Internal customer management and service gaps within the National Health Service.

One implication of being required to respond to the Patients' Charter without access to more resources, is that managers in the U.K. health care sector will have to ensure integration of multiple functions across their units in order to achieve the objective of creating a quality conscious workforce. This situation will probably demand adoption of an internal marketing philosophy within the NHS; thereby ensuring implementation of TQM and/or Customer Care schemes in which departments work together to create effective internal customer chains. To determine the degree to which the NHS have effectively adopted an internal customer orientation, a survey was undertaken using a modified version of the Parasuraman SERVQUAL model. The majority of respondents indicated the existence of Type 1, 2, 3 and 4 Gaps in the internal customer management process within their unit. Major influencers of these service gaps include departments placing internal efficiency ahead of internal customer needs elsewhere in the organization, limited effort to gain further understanding of internal customer needs and an inadequate level formal quality standards for managing internal customer relations. Respondents consider their departments are able and willing to enhance the quality of provision if the issue was given higher priority by senior management. Identified obstacles to increased future emphasis behind an internal customer philosophy include insufficient resources to service internal customer needs, lack of trust between departments and limited confidence about abilities to manage the process. Unless senior managers in the NHS can be persuaded to allocate the resources needed to create effective internal customer chains, then concern must exist about the capability of operating units to fulfil the health care standards specified in the Patients Charter.