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How to improve customer care in practice

Fiona Dalziel says delivering good care when people are unwell, and perhaps scared, is challenging.

Encourage the practice team to establish standards on matters such as impatient people in a queue (Photograph: Istock)
Encourage the practice team to establish standards on matters such as impatient people in a queue (Photograph: Istock)

The people we look after in the surgery acquire different labels from time to time: service users, clients, customers, consumers, even punters. The agonising over what to call these people is not about to end as we move into the brave new world of commissioning and service providers.

However, ask any receptionist who they are and you will be told: 'Well, they're patients, of course.' None of the alternative names successfully encapsulates the precious relationship based on trust that GPs build up over a lifetime of caring.

But what steps could we be taking to improve how patients feel about the experience they have when they need the care of their GP?

Setting the culture and setting an example


This starts at the top with the GPs and manager. Take a step back and think about whether patients are spoken about with respect:

  • Do GPs discuss patients at coffee time with other team members present? Although GPs may need to use black humour to cope with stress, is it constructive for others to hear you speaking disparagingly?
  • Do any of the GP team vent their frustration with patient behaviour to the office staff? Patient behaviour can, undeniably, be fantastically frustrating. But do you want the team to feel that it's OK to have a good old bitching session?
  • When a patient complains about the service, does the manager sigh and roll their eyes at the nonsense patients can concoct? Lots of complaints certainly do demonstrate a lack of understanding of systems in the practice, but that may not always be the patient's fault.

What can you agree to do differently to set the culture? Think about:

  • Reflecting on/modifying your behaviour so that it is appropriate to the setting.
  • Explicitly agreeing standards of behaviour or 'rules of engagement' - what kind of things are appropriate to say to whom, where and when?

Supporting your staff


In general, receptionists are loyal, work under constant pressure for not much money and take the brunt of the more directly challenging patient behaviour. Their feelings of frustration are compounded when the difficult patient at the front desk is sweetness and light in the consulting room.

We all know what good customer care looks and feels like. So do your staff. But delivering it to someone checking in to a luxury hotel for a romantic getaway is very different from delivering it to someone who is unwell, worried, frightened and possibly frustrated and impatient.

Coping well with this needs more than a standard course on the basics of customer care, although this is still vital. Consider these options:

  • Invest in training that helps your staff understand the interactions they have with patients. This should include looking at transactional analysis in some shape or form.
  • Look at how service is accessed and delivered in the practice:
  • What do patients expect?
  • What do they actually get?
  • What is the impact of that on staff and patients?
  • What can we do about that?
  • How will we know we are getting it right?
  • Support staff by feeding back to a patient if their behaviour towards staff has been unacceptable. Respect is a two-way street. Write to outrageous patients and warn them and let the staff know you have done so.

Staff skills

Invest in ensuring that your team is comprehensively trained. In order to deliver excellent customer care, your team has to be competent and effective in all tasks, as well as having an ability to care for patients as individuals as they pass through your hands.

Make sure you cover the following:

  • Induction training - this needs to be systematic, comprehensive and recorded.
  • Continuing training in baseline topics, such as results handling, confidentiality and data protection, and repeat prescriptions, may be externally provided.
  • Task-based training updates on practice procedures, such as how to register new patients, appointments, scanning and filing, will be in-house.
  • Customer care training on greeting patients (face to face and telephone), listening skills, questioning, telephone courtesy, dealing with difficult patients on the telephone and face to face, and complaints handling.

Encourage your team to work together to establish standards relating to customer care:

  • Welcoming patients.
  • Handling a queue.
  • Speed of answering calls.
  • Managing calls that are on hold.
  • Appearance/dress code/eating and drinking.
  • Confirming and closing calls or interactions.

Once standards have been agreed by everyone, they are a useful tool for managing the performance of those team members whose customer care skills are less good.

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