Palmer, 2001, pg 208). With this in mind, perhaps the research would benefit from looking at the consumer perception of technical and functional quality:
(Based on Gronroos, C. (1984) Strategic Management and Marketing in the Service Sector, Chartwell-Bratt Ltd – (cited in Palmer, 2001, pg 209))One of the key ways to measure success is through analysing responses of users. This is one of the easiest and most effective ways to monitor customer satisfaction. “The NHS can only achieve high quality outcomes if it pays attention to the quality of its communications with internal and external publics. This means asking patients what they want, listening to their replies and shaping services to meet expressed needs.
At the same time, the needs and experiences of those within the organization must also be addressed. Staff who are ignored or abused are often incapable of paying proper attention to the needs of client groups, or of communicating a positive image of the organization concerned”. A critical incident is defined by Bitner, Booms and Tetreault (1990) as, “specific interactions between customers and service firm employees that are especially satisfying or especially dissatisfying” (Palmer, 2001, pg 63) Communications of this nature occur daily throughout the NHS.
The term used for such service encounters in the organisation is MPC (Multidisciplinary Pathway of Care). MPC ensures that patients follow a strict plan of treatment from the moment they enter a hospital to the moment they leave it. A multidisciplinary pathway of care can be defined as: “a multidisciplinary process of patient-focused care, which specifies key events, tests and assessments occurring in a timely fashion to produce the best prescribed outcomes, within the resources and activities available for an appropriate episode of care”.