In the wake of planned spending cuts and head count reductions across the public sector, Jo Causon examines how maintaining ‘customer’ focus can minimise the impact on frontline service provision in the NHS.
The public sector cuts laid out in the coalition government’s emergency budget are set to have repercussions for the NHS for a number of years to come.
During the election campaign the political language was confined to efficiencies and productivity rather than cuts, while elsewhere estimates of job losses across the public sector range from over 200,000 to 500,000.
Public services, generally and specifically the health sector as the largest spending element within it, face a very testing time both at senior management level and on the front line.
At the Institute of Customer Service our view is that this is not the time to lose the customer focus that is beginning to take hold within the sector. Indeed, putting the customer at the heart of the service can bring significant operational efficiencies as well as well-motivated and focused staff who want to deliver for their patients.
I am not going to claim that improved customer service alone can find the estimated £20billion in savings that many estimate the NHS will be asked to provide by 2017, but the efficiencies that true customer focus can deliver should not be overlooked. It reduces time wasted dealing with unnecessary customer queries and, more significantly, complaints - which could be managed more effectively by clear customer information, communication and support. It also has a positive impact on staff morale and engagement which itself brings greater effectiveness by reducing absenteeism and sickness levels.
One in five organisations do not measure or track the impact of customer service on organisational performance. According to research conducted among our public sector membership in the spring of this year, those private sector organisations who deliver customer service excellence produce 71% more profit per employee. In public sector terms this equates to increased efficiency.
There was virtually unanimous agreement from the same group that customer service must be delivered ‘right the first time’ to achieve the required efficiency savings, with 70% recognising the need to drastically overhaul customer service to maintain or improve standards in the face of budget cuts.
There is no question that the desire to implement good service exists. The Institute has a growing number of members from the NHS and healthcare organisations, an indication of their strong commitment to the cause of customer service improvement.
In tandem, the Darzi review called for the focus to be shifted from availability of care to quality of care – more information and choice for patients, more personal attention, more input, and for the patient experience to be given much greater focus.
Public feedback to the Commission on 2020 Public Services showed strong support for the public sector. Most people believe NHS staff perform well but the sheer size of the organisation makes achieving across-the-board improvement in patient satisfaction daunting.
Daunting perhaps, but not impossible, and no more than patients and their families have a right to expect. And customer expectations are rising.
What really matters to patients is clear communication, sensitive interpersonal skills, an the ability to treat patients as individuals, a climate where staff are helped to make the right judgement based on a true understanding of what matters to the patient, and of course a transparent complaints system. People have come to expect world class medical care; they are now demanding similar levels of customer or patient consideration.
To achieve it the NHS must embed the notion of world-class customer service into the management structure of its organisations. Top-class customer or patient care is not just another ‘add on’, and needs a personal commitment from the chief executive to ensure that their people, processes, systems, strategies and underpinning culture are all focused on real patient needs.
Such an embedded customer service culture delivers real and sustainable returns on investment at a crucial time. For example, it can help a hard-pressed hospital to retain and develop its better staff who could be tempted to quit under the ongoing threats of job cuts. I; it can reduce complaints and lead to greater innovation as staff have the opportunity to input into improving processes as they see them on a day to day basis.
Front-line staff who know they are working within a true service culture, one shared by all of their colleagues and rewarded by their managers, will be more motivated and loyal and will perform. Instead of being demoralised by a dysfunctional customer care system splashed over the national and local media they will work harder and more efficiently.
Hiring people who are keenly interested in giving the best possible service is pivotal to first class customer care, which is why at interview level, for all staff involved with patients, interpersonal behavioural and customer-focused skills should be examined as well as professional ones.
Cambridge University Hospitals Foundation Trust, one of our members, is increasingly ensuring it recruits people with the right interpersonal skills, and customer care training is becoming mandatory for all 7,000 staff.
Permanent improvement is to be achieved such instruction should be integral to all NHS hospital staff training, from receptionist to ward nurse, from porter through to senior management, and should be ongoing and form part of their continuing professional development.
I am talking here about what is really the very essence of good customer care, of principles successfully applied by organisations large and small, public and private, across all sectors.
Can they effectively be introduced to the NHS? Of course they can. Some trusts and hospitals have already done so, or are in the process of doing so. From our close contact with many of them, we see a clear desire to improve their focus. What is required is for them to see things from their customers viewpoint, not their own.
Jo Causon is chief executive of the Institute of Customer Service