Improving the environment for 'customers' and making their experience of the organisation better are not issues confined to the NHS.

Many companies, especially those with face-to-face contact with the public, have tackled the same problems and found solutions.

So can the NHS learn from them? One man who thinks so is Steve McGuire, acting divisional director for property and support services at Leeds Teaching Hospitals trust, who has been working with Asda. The supermarket has many issues similar to a hospital. It employs a similar workforce to hospital support services, at broadly the same rates of pay; it has issues around communication and the dissemination of information, and motivating and valuing staff; and just as the public wants seamless service from a hospital, so it expects it from a supermarket.

Senior support service managers from Leeds are now spending time in Asda stores, seeing how they tackle these things and learning from their experience.

Although this experiment was set up before the NHS plan, it is relevant to many of the points the plan makes about support services.

Communication lines between shop-floor staff and managers; staff morale and how it can be improved; and delegated responsibility will all affect whether a spillage in a ward gets cleaned up now or two hours hence.

Mr McGuire, whose division employs 3,000 staff, is a relative newcomer to the NHS, having joined in 1993.

'Many of our working procedures are from 20 years ago, ' he says. 'When you look at other industries they have advanced beyond us. '

Areas where he feels Asda is well advanced include teamworking; attracting staff and making them effective; and communication.

So are there changes in the Leeds hospitals as a result of the Asda input? Yes, says Mr McGuire. Staff now get a full week's initiation programme.

There is a suggestion box, with anonymous and named suggestions welcome. The trust's two largest hospitals, Leeds General Infirmary and St James, have been broken down into blocks, each under the control of a manager who reports to a site manager.

Each block is similar in staff numbers to a supermarket.

And, he says, managers are beginning to think differently.

'Structurally and conceptually the work we do with Asda is helping to inform us and having a positive effect on the patient environment, ' he adds. 'What is not acceptable in a supermarket should not be acceptable in the NHS. '