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Wednesday 26 October 2016
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Customer care

Patient satisfaction is fast becoming a topic that practices are having to focus on and good customer service is also noted by patients. In this two-part series we begin with how practices can set standards

“The customer is always right” may have been a phrase coined by an Edwardian king of the retail sector – Selfridge’s department store founder Harry Gordon Selfridge – but it is also an adage that general practice is having to accept is becoming increasingly relevant to its own world.
In an era where a disgruntled customer is only a smartphone away from posting potentially damaging comments on social media, how they are treated – and how they feel are being treated – is key.
And with the Care Quality Commission (CQC) publishing inspections of general practice it has opened the sector to a new level of scrutiny; the importance of maintaining customer care is being given new impetus.  
However, customer service is not something formally advised on by professional associations.  
“We offer guidance for patients on what to expect from their GP surgery but customer service is not [outlined] in policy to members,” says a Royal College of General Practitioners’ spokesman.
General practices looking for specific benchmarks of customer service therefore have to look to those that apply to all service provision sectors, both public and private – or to develop their own.

Service satisfaction
The Customer Service Excellence Award (CSE), a government scheme that replaced the previous Charter Mark in 2008, aims to award providers ‘with the citizen always and everywhere at the heart of service provision,’ with particular focus on delivery, timeliness, information, professionalism and staff attitude. Including a total of 57 standards to be adhered to, there is also emphasis placed on developing customer insight, understanding the user’s experience and robust measurement of service satisfaction.  
In a sector as well used to measurement as general practice – and with as many providers as it contains – it might be expected that numerous surgeries have entered to achieve the award. However, of several hundred CSE award holders, just three are general practice surgeries, although other public sector providers, including local authorities (see Box 1) and the third sector are better represented.

Attitudes to general practice
Staff at the three practices that do hold the award concede that customer service may not always be at the forefront of considerations in a general practice setting.    
“I’ve worked in healthcare for 40 years and seeing the patient as a customer is a recent development,” says practice manager of the Park Green Surgery (A CSE award holder), Macclesfield, Isobel Chetwood. “The Patient’s Charter [first published in 1991] was a pivotal time as it really helped put in people’s minds that they had a right to customer service in the NHS.”  
Paul Williams, practice manager at fellow CSE award holder, The Fishponds Family Practice, Bristol agrees that attitudes have changed considerably in recent years.
“I came into practice management 10 years ago from a very customer focused sector and in those days patients were seen as more of a hindrance than being the reason we are here,” he says.
“All the clichés about the receptionists being the dragon behind the desk guarding the doctors from the patients, they were all there. You would think that people working in general practice would want to work with the public, but that is not necessarily the case. But for us it is about understanding the patients as our customers – and we need to look after them.”
His practice now looks to recruit receptionists from customer-facing ‘people’ sectors such as retail and human resources.   
Chetwood says to her practice that customer service is about “doing the best you can with the limited resources we have”.
“When you start on the [CSE] process you realise that there is a huge amount that you can be doing already, without badging it as customer service. There is also a lot of overlap with CQC inspections.” The Macclesfield-based practice also has its own customer care policy, which it developed around six years ago.

Managing expectations
Putting the patient at the heart of everything the surgery does, while also managing the expectations of patients in an increasingly 24/7 society is key to providing customer service, she adds.  
“It’s a difficult balancing act. But limited resources are not an excuse for poor service. Our staff know you have to put yourself in the middle and think about everyone you have contact with.
“So it’s about not just saying no without an explanation. The most important thing is to listen and to always get back to someone. It is so annoying for a patient to not get a reply.”
Williams agrees about the importance of responding to patient concerns. When his Bristol-based surgery’s patient survey highlighted complaints about the difficulties of getting through on the telephone first thing in the morning, it responded by ensuring eight staff members answer the phones from 8am, until the number of calls tails off. There are also no telephones behind reception.
“A patient trying to talk to a receptionist doesn’t want to see them answering the phone,” he says.
Patient care manager and acting practice manager at the third CSE award holding surgery, Holycroft Surgery in Keighley, West Yorkshire, Joanne Towers, says going for the award helped the practice get a more rounded view of what constitutes good customer service – but adds that this is crucial for the sector.  
“The future of general practice depends on our ability to engage with and look after our patients,” she says.
Williams is just as equivocal in what the consequences can be for a surgery offering poor customer care.
“Patients have a much better understanding of what the market place is and they will vote with their feet if they are unhappy with what you provide,” he says.

Emma Dent is a freelance health reporter.