Dr Simon Atkins and Paul Williams explain how their practice won the Customer Service Excellence Award by improving patients’ experience.
How keen are we to attract new patients and to retain those we already have? The answer for most of us, in this increasingly uncertain financial climate, will be that we are very keen – but we may not have much of a clue about how to achieve it.
Of course, up until now it hasn’t really been an issue, as patients have traditionally been very loyal to their family doctors and have been unlikely to change practices unless they moved house. So we may have been guilty of taking our patients somewhat for granted, safe in the knowledge that the chairs in our waiting rooms are rarely left unoccupied for long.
However, the environment in which we operate has changed dramatically as the public services have been made to pay the price for the financial crisis.
The market has us by the throat, and armed with increasing amounts of information about their practices patients are being encouraged to challenge its performance – and if they are not happy, to take their coughs, colds and QOF-able illnesses elsewhere.
As practices, we need to respond to this, but unlike other organisations we are limited in how we can attract and hold on to our custom. We certainly can’t give away free holidays like the newspapers do, or make glossy ads to tell people to come to us because they’re worth it. When it comes to the crunch, we just have to roll up our sleeves and show them.
In our practice we set up a small working group composed of members of the various practice teams, to look around for ways in which we might be able to improve our service based both on our own impressions and previous patient feedback.
What is obvious when you visit any business with an excellent reputation for customer service is that it’s not just one part that works well, it’s the whole.
When you go to a popular restaurant, you don’t just expect good service from the waiting staff, delicious food from the chef and a decent drop of wine from the sommelier. If the cleaner has had an off day and you’re sitting among other people’s crumbs, it ruins the whole effect. Everything has to be of high quality and everyone has to do their part.
We agreed that we wanted our patients to have that type of positive experience of care and service, from the moment they entered the health centre to the moment they headed out again. This would obviously mean everyone in the team – receptionists, secretaries, cleaners, clinical staff and managers – working hard together to improve our service overall.
This would hopefully not only demonstrate to our patients how well we wanted to take care of them, but – with so much of our funding related to list size – to enhance our reputation for all-round care in general.
What we did
We decided to try and improve our patients’ overall experience by achieving the Customer Service Excellence Award. This is a Government-backed scheme that gives recognition to public-sector bodies and departments (including GP practices) following an assessment across key areas of customer service.
The first thing we had to do was to look at the relevant website, as this gives information about the scheme and points you in the right direction to get started.
On initial reading of the website the task looked quite daunting, but after becoming more familiar with the detail we were pleasantly surprised to find that, thanks to measures already in place, we already met two-thirds of the requirements.
How we did it
A key element of the Customer Service Excellence Award is gaining an understanding of your customers (patients) and delivering services that meet their specific needs, as no two practices – however close geographically – will have the same patients. This involves some form of consultation with patients, be it through questionnaires or through consultation with a patient group.
As an example, we felt that our patients’ experience would be enhanced if we had a specific customer care policy. To achieve this, we first met with our staff to gain their buy-in, and then our patient group to gain their acceptance and advice about areas for tweaking. They very much felt from past feedback that the patient’s experience on the telephone and at the reception desk could be improved upon.
We then came up with our eventual policy, which makes a number of promises to our patients about the ways in which they can expect to be dealt with.
It explicitly states that we will deal with people quickly, fairly and in a courteous and helpful manner, and that staff will take personal responsibility for dealing with queries, answer them as thoroughly as possible and seek further advice from colleagues if needed.
There are standards concerning face-to-face contact such as enabling access, welcoming visitors within five minutes of arrival, respecting privacy and wearing identification badges. On the telephone, it states that we aim to answer within six rings and call someone back if their query can’t be answered at first contact.
There are also standards for replying to letters, emails and text messages within certain timeframes – with five days the maximum for a full reply.
In return, the document lists expectations we have of our patients – from being courteous to staff and keeping appointments, to making suggestions about how to improve the service.
We publicised its existence as widely as possible through our newsletters and by displaying it on our website.
Using guidance through an online self-assessment tool provided on the Customer Service Excellence Award website, we judged when we felt we had sufficient evidence in place in all areas to invite an independent assessor to visit us to consider our suitability for the award.
This involved about 70 hours of work which we spread over six months. Because we are a practice with almost 13,000 patients, we were allocated two days for our final assessment. This involved the assessor working through each of the 57 component parts to the award and satisfying himself on whether we had met the required standard for each one.
In many cases, this was done through discussion with the practice manager and a review of the documentary evidence. However, it also involved review sessions with all sections of the practice team, including GPs, practice nurses, secretaries and receptionists.
This allowed the assessor to get a feel for the culture and delivery within the practice, rather than just relying on what the practice manager said.
Finally, the assessor tested the final delivery – by both observing in our staff reception area and by sitting in the waiting room and randomly talking to patients about the practice and the service they received. He also met with our patient group over lunch to gain additional evidence about how we consult with our patients.
At the end of the two-day assessment, the assessor fed back his comments to our practice manager about whether we had met each of the standards and his rationale for coming to his decision. He then indicated whether he would be recommending us for the award.
We were naturally delighted when he did, as it was due reward for all the hard work that had been put in.
It has undoubtedly generated some good PR for the practice, and has been a feel-good factor for staff and patients alike. However, it is important to remember that obtaining the award is not some sort of publicity stunt, as it can genuinely be used as a tool to examine existing service delivery and to make real improvements to the patient experience.
It is also a way of generating pride in the practice team, as everyone contributed to the achievement.
We firmly believe that this has had a very positive effect on our practice, as our patients and our staff now have a tangible structure upon which our service delivery is based.
It is crucial to understand that winning a customer service award is an ongoing process. Although we were granted the award for three years, it is subject to a partial annual review as part of a rolling process to keep us on our toes and ensure standards are at least being maintained or even enhanced still further. Our practice manager also regularly monitors the standards assessed to ensure we are not slipping up in any areas.
We have been happy to share our experiences with other local practices who have expressed an interest in enhancing their customer service standards.
We certainly feel that our patients and our staff have benefited from going through this process and would happily recommend it to anybody else seeking to improve their practice.
Dr Simon Atkins is a GP and Paul Williams is a practice manager at The Fishponds Family Practice, Bristol