The 2008 Olympics reaffirmed the proposition that it is possible to keep improving on excellence and perfection in sport.

The Beijing crowds saw 132 new Olympic records and 43 world records, with Afghanistan, Togo, Tajikistan and Mauritius winning medals for the first time. While it was taking part that was supposed to matter, the glory and interest was heaped on gold medallists who raised the threshold of perfection.

Perfect Pizza, www.aperfectcareer.co.uk, and Perfect Pieces, specialists in British pottery, demonstrate the thirst of businesses to link to the concept of perfection. It could now be time for NHS organisations to move beyond the campaign to be employers of first choice to the pursuit of perfection. What must they do to earn the mantle of being the perfect employer?

Catharine Arnold's new book Bedlam: London and its Mad describes the conditions at the Bethlem Hospital, which opened in the mid-13th century in Bishopsgate. "While the monks sold off the land and the chapel roof fell in", the hospital became a "byword for thieving, degeneracy and institutionalised corruption". It is unlikely that it was known in the labour market as a perfect employer.

Pulling Through, the 2008 Confederation of British Industry annual employment trends survey, has identified effective people management and availability of the right skills as the top factors contributing to competitiveness. When asked which HR factors were essential to success, management skills came out top (53 per cent), with workforce skills second (44 per cent). This ranking is consistent with the trend since 2001. Flexible working practices are rated higher than low labour costs.

Perfect employer

The pursuit of perfection could be the right target for NHS boards - rather than the less ambitious desire to be better than the pack. Aiming to be the perfect employer rightly allows a degree of competition as well as accommodating collaboration where circumstances and the need for greater economies of scale exist. The perfect employer will balance flexibility with certainty, and opportunity with common purpose. Perhaps the employer closest to perfection never accepts it can get there.

There are different perspectives on employment perfection. The applicant wants their ideal job without competition, the line manager wants a choice of recruits and the taxpayer demands value for money, with a pound of productivity gain for every pound of investment. The perfect employer also disappoints, by undermining other employers and being unable to meet the aspirations of all its staff.

The NHS staff survey could help to identify how far the employer has to go to reach perfection. A quarterly assessment of what staff think of their leaders' commitment to putting customers first could be revealing. As indeed could whether they think they have enough colleagues, whether clinical services would be worthy of their family and friends, how positive they feel and how much they want to leave to get away from their line manager: a perfect test for imperfect employers.