My friend B has been dismayed by the poor standard of treatment her husband has received at their local acute trust.
First he is dumped in a geriatric ward with an orthopaedic problem. Then reasonable requests such as “how do I get headphones for the TV set we have rented?” are treated as impertinent infringements of a nurse’s time with a hand held up, traffic cop style, to stop the question in mid flow. Then his discharge is delayed because it is a weekend. The litany goes on.
At a social event, B meets the chair of the primary care trust that spends 80 per cent of its commissioning budget with this trust. She starts to explain her disappointment. B reports that this chair simply could not accept that it was an issue for the PCT and shrugged her off by saying she should write to the hospital.
The NHS spends huge amounts of its budget settling claims that could easily have been resolved at the earliest stage.
Complainants will say that it is not money they want but an apology plus reassurance that the organisation has learned from its mistakes. Complainants describe feeling unheard, of letters going unanswered and legitimate criticism being fended off with inefficiency, lies or indifference.
Of course customers can be annoying. It is horrible to listen to people - as you see it - irritatingly whining, when you are trying so hard to get everything right, sacrificing your energy and skill. It is easy then to view complainants as ingrates.
In fact, in the NHS it is often difficult to take even the first step. In wanting to comment on our local district nursing service, it took my husband four hours of detective work to find out who managed this service and then a further two weeks to persuade her to answer his messages.
A successful organisation actively solicits spontaneous feedback, making it easy to offer bouquets as well as brickbats.
In the NHS we often have the reverse.
The writer Eileen Shapiro describes pseudo-empowerment: a phenomenon where despite targets and objectives, no one is really accountable for anything, or else accountability migrates mysteriously to someone else.
In the early days of the sandwich chain Pret A Manger, the chief executive printed his name and phone number on every bag. Not quite believing his astonishing promise to respond personally to feedback, I rang this number and found I was speaking to the man himself. He dealt charmingly with my comments, and I have been a loyal Pret customer ever since.
Why could we not have some simple feedback mechanism like this on every ward, in every GP’s surgery and every clinic?
There is an additional twist to my friend’s tale. Until recently, she was a PCT chair herself. As she commented ruefully, “I thought I knew how to make the system work in a joined up, quality way. But it turns out I didn’t.”