Amazon has done something amazing. It has completely reset our expectations of price, delivery and service.
As well as shopping for toasted cumquat seeds, from our sofa and having them delivered by tea-time, Amazon has opened the door to a whole range of products we probably never knew we could buy!
Amazon is a total recalibration of expectations.
We 'expect' Amazon to find our stuff, at the price we can afford and deliver it at a time of our choosing. No high street retailer can compete with that.
I'm expecting Amazon to see-off the pharmacy chains.
Expectations met, raise expectations about what is unmet.
I wonder what the public's true expectations are about the NHS?
Do they really expect an ambulance in eight minutes? Do they really expected to be done and dusted in A&E, in four hours? Do they really expect to be diagnosed, imaged, tested and treatment started in eighteen weeks?
NHS targets are expectations that were set by politicians on the basis that the quicker the better, is always better.
Tony Blair 'did an Amazon' and reframed expectations. He invented the four hour target; 100% to be seen and sorted in four hours. It was impossible. Other politicians reset the clock. Today, we just do our best.
I don't think the public ever shared expectations beyond wanting to be seen in a timely, safe and a prioritised way, that they can attach a rationale to. Waiting is one thing, being abandoned is another.
A&E departments take the pressure when other parts of the system aren't working properly. So, if A&E looks like Armageddon, we have no expectation that our cut finger will point us to the head of the queue.
People are sensible.
To be frank I'm not convinced the A&E target is all it's cracked up to be. The evidence shows that performance targets can be a proxy for wider system failure or success and can have wider consequences. (Here)
Mostly, the public have a sense of proportion. They watch the news and know we don't have enough nurses and a hospital is not the Hilton. It is only the CQC that has that expectation.
Managing expectations is a vital skill for managers.
There are some basics to think about.
It starts with honesty. When we know an expectation can't be met, I think we should say so. Indeed we have a duty to say so.
Allowing expectations to fester into an assumption, is a risk they will become accepted as a right and that soon becomes and entitlement.
The NHS is in the contortion of planing a plan for the next ten years. No one can promise anything for ten years. When the Plan emerges it is important that where there are expectations, they are not assumptions that ignore the risk of them being unmet.
We will have to be honest and honestly... I can't imagine meeting any expectation over ten years.
Communication. Yup, that word again. In the basic day-to-day, it means reporting back, updates, keeping people in the loop.
In a clinic that is running late, it's about saying; 'We are running late because XYZ, but we'll catch up as soon as we can. Thank you for your patience.'
The last bit's the most important...'thank you'.
In reality only a fool bashes on regardless. In a service sector, like the NHS, that is demand led, we must learn a new narrative about expectations.
'The truth is we can't do this. I don't want to let you down... this is what we can do.'
We can't do a full fat NHS. It's a skinny Latte health service, now. The public know that. The majority of patients that come through the doors will have a great experience and be on their way before they can post how pleased they are, on FaceBook.
I bet if you asked most people about waiting targets, they couldn't tell you what they are.
If you told them it was waiting for treatment for a non-life threatening injury, safe, warm, pain free and in a pleasant environment, where most people would be on their way in under four hours. They'd say that's cool.
We've reframed expectations, now we have to recalibrate them and still be proud of what you do.
