Pressure on the NHS to deliver a better patient experience continues to grow
The latest customer experience excellence report from my colleagues at KPMG Citizen Experience Excellence might make for some uncomfortable reading within NHS organisations.
Research undertaken last summer shows that much of the goodwill that the NHS benefitted from at the height of the Covid pandemic has now dissipated. The sympathetic appreciation of frontline staff’s efforts that was clear in2021 research has long since gone.
Instead, we now see dissatisfaction, driven by a perceived disconnect between patients’ healthcare expectations and the service they actually receive.
To reverse the decline in positive sentiment, the NHS needs to work even harder on providing care that is designed with customer at the heart (interestingly, the majority of respondents see themselves as customers of the NHS so let’s persist with the terminology). That means combining both quality care with improved customer access.
While that hardly sounds like rocket science, wait time expectations and the quality of virtual health interactions were cited by our respondents in our most recent research cycle as two of their greatest NHS frustrations.
Virtual interactions were seen as inferior compared to face-to-face interactions, with customers highlighting a lack of compassion and empathy. Meanwhile, insufficient communication and poorly set expectations around wait times have come to define the customer experience. Forty percent of respondents claimed they could not get to the right person or the right place at the first time of asking.
Our Customer Experience Excellence (CEE) research programme has been identifying customer best practice for the past 13 years. In that time, it has generated 5.5 million customer evaluations, undertaken 4000 detailed brand reviews and conducted over half a million customer interviews.
Over those 13 years, the CEE Centre has measured customer experience across six different dimensions - empathy; personalisation; time and effort; expectations; resolution; and integrity. Net Promoter Scores (NPS) are also incorporated into the research as a measure of customer satisfaction and to understand what matters most to citizens.
The most recent CEE UK research took place in June and July 2022. Specifically for the NHS, this generated almost 9000 responses and 1600 feedback comments.
Compared to the 2021 findings, the NPS for the NHS reduced by 50 per cent, falling from +34 to +17. The percentage of respondents who would actively recommend the NHS to others fell from 52 per cent to 43 per cent whilst the percentage who deter others from using the NHS increased from 18 per cent to 26 per cent. Rather than fixating on the scores however, it’s more important to focus on the reasons why they’re moving in the way they are.
The reasons why
Within the research, the empathy, kindness and professionalism of frontline NHS staff was shown to be the biggest contributory factor to a positive patient experience. Over 80 per cent of respondents felt that staff were friendly, courteous and honest. NPS increased by 50 points where this was the case.
At the other end of the spectrum, disjointed services, difficulties in accessibility and shifting patient expectations contributed to the poorest experiences. For example, NPS drops by 41 points when the NHS doesn’t recognise a patient’s previous interactions (something that happens on 40 per cent of occasions). It decreases further still (by 49 points) when healthcare services are difficult to access; when there are long wait times or slow follow-ups.
Issues such as this combine to take the shine off the high quality of care that is typically delivered once all the various barriers to access have been overcome.
The research also demonstrates a growing disappointment in a service that is no longer perceived as going above and beyond. With the pandemic receding into the past, any previous tolerance for failing to meet patient expectations is now waning. While still understanding the pressures the system is under, patients no longer feel it is delivering what they expect of it.
A hint of a silver lining
If there is a silver lining to be found here, it’s in how the NHS performs considerably better than the public sector average in terms of its customer experience. However, a large gap remains between the NHS and the customer experience leaders.
For the purposes of the research, 333 brands and 10 sectors were ranked on their customer experience maturity. Encouragingly for the NHS, it comes close to being in the top 50 per cent of all ranked sectors and brands. Compare this to the public sector average, which ranks in the bottom 10 per cent, and it’s clear that the NHS offers a considerably better experience than most of its public sector brethren.
Nevertheless, for the NHS to deliver truly world class care, delivering a world class experience is crucial. Learning from global best practice and applying this within a healthcare setting is a powerful tactic for reducing the gap between the customer experience leaders and the NHS.
In practical terms
But what does that mean in practice? Well, several things, such as ensuring that any future digital transformation is patient-led – because when innovation fails to take customer experience into account, it typically becomes unsustainable in the long term.
The best organisations also tend to make more provision for self-service. In healthcare terms, the benefit could be two-fold; reducing the waiting list backlog and creating leaner, more efficient pathways whilst also improving outcomes for patients whose health may have otherwise deteriorated further as they waited.
Those same leading organisations are also successful at using digital technologies as a workforce enabler. The NHS workforce is undoubtedly the organisation’s greatest asset. However, it still needs help, through digital investment and transformation, to remove unnecessary, time-wasting processes. This would help staff perform to the best of their ability and to meet increasingly demanding customer expectations.
These are undoubtedly challenging times for the NHS. A shrinking workforce, a lack of clarity over funding and concerns around social and community care are just some of the factors placing immense strain on an already-stretched organisation. In such times, having a truly customer-centric approach is even more crucial than ever
It’s only by understanding what truly matters to patients that the NHS will be able to combat its existing resource pressures whilst also delivering a world class experience.
To read the latest KPMG Citizen Experience Excellence research report in full, click here.