Set up just over 50 years ago, the NHS is the largest organisation in Europe. (7 Dec 2002, www. nhs. uk) It is a state run, not-for-profit establishment, offering direct, primary and secondary care. It is a professional, labour-intensive and high-contact service, which is carried out by a service provider such as a doctor or nurse, thus also making it a primary service. Marketing is “as important in health care as in business.
” (Caroline Ashley, 1998) As well as the traditional “four P’s” considered in a traditional marketing plan, being a service, the NHS must also consider the additional three: people, processes and physical evidence. “The process of delivering a service involves a chain of related services and servers and the successful enactment of a wide range of behaviours. ” (Solomon et al. , 1985; Zeithaml et al. , 1990 cited in Dobni. D et al. , 1997). It is essential that quality control procedures be in place throughout the chain, to ensure quality service outputs.
“The inseparable nature of services means that the human element forms an intrinsic part of the services package,” (Woodruffe, 1995) thus making the role of the employee extremely important. “Approximately 1,166,000 people work for the NHS,” (The Department of Health, cited in the Guardian, 2002) accounting for an enormous proportion of total costs. “Customer perceptions of quality are frequently influenced directly by the actions of service personnel.
” (Woodruffe, 1995) Therefore, due to the intangible nature of the NHS and the subsequently high levels of customer-producer interaction, “people” are the most important “P” within the marketing mix. Defined by Berry, (1980, cited in Palmer, 2001) internal marketing is “the means of applying the philosophy and practices of marketing to people who serve the external customers so that the best possible people can be employed and retained and they will do the best possible work. ” “Central to successful service delivery is management of the customer/provider interface.
” Due to the highly inseparable and perishable nature of NHS services, direct control is impractical, so NHS staff are responsible for their own actions. This is empowerment. (Palmer. A. , 2001) It has been achieved by the further decentralisation of control, giving increased responsibility to local authorities and front-line staff. (NHS, http://www. nhs. uk) Empowerment is believed “to lead to better staff and customer relations and higher levels of service quality through employee pride in the job and individual ownership of problems and short-falls. “