
Department of Health Customer Insight Unit, Customer Insight Project
Within the health service there is a groundswell of interest in fresh approaches to understanding and engaging with customers and their potential to deliver better health, better care and better value. The challenge is to turn that interest into a meaningful agenda for change by building the business and policy case for a more thoroughgoing customer-centredness in commissioning and delivery. A critical first step in articulating that case is achieving clarity about how these fresh approaches differ from existing approaches to research and consultation. How do we unlock new value, rather than merely repeat the things we have heard from patients and public many times before? The Department of Health Customer Insight Unit commissioned SHM to undertake a project to explore how NHS organisations – and especially PCTs – can move beyond traditional modes of research and consultation to new approaches designed to gather deep insight about local populations.
SHM undertook a project that sought to test the extent to which fresh approaches to customer insight can help address real commissioning and service delivery issues. In one area, we focused on understanding how customer insight could support and enrich existing work to improve services for older people with fractured neck or femur (broken hip) injuries. The project involved SHM facilitating two workshops with two different groups of older people.
- The first workshop involved a group of older people recruited from a nearby GP surgery. The older people were aged 70-85, were mobile and active and considered themselves to be healthy.
- The second workshop involved older people recruited via an older people’s organisation. The older people were aged 75-90, and all of them had received extensive hospital treatment and follow-up healthcare support for fractured hips caused by falls; and some had received hip replacements.
The older people’s stories in the first workshop suggested that where health and mobility issues are concerned, they tend to delay accessing health services until an issue becomes critical. They enjoyed active lifestyles and diverse interests, and were concerned about health professionals advising them to slow down—that is, recommending that they cease activities that bring them so much enjoyment. The older people’s stories in the second workshop suggested that many of them used to think like the first workshop group. However, having now experienced a fall, and the major surgery and long period of recovery and rehabilitation necessitated by such an episode, they viewed the use of health services very differently. They felt that decreasing mobility, deteriorating function, pain, discomfort, and falls and accidents are simply part of getting older—they are inevitable and simply to be endured as one waits for the end of one’s life.
The main implication of the customer insight project is for the local PCT’s primary prevention activity focused on campaigns designed to inform older people about preventing accidents. Insights into the motivational mindsets of older people – and the ways in which these impact on their willingness to use health services – are currently being incorporated into training and development programmes for local GP surgery staff. This training is designed to enable surgery staff to identify and work with the particular mindsets of older people’ and therefore engage them more effectively in discussions about maintaining their health.





