Lord Darzi's next stage review sets out that the NHS will begin systematically measuring and publishing information about the quality of the care it provides. Measures will include patients' views on the success of their treatment and the quality of their experiences.
However, the report does not detail how patient satisfaction will be measured.
The private sector in the UK and healthcare providers in US have been measuring satisfaction for some time. Like other well-run organisations, they use customer satisfaction surveys:
to ensure customers are receiving the best service and care;
to maintain and improve standards continuously;
to benchmark service standards against competitors;
to gather feedback on what customers value and how to improve;
to retain customer loyalty.
What is customer satisfaction?
The Chartered Institute of Marketing defines customer satisfaction as the provision of goods or services that fulfil the customer's expectations in terms of quality and service, in relation to price paid.
Measuring customer satisfaction
Customer satisfaction should be measured on a continuous basis so trends can be tracked and any issues can be picked up quickly and acted on.
Measurement should include all aspects of the service provided.
Service levels should be rated from 1 to 5, good to bad, so ratings can be compared over time.
Customers should be encouraged to give feedback on what they valued and what could be improved - this is exceedingly valuable information.
It must be confidential and anonymous.
It should be completed after the treatment episode once each patient has returned home.
Staff should encourage patients to complete the questionnaire.
Unlike patient experience, patient satisfaction must be measured continuously. There is no point in having satisfied patients for one day a year. This means a properly randomised sample of all NHS patients from each ward, department and tier throughout the year must be used.
To track improvements, a standard rating assessment should be introduced for each aspect of care - administration, catering, clinical, nursing, reception, and so on. There should be a number of opportunities for patients to give feedback on what they most valued and what could be improved. The latter should be seen as the most valuable to improve standards.
Measuring satisfaction while patients are still undergoing treatment in hospital will not give valid results. This is because patients may feel vulnerable, not in control, grateful, in pain and unwell. They should be sent a paper questionnaire one month after completing a treatment episode, ensuring first that they have not been readmitted or died in that time. It is very important that all staff encourage patients to complete the questionnaire as it will help improve the response rate.
Tools for improvement
Many will only judge the hotel services and interpersonal contact and care, not clinical treatment. There will probably be only a small number providing useful feedback, but this is invaluable to improve standards. It is important to use other methods of patient feedback as well.
Above all, patient satisfaction surveys should be seen as an important management tool, not a way to produce positive spin. Any feedback must be acted on. If staff are praised, tell them and reward them; if they are criticised, act on it to make sure it does not happen again. Some private sector healthcare organisations take this very seriously and the patient ratings are part of their managers' appraisal and bonus scheme.
The NHS should use customer satisfaction to raise standards. It is critical that the opportunity to measure, evaluate and act on patient satisfaction is given the importance and resources required to do it properly if we want outcomes on a par with the rest of Europe and the US.