Marketing Issues In The Uk Public Sector
Introduction
In the United Kingdom, public health services are managed by the National Health Service (NHS). Unlike other countries like the United States, health in the UK is provided under a national health care system. This scheme is funded by the government through taxes and is also operated by the government. This kind of system is founded on the belief that all citizens in the United Kingdom are entitled to medical services. This goes a long way in ensuring that all the necessary medical services are available to consumers at their point of need. The National health care system is also advantageous in that it can provide long term services to those in need of them. The NHS was established with the intention of providing health care for all who needed it at the point of delivery because in the past, health care was not available to all who needed it. Consequently, there was a need to make sure that health care services were more coordinated in the region. There are numerous organisational changes that the NHS has undergone. First of all, it created an internal markets idea where health authorities and doctors were given funding from the government and they could use this to purchase health care from different groups like acute hospitals. However, with time, this scheme was not very effective as there was too much bureaucracy. Consequently, there was a need to bring in reforms in order to reduce inefficiencies and the current system was born; the use of primary care trusts. (Department of Health, 2006)
The Health care system in the United Kingdom is operated by a national budget made by the government. This budget normally includes all the issues that will affect the effectiveness of service provision such as; capital outlays, operating expenses and medical training. Specific health care providers normally operate on set budgets made on a yearly basis.
Despite all these benefits, one must not underestimate all the disadvantages that come with provision of health services under such a scheme. First of all, the total available resources will always and have always been less than the demand for health care. Consequently, there is a need to prioritise issues and allocate finances for the neediest groups. Groups such as the elderly are maintained at a pre-set fee and must therefore be denied certain medical procedures such as kidney dialysis; this procedure is only allowed for those who are fifty five years and below. There are many patients in the UK who have still not reaped the full benefits of a national health care system. Another challenge facing the health care system in the UK is the fact that there is little room for technology within service provision. All these challenges will be examined in detail in the subsequent portions of the essay.
Overview of the health care system in the UK
There are a number of stakeholders that are involved in provision of health services within the United Kingdom. The first being the Department of Health; their main objective is to ensure the well being and health of its citizens. Additionally, there is the National Health Service whose objectives are not clearly laid out. There are also Primary Care Trusts (PCTs) that have been commissioned with the process of selecting a number of health services for their local population in order to ensure the well being and health of the population. PCTs have the option of choosing health care services from any of the following groups (Department of Health, 2005)
- social services
- voluntary services
- private clinics
- private hospitals
- NHS
In light of these alternatives, there is a variety of health care providers to choose from and these health care service providers need to market themselves in order to ensure that they get commissioned by the NHS trust care. Some of the issues that need to be given top priority during marketing include availability of suitable equipment and employment of new technologies in provision, Possession of well trained staff among other issues. Because of all these differences in priority issues, there is competition among health care service providers.
It should be noted that the government currently has moved towards incorporation of marketing strategies in the process of health care provision. The government has indicated their commitment towards marketing strategies because it uses private providers in the process of reducing the amount of time people spend waiting for services provided by the NHS. The government has also included independent centres in the process of treatment and diagnosis. Additionally, patients have been given choices between the NHS and private care providers with regard to elective services. The Department if Health (2006) asserts that whenever commissioning if health services is done, there should be utmost consideration of contestability. The latter trait is also applicable to medical services provided outside the hospital scenario such as carer services.
The relationship between the National Health Service and its suppliers is not clearly defined. This is because the NHS has some inherent community values between the organisation and its partners, however, it also has to consider the fact that it has to be contestable and market driven. This presents some complexities in the supplier-organisation relationship. There is a need to make sure that both aspects are adhered to. Health care trusts; who serve as health care commissioners, usually establish a criterion that facilitates the structuring of the local market. They are also charged with the responsibility of choosing service providers that will deliver health services that fall within their strategic direction and those ones that will also demonstrate that the organisation have obtained a return on their investment. (Coast, 1996)
What people think about the service
It should be noted that not many patients/clients are satisfied with the level of service provision by the NHS and even other service providers. The organisation subjects most of its patients to long waiting periods. Besides that, there are limited resources hence the NHS has to prioritise which services are more vital. The overall effect of this is that some patients may miss out on vital health services. Other people think that the NHS has not given them adequate opportunities to choose different health car options. Consequently, most of them seem to lack the ability to get better health care even when they can afford to.
Problems and issues of the service
Market research is a vital part of any organisation that wishes to stay ahead of its competitors. There is a need to include the needs of the patient when trying to decide on which health service providers will be chosen for certain medical services. Private health care providers should be acceptable to patients. If the NHS simply chooses its own bidders without consulting the population, then there may be customer dissatisfaction.
Another major marketing issue affecting the health service system, in the UK is the issue of technology and innovation within service delivery; this falls under the ‘product' portfolio of the 4 principles of marketing. Service innovation is one of the key marketing techniques that any organisation worth its salt needs to take advantage. Principles of marketing are founded on the belief that a product with more value will fetch greater demand from the market. Service providers who continuously embrace innovation will provide consumers with greater value for their investments and this will give them an edge over their competitors. The NHS has not fully embraced those options in its marketing strategy. Consequently, patients are not getting the best quality service from the organisation. Innovation could have been seen through provision of health care for patients in the privacy of their homes. The organisation also has the option of introducing outpatient follow ups. This will ensure that health care consumers receive ‘after sales service'. This could go a long way in reducing the long patient lists since potential health problems could be detected early enough and dealt with. The overall health of the population may improve and this will enhance consumer satisfaction. The organisation needs to embrace the fact that most of its consumers re not satisfied with their level of service provision because they have not been innovative. (Maynard, 1991)
In line with innovation, the NHS has not introduced numerous choices for the consumer. There is a lack of innovation during the process of designing product packages. Issues such as community service are not included in mainstream services offered by the NHS. The result of such an approach is that there is a sort of monopoly by the NHS trusts and general practitioners. The health organisation has not realised that consumers need to determine for themselves which services are more appropriate for them. By increasing choice for patients, there will be more responsiveness among health care providers and the NHS. This is an aspect that is lacking and needs to be embraced.
Innovation is not only applicable to the NHS; private health care providers need to embrace this too. In the past, they have not demonstrated their ability to incorporate new and creative ideas in health care provision. There is also a need to adopt technology in various aspects of their operations. Currently, most practitioners may be seen trying to outsource IT experts when dealing with medical records. This causes serious impediments to the delivery of services a it is too bureaucratic. Patients have complained about how most doctors they approach spend most of their time on the computer rather than on patients themselves. This means that there is a need to train medical professionals on how to deal with new technologies. In line with this, there is also a problem with the coordination of Information Technology systems. Complaints have brought forward by patients about how different health providers affiliated to the NHS have no coordinated health care records. Therefore, a patient who had done an x-ray in one health clinic and seeks treatment from another health clinic will be asked to carry his or her results manually to the second clinic. This need not be the case; all private health care providers affiliated to the NHS should coordinate their information systems to maximise efficiency and also to prevent undue waiting periods for their consumers. (Dopson, 2003)
The third marketing problem that the NHS has is the issue of consumer education. Most consumers who may opt to go for elective services do not have the knowledge of where they can find these practitioners. The main marketing issue here is promotion. Compared to other public health services like education, there are minimal cases of promotion in the health services sector. Consumers need to know the various health options available to in order to make use of them. The main promotional tactic that has been utilised by the NHS is public relations. Many NHS trusts usually establish community services with their local populations and this is the major route that they have concentrated on. However, there is very little implementation of advertising campaigns by the NHS and other private health care providers. Additionally, there is the use of sales personnel to market health products. The latter strategy could be adopted by private health care providers who offer elective services. They have not promoted their services to various individual in order to let them know what they can offer. (Hyde, 2004)
External forces affecting the problems
Political
The NHS and private service providers are faced with certain political issues. They need to make sure that decisions made are in line with current legislations. If this does not occur, then there may be challenges from the public. For example, an NHS trust in Derbyshire was faced with court battles from a patient after the primary trust made the decision to procure United Health Europe Limited as their private service provider. The case started in the High Court and eventually reached the court of Appeal which ruled that the NHS should start another process of procurement as they had made the wrong choice when selecting the private care provider because they had not engaged in adequate consultation with the public. This indicates that the NHS was lacking in the area of market research.
The Health Care and Social Care Act of 2001 requires that NHS primary care providers need to engage in adequate consultations with the public whenever there is a need to introduce new services to the market or before market testing. The issue of market research was also highlighted in the case of Morris v Trafford NHS trust. The NHS needs tp make sure that there is full involvement of the local community in any of its decisions.
Another political issue that affects the above marketing issues is conflict of interest. There are instances when commissioners of health services happen to be health providers themselves. This could undermine efforts to choose the most appropriate health clinician or service provider if the person doing the choosing can be chosen too. (Chappel et al, 2001)
Economic factors
The major factor that the NHS has to consider when offering services to the public is its budgetary constraints. The NHS is run by the government and mainly depends on budgetary allocations granted by the government. Consequently, there is a need to make sure that all the marketing services will be conducted within the given budget. This is a major constraint during the process of decision making; most services, equipments, recruitments have to be laid aside just because there is alack of adequate funding. Subsequently, the best decisions need to be made in order to maximise the limited resources available for use by the National Health Service.
In addition to this, there is also the issue of competition among private health care service providers. The government gave private health service providers the mandate to offer treatment and diagnosis to patients. This means that they need to make use of various marketing tools in order to stay ahead of their competitors. Most of them still lack the ability to develop adequate marketing strategies to deal with this new development. There are various options that marketers can use to deal with competition.
Another economic factor that affects the NHS is the fact that they have so many factors that they need to include in the decision making process. NHS trusts have numerous partners and stakeholders that they deal with on a day to day basis. As a result, they cannot make marketing decisions to suite themselves alone and then leave out their partners' view points. They have to adopt consultative approaches within their marketing processes. (Mullen, 2004)
Social factors
It is quite necessary for the NHS to tackle some of the needs that their local communities have. This means that there should be identify some of the needs that their clientele have before they can adopt models for the company. It should therefore be noted that the number of patients is increasing by the day and the NHS needs to find out some of the causative factors from the community itself and then come up with strategies to deal with it. The issue of community involvement has led to one of the major marketing problems facing the NHS; market research. They seem to lack the ability to involve the public in this crucial awareness strategy and have therefore been lagging behind.
Private service-providers need to come up with innovative packages for their clientele. However, this can only be achieved through staff training and development. They also need to ascertain that their staff members have the best possible working conditions and also that they are given good salary packages. This will reduce confrontations within private clinics or hospitals and will also enhance cohesion.
Cultural factors
The people in the United Kingdom have taken up unhealthy lifestyles that are incompatible with healthy populations. Most people are fond of eating junk foods or foods rich in cholesterol. This means that the UK population is particularly vulnerable to heart related complications. Additionally, a large majority of the population engage in smoking hence increasing the cases of respiratory illnesses. Therefore, the NHS needs to prioritise some of these issues. They need to asses the level of prevalence of the above mentioned diseases through market research and then they need to come up with special product packages to combat them. (Chappel et al, 2001)
Technological factors
There is a need for the NHS to embrace more technology in the area of service provision. The field of medicine has numerous applications that can utilise technology. This can be in record keeping, coordination of services by other NHS providers, use of up to date equipments in the treatment and diagnosis phase and also in the administrative process. Countries such a the US do not have a national health care system and they boast of having one of the most technologically advanced medical systems in the world. This brings to light the fact that a national health care system can slow down technological adaptations. However, with consistent efforts by the various stakeholders in the NHS, then there will be continuous improvement in this area.
Private health providers also need to embrace technology through use of advanced equipments and training techniques for their staff members.
Environmental factors
The major environmental aspect affecting health care providers is in relation to the community. The organisation is expected to participate in community cleaning services in order to serve as an example to the locals. This will boost their public relations and will go along way in promoting their services. Additionally, health care providers need to make sure that they use biodegradable disposing bags for their health related wastes.
Marketing strategies that can solve the problems
The first thing that the NHS needs to do is to adopt a market research strategy. Market research is the process of;
- collecting
- recording
- analysing data that exists in the market (Kress, 1988)
This data will normally involve both consumers and competitors. Most of the time, market research is done in order to find out information before introduction of certain products or in order to come with forecasts. Normally, organisations will need to come up with demographic factors about their clients. Market research should be mainly be adopted by private health care providers. Since the government has given private service providers the mandate to offer health services to consumers directly, there will be a need to come up with the most attractive package since the sector is no vulnerable to market forces.
Some of the tools that the private service providers or the NHS can use to conduct their market research can include the use of questionnaires. They could find out what patients normally look for in a good health care system. In order to reduce ambiguity or diverse answers, there could be a list of these items to choose from. Additionally, the questionnaires could also include information about where consumers mostly go to purchase their health care and what prices are charged. This will give private service providers information about their competitors and will help them to come up with better prices for their services. This will help them in the process of achieving competitive edge. The main advantage of using questionnaires is that they take up relatively minimal time compared to other sources. Secondly, questions are straight forward and uniform. This will help the service providers come up with solutions as fast as they possibly can.
Market research can also be conducted through secondary sources. Here, private service providers can use the internet or company websites in order to compile information about some of their competitors. By conducting marketing research, private service providers will ensure that their prices, products and location strategies suite their clients. The internet is quite a valuable source on some of the strengths and weaknesses of health service providers. In case company websites are not available, then private health care providers can make use of journal article or newspapers containing information about their field of interest. There are also other countries in Europe that have adopted similar health care system to the UK's. As result it possible for the NHS to emulate some of their marketing strategies in order to improve the public's health. (Rossi, 1983)
Market research will go a long way in ensuring that two of the marketing problems mentioned above have been solved. The first was the issue of patient involvement in decision making processes. Issues found from the research should act as a basis for some of the changes to be incorporated into the NHS and also among private care providers. The second issue that will be solved is the issue of innovation. Consumers can give their take on some of the services that they would like to see in the NHS or among private service providers. This will ensure that most of these issues highlighted could be lumped up into anew product package. Consumers have numerous and creative ideas that could boost the public health care system in the United Kingdom.
The second marketing strategy that private service providers could adopt is through brand positioning. There are two main avenues available;
- intangible brand strategy
- tangible brand strategy
Intangible strategies are those brands that are not linked to any particular product. Such brands are usually designed to capture audiences through their names rather than the rationale behind them. The second type of strategy is the tangible brand strategy. These are brands that are linked to specific functions. The most appropriate strategy for private health care providers is the latter. This is because some of the most powerful organisations in the world have adopted this strategy. For example, FedEx has established a tangible strategy that links its name to guaranteed delivery. Citizen Bank has established brand that is responsive and rapid. (Bohmer et al, 2001)
The first step is the process of creating a strong brand image is through a compilation of items that may be most attractive to customers these could include
-properly trained nurses
-convenient locations
-best trained doctors
-has treated people for 50 years
These and many more could act as a platform. The market research strategy mentioned above could also act as a guide and will need more editing and analysis in order to come up with the most popular attributes. Thereafter, the health care providers could compare their attributes with those ones offered by the competitors and deduce which ones will fetch the highest market power. The health care providers then need to come up with feasibility options for different brand options. For example, is they choose the issue of having well trained nurses as their brand strategy, then they must asses what it will entail financially to adopt that trait. This is because possessing well trained nurses is a good motivating factor for patients but may not be very affordable for a particular service provider. (Mitton & Donaldson, 2004)
The issue of brand strategy is quite useful to private service providers because they have now been given the mandate to provide elective services. If clinics, hospitals, etc do not adopt a brand strategy, then they take the risk of disappearing among the other health care providers. Brand strategies will solve the problem of consumer education because they will act as platform for promoting the respective health service provider.
Conclusion
The National Health Service and private health providers have not involved the public in their decision making processes, they have also been slow in promotional efforts. Lastly, the two groups have also done very little innovation in their service delivery. These three marketing challenges can be solved through adoption of brand strategies and through market research. (Fowler, 1993) In the current market place, organisations are becoming highly competitive; using these marketing strategies could put an end to patient dissatisfaction.
Reference:
Department of Health (2006): About us: The Department of Health, retrieved from http://www.dh.gov.uk/AboutUs/fs/en accessed on 30 April 2008
Mitton, C. & Donaldson, C. (2004): Priority Setting Toolkit: A guide to the use of economics in healthcare decision making; London, UK: BMJ Publishing, pp. 35–45
Bohmer, P. et al (2001): Maximising health gain within available resources in the New Zealand public health system; journal of Health Policy, 55:37–50
Chappel, D. et al (2001): Implementation and evaluation of local-level priority setting for stroke; Public Health. 2001, 115: 21–9
Maynard, A. (1991): Developing the Health Care Market; The Economic Journal, 101:1277–86.
Mullen, P. (2004): Quantifying priorities in healthcare: transparency or illusion? Health Service Management Resource; 17:47–58
Coast, J. (1996): Priority Setting: The Health Care Debate. Chichester; UK: Wiley
Fowler, F. (1993): Survey Research Methods; Newbury Park; CA; Sage; pg102
Kress, G. (1988): Marketing research; Prentice-Hall; London; pg 98
Rossi, P. (1983): Handbook of Survey Research; New York; Academic Press; pg 103- 108
Department of Health (2005): NHS improvement plans: putting people at the heart of public services; a report by Department of Health
Dopson, S. (2003): Leading Healthcare Organizations; Pal grave Macmillan
Hyde, j. (2004): Managing and Supporting People in Healthcare; Bailliere Tindall, London International Journal of Healthcare Management
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