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By Ed g2s - Own work, CC BY-SA 3.0,

Small changes can make a difference: a birthday present to the NHS

Time taken to establish a rapport with customers is not wasted

I don’t think the best way to celebrate the National Health Service’s 70th birthday is by having an extended stay in an A&E department waiting room but that’s what happened to me the other day so I’m sharing it with you as it illustrated an important lesson in customer experience:

Establishing rapport is absolutely critical

When you enter any kind of customer journey, the first impression you get is crucial – how many times have you been left standing around on entering a restaurant or had difficulty distracting counter staff from their apparently more important conversation with their co-workers? Think about when it works well: a prompt and friendly greeting and offer of help puts you in a good frame of mind to enjoy the rest of the experience.

In this regard, accident and emergency departments are no different from restaurants, retail stores or your local bank branch: all interpersonal elements of the journey should be geared towards making you feel as good as possible, even though you might not be feeling that great to start with.


Last Monday night in my local A&E was not the best time to visit: when I arrived, the waiting room was packed, and I resigned myself to a slow journey through the various tests and investigations I was in for.

However, on the plus side I was able to observe a critical opportunity for improving patient experience that was missed on every occasion. Every time a medical practitioner from nurse to consultant called a patient they did the following:

  • Stand on the edge of the room and call the patient’s name (not all that clearly but the patients could just about hear).
  • Once the patient had started to get up, immediately start walking to their treatment/assessment room.

It’s this latter step that began to bug me: I’m pretty agile but at one point I “lost” the medic who had called me and had to find his room. Not, admittedly, a massive crisis, but consider if I had mobility issues or had limited mental capacity and became easily confused it wouldn’t be the best start to my treatment.

Without fail, the patients were left following in the medic’s wake and it struck me that in doing this – I think the assumption was that they needed to read the patient’s notes before they arrived in the treatment room – they were missing out on a crucial opportunity to greet the patient and escort them to the room. Typically, this step in the journey takes only a few seconds but it would create, I think, a significant difference in patient satisfaction if they were introduced and had a very short rapport-building chat on the way to the room.

I’m one satisfied customer despite this as, at each stage in the journey, I was treated with all the care and consideration you would want. Even though it was a busy night, and everyone could have been quite harassed or under pressure, it didn’t show.


Not one to let a piece of ad hoc research go to waste, I have written to the hospital’s feedback line to offer them my advice. It’s hardly free consulting, but you could consider it my birthday present to the beloved institution as it celebrates its 70th birthday. I’ll be interested to hear if they think it’s worth a go but however much I love the NHS I’ll be happy if I don’t have to have first hand experience of any improvement that results any time soon.

Nick Bush

Nick is a business advisor and non-executive director who helps organisations improve their focus and performance by developing customer-centred strategies and business plans. He has helped companies transform the way they do business through better strategies, change management and technology, with a relentless focus on the customer. Nick has worked across all kinds of business sectors from telecoms to banking, chemicals to charities - as owner of Open Chord his current focus is on helping arts and non-profit organisations to be more successful by creating a solid planning foundation that will help them grow.