The end of hospital car parking charges?

Moves to end hospital parking charges One of the most emotive aspects of charging for car parking is receiving attention from the NHS. The following reports from the BBC and the Independent provide the important details. The BBC reports that Andy Burnham, the Health Secretary has outlined proposals to phase out hospital parking charges for in-patients and some out-patients which he says have caused “great resentment”. The health secretary pledged a “fairer” system for relatives and friends of people admitted to hospital in England.  He is looking at whether to abolish ees for all in-patients’ visitors – or just those admitted for a long stay.  For out-patients he will look at free parking, or a cap on charges, for those who need to make regular appointments.  Parking is already free at most hospitals in Scotland and Wales and for certain priority groups of patients in Northern Ireland. ‘Frankly confusing’ Mr Burnham announced in September he wanted to phase out over three years charges at hospitals in England for patients who are admitted. But the eight-week consultation – which runs until 23 February – will also look at charges for out-patients who have to make regular appointments – like cancer patients with regular chemotherapy sessions. Further details on the BBC coverage can be seen at http://news.bbc.co.uk/1/hi/uk_politics/8433395.stm The Independent also provides a detailed coverage of the same proposals for consultation with the following report  http://www.independent.co.uk/news/uk/politics/burnham-launches-hospital-parking-review-1852369.html Burnham launches hospital parking review By Paula Fentiman, Press Association Tuesday, 29 December 2009 People will be asked their views on proposals to abolish charges for some out-patients as well as in-patients. Mr Burnham pledged to phase out car park costs for in-patients over the next three years when he addressed the Labour Party conference in September. The Health Secretary also said he wanted to introduce parking permits to allow friends and relatives to visit in-patients for free. The eight-week consultation will ask if free parking should be available for visitors to all in-patients or if it should only become free for friends and relatives of those admitted for a long stay. It will also suggest options to make parking charges fairer for out-patients. These include giving access to free parking for those who need to attend a series of appointments or placing a cap on charges for priority out-patient groups who attend regular hospital appointments. Mr Burnham told GMTV: “I am aware of the strong feelings on the issue and to be honest I don’t think the NHS has given the attention it deserves to this issue because people do feel very strongly about it. “What I am saying is that people who are going into hospital are often at a low point in their life emotionally or financially. “The cost of parking can add extra pressure to them so I am saying we need to do more to recognise that and to have fairer parking charges across the NHS. “The consultation we are launching today is to develop a clear set of principles that we can apply across the system and that is why I want to hear people’s views.” He said out-patients receiving regular treatment such as chemotherapy or dialysis could face “very serious charges too” and asked for views on both in- and out- patients. The Health Secretary said he noticed the problems caused by parking costs when his father was in hospital earlier this year. “It really brought home to me how some people were not getting the number of visits as others were because their family could not afford the charges,” he said. “I am very clear that that is a part of patient care, having regular contact with the family. It can help people recover more quickly.” Mr Burnham acknowledged it cost the NHS money to run secure car parks in hospitals but said there was a “balance to be struck”. “It is right that we make sure that the funds that are raised come back to benefit patients,” he added. “I also believe there are efficiencies that hospitals can make that can make this affordable to them so we’ve thought carefully about it. “We want to get the balance right.” Mike Hobday, head of policy at Macmillan Cancer Support, said: “We are delighted that the Government has finally listened to our repeated calls and is now looking at giving free parking for all cancer patients. “At long last the Westminster Government has acknowledged the high cost to patients and it is time they abolished these charges once and for all in England. “A recent poll by Macmillan showed that eight out of 10 people want the Government to abolish hospital parking charges for cancer patients. “Hospitals save £6,000 by delivering a six-week course of radiotherapy on an out-patient basis – money which could, and should, be used to help all cancer patients with the cost of parking. “We hope that the consultation will result in the lifting of a great financial burden for cancer patients. “Charging people to visit hospital to receive life-saving treatment has caused needless distress for far too long and is nothing more than a tax on illness.” The average charge for hospital car parking per hour in England in 2008/9 was £1.09. All trusts are expected to have concessionary schemes to offer reduced price or free parking for patients who visit hospital regularly and the trusts are responsible for ensuring that eligible patients are aware of concessions. The Department of Health consultation will close on 23 February next year. Customer Entitlement aims to examine the consultation proposals and present them here for analysis and feedback. The issues of interest for Customer Entitlement are: How did the NHS adopt a policy of car parking charges for patients and their visitors? What was the extent of the previous consultation? Were key issues effectively debated? What was the ultimate rationale for the adoption of charges? What has changed now and what lessons have been learnt? How significant is car parking income for hospital budgets? How did hospitals become so reliant on what must be a small proportion of their income? Many hospitals have opted to increase their charges for car parking rather than cutting costs elsewhere. How do they justify this?

British Airways in distress: Whose head should roll?

Customers come last…

The concerns of passengers, who are loyal to British Airways like this writer, will have minimal hearing in the next few days. The bigger issues of the day will be how British Airways will be posturing to take on the unions in trying to settle the potential strike which has been announced to hit the holiday traveller over Christmas and New Year.  ‘Big business’ wrangling is going to become very big, when the problem is actually quite small.

As early as August this year, there has been a slow build up of concerns and more information has been made available to the business Press about BA’s woes in the current economic recession. It goes without saying that the economic downturn can either be treated as the cause of the airline’s current problems or the excuse for not taking timely action in the past. In large scale asset hungry businesses such as airlines, costs do not escalate overnight. The number crunchers in British Airways’ finance team must have known how much of a downturn would be ‘needed’ to bring the airline on its knees. They would have almost certainly prepared projections of falling demand and escalating costs curves which would bring the airline closer to high levels of risk if not disaster. But at a time like this, the choice of vocabulary has to be closely guarded just as the mudslinging between the airline and union needs to be curtailed. The blame game may turn bitter and powerful negotiating ploys may be used to achieve temporary ‘advantage’ as far as managing the image of the airline as well as the union is concerned.

Customers are more interested in seeking an early resolution and but should their loyalty not come with a price? It seems that a six monthly revenue downturn of 13.7% up to November was enough to create a serious situation for BA even when it had set June as the deadline for taking firm action. It is not clear why the last few months have not sent serious signals to British Airways’ management to take firmer action. This is not to suggest that they have been complacent.  But they seem to have ignored the fundamental and some of the most basic rules about cost containment:

• Costs are dealt with as a problem only when they are seen to be a problem. How does the airline communicate with its staff and how effective is its strategy for ensuring that staff is able to recognise that serious turbulence may lie ahead? Airlines, like banks, tend to acquire a ‘dream world scenario’ that life will always remain cosy and that the problem is far too big to affect them in their simple lives. ‘They’ meaning the management and even Government will always find a solution. Has this been the case at British Airways?
• Costs can only be contained at the level at which they are incurred. So, much of the cost burden, which is high fixed cost is created by management working under various assumptions relating to risk. Considering the access to resources and vast amount of professional expertise at their disposal, the finance managers at BA must have seen the problem coming assuming that they were committing time to preparing business models under various conditions of certainty and risk. They weren’t? Is that really so?
• The third rule of cost improvement is that they have to be ‘managed’ rather than ‘reduced’. Cost management implies control and confidence in dealing with emerging costly scenarios. Cost reduction suggests that hatchet-men ( these days there are also women) are on the warpath again and that under certain conditions, they prefer not to talk to anyone except senior bosses and boardrooms who expect to hear good news as soon as costs have been slashed. This is clearly a simplistic view but it remains to be seen when BA started to manage its costs and at what stage it drew out the hatchets from their armoury.
• The fourth rule for cost management is that people should be held accountable for cost. It should be clear in their job descriptions that they have serious responsibilities for managing costs at a time when realistic solutions are possible to identify and implement. However, it is also clear that as investors seek higher returns and greater recovery rates from their investments, they could well be the very people who place their own funds at risk. Managements then get caught in frenzy and more and more risks are taken assuming that the dreadful reality will stay away. Did the cost managers at BA stand up to senior management and fulfil their own accountability for cost? Indeed, is cost control a key accountability in every budget-holder’s job description at BA? How is it enforced? Do they get relevant information in time and in a form that they can understand?
• Professional top managers seek help from organisation developers. Today, many would consider this to be ‘old school’ when the advance of the accountants and information technology specialists has tended to divert attention away from specialists who understand the behavioural process which underpins management decision making and secure company-wide consensus to managing change. After all, people who know how to swim against the tide are also those who help chief executives to develop consensus in the organisation and sell the consensus through successful action in bringing about the transformation.

If you have been reading this so far, you will want to know how the problems are going to be resolved. One interesting way is the approach taken by Japan. In its analysis of the situation at British Airways, the BBC reported on the approach taken by Japan’s “Enterprise Turnaround Initiative Corporation which buys the debt of companies in trouble and sends in turnaround specialists to help them restructure their operations.  The body, established a few months ago, operates like an investment fund and initially has been authorised to release up to 1.6tn yen in state-guaranteed funding to companies” said the BBC in last month.

The second way of resolving the problem is probably even too early to contemplate. The present dispute must be sorted out without too much pain to staff and customers. Just before my family uses British Airways again in January next year, hopefully well after the strike will have come to an end, I will nominate the people or the group who should be removed from British Airways for a new start to be made. It will not be Colin Walsh. That would make the solution too simple and predictable.  Customers like me will continue to support BA but our support must come at a price.

Focus on ‘Consumer Focus’

Consumer Focus may need to focus on itself; what is in store as the restructured organisation seeks a new Chief Executive?

 

Consumer Focus is described as ‘the new statutory organisation campaigning for a fair deal for consumers ….’. Its statement which accompanies application details for the new post of Chief Executive says that its ‘role is to put consumer across the UK at the heart of business and government decision making.’ The literature goes on to say “We will be the voice of the consumer, and work to secure a fair deal on their behalf. We were created through the merger of three consumer organisations – Energywatch, Postwatch and the National Consumer Council (including the Welsh and Scottish Consumer Councils). The new approach allows for more joined-up consumer advocacy, with a single organisation speaking with a powerful voice and able to more readily bring cross-sector expertise to issues of concern”.

Consumer Focus has strong new legislative powers. These include the right to investigate any consumer complaint if it is of wider interest, the right to open up information from providers, the power to conduct research and the ability to make an official super-complaint about failing services. Its first challenge may be provided by public services. Will Consumer Focus track the work of public services under emerging expectations, given there are likely to be spending cuts? Will a statutory body consider it appropriate to follow and ‘expose’ the dynamics of the public sector of which it will be a part?

This is what Wikipedia has to say on advocacy (http://en.wikipedia.org/wiki/Advocacy):

“There are several forms of advocacy, which each represent a different approach in the way change is brought into society. One of the most popular forms is social justice advocacy.

Although it is true, the initial definition does not encompass the notions of power relations, people’s participation and a vision of a just society as promoted by social justice advocates. For them, advocacy represents the series of actions taken and issues highlighted to change the “what is” into a “what should be”, considering that this “what should be” is a more decent and a more just society (ib., 2001.) Those actions, which vary with the political, economical and social environment in which they are conducted, have several points in common (ib., 2001.) They:

• question the way policy is administered
• participate in the agenda setting as they raise significant issues
• target political systems “because those systems are not responding to people’s needs”
• are inclusive and engaging
• propose policy solutions
• open up space for public argumentation….”

The key issue for Consumer Focus is whether it sees itself as a B2B, a business to business organisation which only talks to organisations similar to itself. There is some merit in this approach in that it can access accumulated knowledge and experience of the 200 odd organisations that it claims to have consulted. However, how will it engage with the general public?

The organisation admits to being well-resourced to use these powers and campaign on the issues that matter most to consumers and further saying “we’re the largest and the best-resourced advocacy body in the history of the UK consumer movement”.

The statement goes on to day Consumer Focus is “not an advice agency nor are we a statutory regulator. Other bodies such as Consumer Direct, Citizens Advice, local authority trading standards and the Office of Fair Trading play these roles. We do have an Extra Help Unit (EHU) for vulnerable ‘energy’ & ‘post’ consumers”.

This background information clearly shows that Consumer Focus has a great deal to do in sorting out in its own backyard before it can provide a cohesive and strategic service to the consumer. It will face a number of challenges.

This analysis did not aim to simply challenge the merits or demerits of its positioning. Is the structure likely to delimit the delivery of the stated goals? Which came first; the goals or the structure? It is hoped that the structure does not impede the delivery of goals. It would be interesting to know if the organisation’s corporate business planners had first created a series of customer focussed goals and then created an appropriate structure for delivery to facilitate the implementation plan; if form has not followed the function, there may be serious challenges for the new administration.

Delivery – the present organisation structure appears to be cumbersome and reflects a more of a civil service operating culture than that of a proactive and forward looking service organisation which can become attractive to clearly defined consumers and customer sub-categories. The organisation chart also shows country bias and focus where vertical structures are connected to each other to form a business model. However, the lack of clarity in relation to identifying cross-cutting service drivers may create problems in the very near future. What a new organisation cannot afford to carry on is to repeat its bureaucratic model where each country director may have to create a probably isolated knowledge base as opposed to joined up the cross-cutting campaigns to reflect modern trends in customer service delivery model and its evaluation on a thematic basis.

The consultation process has identified four strategic campaign goals to achieve a fair deal for consumers; they are Value, Service, Access and Sustainability. Assuming that these goals represent a reasonable stating point, the challenge for the new chief executive will be to position these goals as service drivers and how they will deliver consumer benefits. Are the goals of the new organisation going to be congruent with the benefits that the consumer expects? What does ‘repositioning’ entail? This will depend on how Consumer Focus defines its primary markets.

The other key principles of the new organisation’s consumer strategy appear to be sustainable. Consumers are going to be helped to exercise greater personal responsibility and will be supported to do so through greater transparency and information provision; not a problem in itself but it remains to be seen how Consumer Focus will be empowered to benefit from this principle. Enforcement will ensure that business that ‘behave fairly are not disadvantaged by the few that attempt to break the law’. If the new org is not going to be a regulator or an advice agency, how are these principles going to be converted into targets for the organisation’s action plan so that they are stretching and measureable? The principle of change presents many exciting opportunities; consumers are going to have information about emerging consumer markets and the enforcers will be expected to deal with them. Does this suggest a watchdog function? If today’s announcement of the merger of Orange and T-Mobile telephone companies were to be approved on competition grounds, how and what type of information will Consumer Focus provide to ensure that it is objective advice to consumers and what action will the information providers expect from the consumer lobby or actual users? Given the need for clarity in the new organisation’s purpose, what will Consumer Focus expect from customers of these companies assuming that they get information on the new business model of the merged operations and insight into its cost and volume implications which will impact on customer service and best value?

Assuming that these concerns can be dealt with, what is the type of business profile and customer service ‘value image’ will the new organisation present? Consumers are more likely to ‘warm up’ to the new organisation if they can relate to the proposed impact that it hopes to make consumer issues? Will Consumer Focus be able to discard its rather staid and civil service presence and realign itself to become a proactive and consumer friendly organisation which will be driven by creative digital technology to maximise its access to consumers? Could it be argued that Consumer Focus should more likely direct itself at lobby groups, delivery organisations and government departments? There is no doubt that there is a viable job to be done and Consumer Focus will find its feet but how long will it take for the new organisation to become effective and useful? There are two or three things the new Chief Executive will be able to say. The first is “Give me time, I am reorganising before I can deliver” and the consumer may have to wait for 2-3 years before visible results can be seen. Or is it likely to happen that the first chief executive may only be able to reposition and realign the organisation and that it will be the second incumbent who will more likely be able to make an impact?

Whatever the outcome, Consumer Focus will have to become very slick in its campaign if it is going to win the trust and respect of the public and the consumer in a relatively short time. The new chief executive will have a very demanding and visible role to deliver but given the concerns about the structural issues and the current business model, Consumer Focus will have a major challenge on its hands. The above analysis has tried to reflect the concerns of a lay member of the public.

What plans does Consumer Focus have to respond to these questions other than to rush to defend itself?  Our experience of challenging other service providers is that they either do not take bloggers seriously or they do not have the mechanism of responding to challenge or both. If this single blog is considered to reflect the opinion of one hundred silent observers, it may be doing a worthwhile job. Nevertheless, this blog is quite used to being ignored.

Shooting in the dark- recruiters who fail.

Recruitment Agencies Fail on Customer Service

One of the outcomes of the present recession is that as notifications of vacancies by employers have fallen, a wide range of agencies involved in recruitment and selection have also cut back on their own staffing. The is quite understandable as the cost levels of the agencies have not allowed them to retain staff who, in turn have not been able to place people in return for commissions. Agency recruiters who work under such conditions must feel the danger of losing their own jobs even on a daily basis if they were to fail to match the needs of the job hunter with demands of the advertiser on a regular basis.

It seems however that many recruitment agencies which normally try to protect their reputations against poor service may have, during the last six months at least, given up under pressure or decided that as the customer may have to become more tolerant of the agencies or face the risk of alienating them. A former colleague who has been looking for the last six months says “ It almost feels at times that the jobs squeeze has given the agencies special ‘powers’ to become less responsive and more arrogant when they deal with us”.  Let us hope that she is wrong.

The use of email to submit applications seems to have suited all parties involved in the recruitment and selection process. There should be better information flow, more opportunities to match people against live and ‘stale’ vacancies and to make the job search more customer friendly from the point of view of the job hunter. The reality as reported by friends and colleagues suggests that something else may have been going on. Agency bosses and operators have a hard task of matching skills in their own teams. The decisions that are being made to provide strong and proactive support to recruiters and interviewers seems to be producing variable results. Under normal trading conditions there must be a critical mass of vacancies that sustains the overhead costs of the agencies. It seems that during the last three months the balancing act has been largely failing or even abandoned by agency managers.  Senior candidates for prestigious jobs talk about sending their applications to well established agencies and losing them in cyberspace or the IT ‘hole’. Very few agencies seem to be sending out acknowledgements confirming receipt of applications and there is extremely limited feedback on how the processing of applications even for time-sensitive jobs may be progressing. The agency is the ‘king’ and customer has been dethroned. Has the customer lost their importance just because there are more applicants and fewer jobs? Serious and honest answers are needed if good candidates are not to be stopped from applying. In that case the prospective employer pays the price. International agencies have also been known to disregard good recruitment practice for many years in preference for cost savings.

It would seem that there are systemic failures in agency operations.  With a few exceptions, most agencies have not installed automated response mechanisms suggesting that they are actually much smaller than their advertising board seems to suggest or that they have not made the right decisions relating to digital business design. Perhaps they ought to be taking a few tips from Slywotzky and Morrison who say that ‘Becoming a digital business is not about having a great website, setting up separate e-businesses, having next-generation software or wiring your workforce. It’s about using digital technology to become unique…to create and capture profits in new ways”.

It is said that the tail-end of the recession is a good time to invest in new forms of efficiency creation. Where agencies have lost good consultants or support staff, the least they may want to consider is to upgrade their digital preparedness.

There is a final point. The recruitment consultants who took for expertise and skills in their clients may need to occasionally turn the mirror on themselves. While their skills in sector-specific knowledge and interviewing techniques may be beyond reproach, have they mastered the basics of the in-house digital response system which may be abandoned as junior staff has left?

One in a Million? A Customer Service Problem in the NHS

 

The protestors and rioters from last week, who took a stand against wealth creation should perhaps also recognise how our National Health Service is the envy of the world and also how it would benefit from more tax revenues….which are made possible by more wealth creation…

A young woman in her early thirties sought treatment from her GP believing that she had sinusitis. The doctor noticed her acute discomfort and pain and realised that she needed to go to the hospital if her condition did not improve within four hours.

During the next four hours her condition did worsen and an ambulance was called. The paramedics came fairly quickly and looked into her pulse, eyes, breathing, and heart and carried out other checks to establish that she had not had a stroke or was not facing other imminent risks. Upon arrival at the hospital they passed patient on to the Accident and Emergency ward and went off to their base.  By this time, the patient was in acute pain from a pounding headache and the increasing level of nausea was adding to her discomfort. One of the paramedics remarked just before she left that what the patient was experiencing ‘was more than a sinus or a migraine’ and suggested urgent treatment by the doctor.

The ward sister had other ideas and after ‘processing’ the patient decided to place her in a queue. When asked how long it would take before a doctor would see the patient, she replied that there was a four hour wait. The patient’s family asked for a reconsideration which was denied. They then decided to take the patient to a private hospital where a team consisting of general practitioner, ENT/head specialist and a neurologist soon diagnosed meningitis and began an urgent course of treatment. The patient was discharged after six days of exceptional care and treatment and is now making a slow but sure recovery.

The patient’s family is considering making a formal complaint. However, they are also aware that the NHS is likely to come up with many defensive positions. The family has since discovered that serious meningitis patients, when not treated urgently, have had strokes and three have died. How is the A&E ward likely to respond to a formal complaint? They could resort to any one of the following number of positions or a combination of them:

• The ward sister was always aware of the risk factors but it was patient’s family who discharged the patient and therefore, deprived her of treatment;
• It was the family’s wish and right to take the patient to another hospital and the ward sister had no control over them; she allowed them to leave according to their wishes;
• Although a four hour delay had been ‘announced’, the ward sister or her team would have kept a close watch on the patient and would have either moved her to the top of the list or taken her straight to the doctors’ treatment room upon seeing any evidence of life threatening developments;
• The patient’s family decided to leave the hospital at around midnight and at that time the hospital had limited resources but a long queue of patients;
• Although the family had exposed the patient to considerable risk, the ward sister did not consider that it was her responsibility to stop the family from taking away a patient that the health service’s own ambulance service had brought in.
•  The advice given by the paramedic that ‘it is more than just a migraine or sinus attack’ was not completely lost or ignored.

The family has a firm view that given the propensity of the health service to make excuses or to offer implausible explanations couched in medical jargon, they are not going to make a complaint. The family also believes that the entire process of registering a complaint is time consuming and unproductive. ‘The NHS is very good at defending itself’, they say.

Had the patient’s condition worsened and especially if she had become exposed to irreversible danger, the A&E ward would admit that it had ‘several lessons to learn from this incident’. Following, at best, an acceptance of mismanagement but not a formal admission of liability the business of the A&E ward would have returned to normal. 

The views held by the family about the NHS and their perceptions of the health service’s slick approach to freeing itself from risk factors and dealing with danger leave very serious concerns. There is, of course, also the dreaded statement “There are lessons to be learnt from this episode…. and all response mechanisms for dealing with similar cases in the future have been thoroughly upgraded”.  One member of the family is less convinced. Is it not becoming too common for service providers to fail miserably before they admit to having lessons to learn? 

 

 

 

There is no need to wait for the General Election

Concerns about effective delivery of environmental services are likely to increase as policy makers look at prospect of a General Election sometime in 2010 if not sooner. Service providers may also be asked to adopt new agendas to respond to forthcoming manifesto challenges. What is going to be different than the critical debate that customers have already had so far? Also, will customers be able to lead on the agenda this time around? How can customers be involved in leading the forthcoming debate, if indeed there will be one, on local authorities’ capacity to improve critical services generally classified under ‘environmental services’? References to specific case studies and views of providers and beneficiaries of specific service providers should help to enhance critical debate. We also wish to set up an Online Customer Panel, which will evaluate the emerging debate, if not lead it through a web-based presence.

Would you be interested in making a contribution? The Campaign for Customer Entitlement is interested in providing insightful analysis through critical reviews aimed at understanding and evaluating the criteria and rationale used by policy makers and top managers for providing and monitoring these services. The focus of attention will be on public services covering the most contentious areas of public interest, normally described as the Environmental Services group, covering the following services:

o Parking services,
o Waste management and recycling,
o Highways maintenance and
o Closed circuit television.

However, in contrast, two other services will also be examined to show how the customers’ expectations for radical change do not just stop there. Service users are also demanding urgent review of the way customer services ‘desks’ and support services for elderly clients are managed. These ‘contrasting’ services have been selected for two reasons – elderly users of customer service support centres are less vocal but can become equally concerned. In the case of elderly services, there will be greater coverage of elderly ‘linklines’ or electronic alarm services which respond to urgent demands for client services in their homes or other dwellings. In general, elderly clients tend to be docile and forgiving, many of their relatives and supporters tend to have serious concerns with the way services are provided. It is useful to examine some of the pertinent details relating to environmental services:

Parking services also comprising traffic management and control.

Are councils with large parking services departments getting to grip with the critical issues relating to customer satisfaction? Customer complaints have been escalating. Local and national media continue to report on increasing levels of customer concerns. Have the councils formulated the best mix of strategies, set up the most viable structures and invested in mechanisms for delivery? Recent experience and Press coverage suggests that in many cases councils have been overwhelmed by demand and have failed to develop efficient business models to respond to the parking problem. What does the customer expect and how are their needs going to be met?

Waste Management and Recycling.

What have the Councils learnt from Best Value? Was this just a very costly exercise both for the councils and the Audit Commission? Reports from the Best Value inspections do provide useful insights. There are many critical findings, which should inform a focused but potentially hostile debate. Is it true that only a few councils have benefited from inspections? Are most of council run parking services still unaffected by best value criteria? Is it true that the Audit Commission did not select parking as a key service worthy of inspection? Some of the key questions for future analysis are:

·       Have the heads of parking services been encouraged to ask to the right questions – where their services are, where they want to be and how they must get there?
o Are parking managers challenging policy makers to get the best support? How are they supporting their arguments? What is their business case?

·       Do local politicians actually know the gaps in parking resources that they need to fund? Have they been kept well informed?

·       How has the Audit Commission responded to the outcomes for the first phase of inspections? Does it have plans to publish analyses of aggregate results which may impact on parking planning and provision in the future?

Highways Management and Maintenance.

The media, particularly the BBC has been highlighting critical problems but only on a piecemeal basis. Currently they have been featuring the cost of poorly maintained roads and how users are sustaining damage to their vehicles. There are has been no analysis of the key issues. Critical questions about resolution of the problems remain to be asked.

Service Portfolios relating to services for the elderly.

We are living in an ageing society and any service that impacts on the quality of life of elderly people is a critical service and worthy of critical evaluation. While a number of councils have been partially successful in making changes they have not maximised the benefits of reviews. Newham Council appears to have taken the lead in challenging their alarm service, developing viable business plans and creating a basis for optimal funding. A number of others are reviewing the future of their services. Two case studies are under consideration and likely to be presented for detailed analysis, subject to permissions being granted by the service provider, namely Bexley and Greenwich Councils. In one case, a council commissioned seven different reviews of one of their elderly people’s services. All review reports but one made the same recommendations which were not implemented. Two clients were reported to have died but apart from some superficial action, the dismissal of staff was seen as a sufficient solution. What are the necessary and sufficient conditions for maintaining successful link line services? The technology is changing and the service providers also need to take into account the needs of clients, NHS trusts, voluntary agencies, private sector providers and indeed potential funders and collaborators who may support programmes for outsourcing the services.

Customer Services Management.

Most council services have invested heavily in providing access to services and setting up ‘one stop shops’, reportedly ‘transformational’ service response systems and invested in customer response mechanisms supported by major investment. Have these service upgrades worked? What are the most critical questions that have remained unanswered?

Closed Circuit Television (CCTV).

Recent reports from police authorities suggest that CCTV has failed both as a deterrent and in recording crime to a standard that would result in higher levels of public safety. What has failed, how and why? CCTV is a major ‘industry’ that is supported by highly effective technologies. Many British suppliers have produced adaptable technology and support services. However, in one council it was suggested that half of the camera investment of £2 million had been wasted. Fifty percent of the cameras were either not working or recording crime. Many cameras schemes in car parks have failed to realise benefits. It would seem that there are three central areas of conflict as far as policy is concerned:

a)       There is a high level of fragmentation- councils prefer to exercise control over relatively small geographical areas when some of the solutions may favour economies of scale arising from installing cross-borough systems. Will councils opt to give up control in favour of value for money?

 

b)       Technology is changing fast, with new parking innovations offering more value for money. Councils are understandably finding it very hard to keep up with the pace of technology. What is needed is a new way of creating access to technology. More on this later.

 

c)        CCTV, when connected to parking services is an income generator for councils. Is there a conflict between preserving income versus providing the best service?

CCTV is a highly ‘capital hungry’ service and most service managers tend to seek highly proactive approaches to configure their services in a climate where finance directors and policy makers are cutting budgets. The latter also tend to make ‘promises’ to constituents to install cameras, thereby creating the expectation that the presence of a camera will automatically deter crime. How can councils make some inroads into the very complex problem of ascertaining what is the optimal capital investment for CCTV assets? In London alone, on the average a council could be spending £1 million a year on its CCTV services. Noting the difference in camera intensity and configuration between outer London and inner London boroughs and the resulting impact of staffing, it is estimated that CCTV revenue and capital budgets vary from £2 million to £15 million per year- suggesting an average CCTV budget of £5 million per council. Questions: Is London’s estimated fixed cost investment of around £150 million effectively utilised? Further, are annual estimated staffing budgets of £20 million for the London boroughs used to provide full public benefit?

These examples should suffice but highlight the fact that there is a need for extensive research into policy and how all the above services are organised to sustain various conclusions that will inform the public debate in the next two years. Most importantly, there is a need for regional and national topicality. The proposed coverage will not be just London focussed. Also the range of services to be covered must appeal to wider audiences.

APPROACHING THE COMMUNICATION CHALLENGE

Public services, such as the ones highlighted above, are based on complex planning and delivery models. They are difficult services to run but affect the quality of lives of residents. The services highlighted above also reflect operational challenges faced by many other services of a similar nature. So no single council service is particularly mismanaged or suffers from disadvantage and no service is excellent or managed out of the ordinary.

My top six conclusions are:

1. Policy makers, i.e. local politicians of all political backgrounds do not always get to know the full picture on which to base their decisions; either top managers can be economical with the truth owing to custom and practice or they sometimes do not know it themselves. In almost all cases the decision-making process does not seem to benefit from access to key data and the most pertinent information. However, are policy makers asking for the right information? One has to challenge conventional systems rather than the managers or politicians.

2. A culture of short-termism prevails. The focus of service planning is biased towards the current financial year leaving key long-term decisions pending in a vacuum. These decision cycles are not always cost effective.

3. The public may not be asking the right questions. Does the average voter know much about the backlog of road repairs in their borough? It is estimated that backlog of repairs in a typical London borough could be twice the annual budget for road services. If average street maintenance budgets run at £ 8million, the backlog of accumulated road repairs could be as high as £15 million. Projected for London as a whole, the backlog of highway maintenance could be as high as £300 million, depending on how the costing is justified.

4. Party politics make very little difference to core services. There are rumours that cartels may start to operate in core services such as waste management, parking services, CCTV, i.e. any high volume contracting services where there are a few suppliers. Are managers given enough time to investigate these constraints?

5. Councils have cut management budgets to the point that currently many managers are taking responsibility for an untenable combination or mix of services. Temporary or interim management budgets have soared but on completion of many tasks, interim managers may leave very little permanent benefit if their output is not integrated into services. Only a few councils use interims well. The whole issue of management needs urgent review.

6. Council programmes for improving public service performance have also not been successful. The work of the Audit Commission has not been challenged, as is the lack of buy-in of the Commission’s role by councils. Some councils  apparently saw the Best value Inspections as an imposition. In many cases it was the inspectors who began to receive scrutiny.

But here is number 7. There is no need to wait for a General Election in 2010 before serious action is considered.

THE SCOPE OF A FORTHCOMING STUDY

A future study will be aimed at management and policy. It will aim to cut through complex issues and offer insight into actions and decisions that have led not only to under-performing public services but also unlikely to curtail short-term solutions. The study will aim to challenge conventional wisdom but in every case also offer direct service based examples. A report will also aim to present examples of success and through aggregation of findings aim to provide convincing evidence that most environmental services departments are not learning organisations. ‘Crisis management’ may be a better description of their mode of operation.

We hope that the report will be timely. Councils are working towards the implementation of a new regime of inspections, to be known as Comprehensive Area Assessments (CAA). Will councils fail to benefit from CAA unless certain actions are taken well in advance to benefit from it?  The implications of failure could be very serious for customers.

There is a final concern. Will the Audit Commission be more confident and even more resolute in carrying out its comprehensive area assessments than was the case with some of the best value inspections?

 

Did they do well?

Many local authorities have been grappling with the problem of customer service. Many programmes of change have been tried and tested; some with success and others with notable failure. In the case of Ealing Council, ‘Response for making a difference’ was a substantial programme with promise of many efficiencies. Did they achieve their objectives? A substantial capital programme was authorised by policy makers to set up a customer response initiative which promised to change the way the entire council was supposed to function. Its a good time to visit the Council and to report on how the scheme has fared and to learn from its successes. However, there have been contradictory news which suggests that the scheme was actually abandoned. If that is the case what was put in its place?

Service providers continue to refer to the challenge of unlimited demand which has to be met with finite resources. Is this still the case? Yes and no. Local authorities are not start-ups. They have been in the ‘business’ for many years and so they would mostly know the specific patterns of demand they have to deal with. There are also many customer service management (CSR) and response management programmes on the market, offering various outcomes in terms of effective response, data aggregation, back office efficiencies and joined up service delivery. Customer response varies from centralised response at civic centres to several ‘one stop shops’ at various locations within borough boundaries.

It would also be useful to look at some of the CSR programmes. Which councils are using them and why? How much do they cost to install? In addition to set up costs, what further actions do councils have to take? At the end of all these comparisons, the main question to address remains: is the customer getting the right service at the right time and in the right format? We have not mentioned ‘the right price’. Is that not a key factor? No, not if councils are not charging for a service. However, there is a ‘price’; it is the cost that the customer has to incur in order to access the service. Customers do pay a high price for service failures.

More of these questions will be addressed in a future analysis. And yes, Ealing will be our first stop.

Broadband Services: Please do not show this to my service provider

Broadband services are rapidly expanding and new providers are coming into the market. There is no evidence available on how many service providers may be leaving the market.

 

Many magazines publish guides to the major services and use different criteria to highlight their distinctiveness, cost effectiveness and value for money. What does a customer expect from a good broadband service?  Quick and reliable access to the service is a good starting point. Cost is another factor but many people who work from home do not mind the cost as long as reliability is not compromised.

 

One can hardly expect service providers to discuss openly what types of complaints they receive. However they must know why customers are leaving them. Do they? 

 

A future article will deal with the top ten issues that have frustrated broadband service users. Service providers will then be invited to comment on how they have dealt with similar complaints. Even more important is how they review their customer service policies.

What can a solitary campaign achieve?

For a start, customer service campaigns are never solitary. There is always a group of seemingly undervalued and unrecognised people known as ‘the customers’ who step forward and expect to be acknowledged. I know of at least three managers who spend a great deal of their time in dealing with customer correspondence relating to service complaints but they are not able to link the feedback from customer correspondence about their needs and expectations with the opportunities they could create for upgrading service delivery. There are five challenges for these managers:

1. How to skillfully handle customer complaints
2. How to ensure that the same complaints are not repeated everyday
3. How to train other staff to deal with complaints – do you want to employ the world’s highest paid complaints handler because a director does not trust his own staff to deal with ‘irate’ customers?
4. In keeping with number 2 above, how should the organisation learn from existing complaints to the extent that it is able to integrate improvements into the delivery mechanism? The alternative is to keep on dealing with the same complaints repeatedly.
5. How to learn from other service organisations.

There will be more discussion on how to address these opportunities. What would also be useful is to discuss how service providers should avoid being reactive when things go bad. Good complaints avoidance programmes should be strategic, ongoing, continuous and be based on open communication. Simple? Not really. We hope to bring you a few examples of success.

The Campaign for Customer Entitlement is nothing new. There have been many commentators and analysts in the past who have campaigned on behalf of the customer. The popular media features to customer complaints against service providers on a daily basis. It makes even better copy when they name and shame service providers. However, in extreme and justifiable cases this may be the only alternative.

The Airport and the Airline

Consider the plight of the hundreds of travellers who were stranded at Heathrow Airport’s Terminal 5 during the last few weeks. These customers of British Airways and British Airports Authority were angry, exhausted and complaining about their customer service entitlement.

 

Agnes Huffy[1] is an American consultant who advises airports and airlines. Her services might have come at a high premium last month at Heathrow, where the airport operator was blaming the airline in the early stages of the critical breakdown of services. The customers felt that their entitlement was going to be serviced by the airline because they were the service provider that had ‘taken’ their money. The roller coasters of customers’ emotions were probably matched evenly but in private by predictable waves of blame and confusion where airline and airport took turns in allocating fault.

 

Agnes Huffy, writing at a different time in relation to entitlement says “I was always under the impression that the delivery of good customer service was a key objective for all public contact jobs. I thought that a company’s success and survival depended upon its ability to provide excellent service to distinguish and differentiate itself from the competition. Today, it appears that such differentiating factors include a growing number of complaints about “service,” which many feel has disappeared not only from our vocabulary, but also from our overall travel experience”.

 

No Agnes, it is still there but customers seem to have become used to accepting declining levels of service in all spheres of the customer/service provider relationship. There seems to a cultural shift in accepting less for paying more. Someone was saying that service is better in Loitokitok.

 

Agnes Huffy goes on to ask, “ Have we irreversibly learned during our formative years to expect more than what is realistic? Perhaps our ambition and will to succeed creates a false sense of entitlement that we carry throughout our life experience. To understand the root of the issue, perhaps we need to consider the source. If you ask the disgruntled why they are disgruntled, we usually find it stems from a combination of a pre-conceived lack of trust, and an innate belief that they automatically deserve to get the most — regardless of the level of output or investment on their par”.

While I think I know where Agnes Huffy is coming from, I would not have said what she says next within ten miles of Heathrow Airport. Agnes Huffy says “ In a society where people are constantly clamouring to get the most out of everyday experiences in life, whether in business, travelling, playing, or at home, our perpetual expectation is to always get what we want. When this does not materialize according to our expectations, and in as timely a manner as we anticipate, we become frustrated, impatient and irritated, often generalizing the past negative experiences and perhaps even blowing them out of proportion. These negative mind patterns then continue to repeat themselves and become oppressive to our overall worldview”.

The customer for public services in Britain is described by labels, which reflect the different expectations of the service provider and the recipient. When my local council does not collect my rubbish bin, I may be classified as a disgruntled ‘resident’. But is the expectation of a reliable collection of my bin also not my entitlement?  Leave my bin outside for a day and the cat from 11 houses away will expose chicken tikka massalla that I did not share with him- he loves my food more than his own.

Armando Martinez, who works in the rather esoteric and higher-level world of ‘telcos’- telecommunications companies providing broadband and other personal media related services says, “ Entitlement is the process of authorizing a service (a music or broadcast TV channel, pay per view, etc.) or content (a movie, program, game or special event) to a customer. Entitlement also includes the assignment of rights, which are the rules that govern how services and content can be used”. Entitlement management systems are increasingly needed in Britain’s public sector. These systems should be capable of managing complex functionalities and challenges, such as those of collecting my bin, repairing my road, cleaning the street in live in and educating me to learn more about recycling the waste that my household generates. Is my local council’s entitlement management system able to track what service its customers, not ‘residents’ need? Has the council invested in capable systems to track how services are provided and how the delivery of entitlement is monitored by them?

Did the attributes provided below apply to the situation at Heathrow Aiport?  Could one have switched the labels? How many customers might have gone home feeling that it was service providers who were unhelpful, inattentive, impolite and unprofessional?

Customers		Service Providers
·         Unreasonable ·         Angry ·         Upset ·         Disrespectful ·         Demanding		·         Helpful ·         Gracious ·         Attentive ·         Polite ·         Professional

Agnes Huffy: “To have proper perspective, we need to adjust our way of approaching customer service interactions and communications. We should not expect rude treatment, and we should definitely not be so surprised when we experience kindness, consideration, and attentive customer care”.

Campaign for Customer Entitlement (presently with just one member) will be examining issues relating to customers’ right to service -entitlement, especially in relation to services. While the content will be drawn largely from public sector experience, there will also be occasional coverage of service delivery in business. The public sector has a lot to learn from business but the reverse is also true. 

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[1] Agnes Huffy, “Customer Service in an Era of Entitlement”. Airport Business, www.airportbusiness.com