Do your end users really trust you?

Consumers in the NFP and health sectors are being empowered to choose their services from the providers they trust. If these consumers are not satisfied with the service they receive – or reportage of the service they intend to use – they will simply shop around for another provider. Worse still, if they do not experience safe and quality services, they may be harmed. In this new environment, boards need to realise that their first priority, and that of their organisations, is to respond to their consumers’ requirements and work hard to build their consumers’ trust.

Government funding of not for profits is shifting from organisations to consumers. Money is being distributed to the consumer, who then chooses who they purchase their services from. This empowerment of consumers, who along with regulatory bodies are demanding safer quality services, will have a major impact on organisations approach to service provision.

Boards of NFP and health services number one priority is responding to their consumers’ needs. To understand these often changing needs, organisations must learn how to work with consumers at a system level. They must also understand how to co-design their future services in genuine partnership with their consumers.

To lead in this environment, boards must learn how to genuinely partner with their consumers: consumers’ voices must be heard – unfiltered – at the board table. This will enable a deep, genuine understanding of their consumers’ needs, which they can then create strategies to address. In the absence of this engagement and understanding, their organisations will no longer be able to achieve their vision or have a sustainable future.

Through our governance evaluation and capability building work with 100s of health and not‑for‑profit sector boards over the last 20 years, we know that this is the number one challenge for boards right now.

Following the health and NFP sector evaluations and benchmarking in 2016, 80% of boards noted the following key priorities:

  • NFP sector following the introduction of the NDIS: to become a social enterprise and move away from a reliance on government funding. This will require a focus on retaining present consumers through a complete understanding of their needs
  • Health sector following the introduction of new Australia‑ and state‑wide new Clinical Governance Frameworks: to ’develop safer quality services in genuine partnership with consumers.
    In response to these issues, we invited Liat Watson, one of our professional associates and convenors, to be our guest presenter in our expert insights webinar series. Liat is a Health and NFP Consumer Consultant. Her presentation, ‘How many meetings does it take to change a life?’ discussed these issues. She also provided three key tips for how boards can address them, specifically:

  1. Co‑design real solutions with consumers based on their user experience, not just that of the service providers
  2. Include consumer representatives at the board table to ensure the correct and unfiltered translation of consumer feedback
  3. Get raw feedback from the public about your service via social media: know what others really are saying about you.

Each of these are discussed in turn below.

Tip 1: Co‑design real solutions with consumers based on their user experience, not just that of the service providers

End-users (consumers) know a lot about your service: what works, what doesn’t; who communicates well, who doesn’t; poor performing departments; staff attitudes and human behaviour. Co‑production and co‑design with end-users results in the development and delivery of services that are, and remain:

  • relevant
  • fit for purpose
  • easier to navigate.

Consumers let you know the real situation (inputs & activities versus impacts & outcomes)

It’s one thing to gather the data (surveys, feedback mechanisms, etc.), but then you need to understand it’s relevance to, impact upon and outcomes for your end-users. Data that’s gathered in traditional systems is usually left to management and boards to assess through their own lenses, based on inbuilt assumptions and institutionalised thinking.

It’s a paternalistic model of “You tell us the symptoms, we’ll provide the diagnosis,” or ‘Thank you for your feedback, we’ll take it from here.” But, if we’re not doing what matters most to patients, then it’s just business as usual. And this is where co‑production and co‑design come in. In its simplest terms:

  • co‑production means coming to the table with consumers with no agenda, then deciding together what the issues are
  • co‑design is the creation of solutions to these issues together.

Tip 2: Include consumer representatives at the board table to ensure the correct and unfiltered translation of consumer feedback

Consumer representatives are your critical, front-line ‘eyes and ears’, so recruit them, train them, partner with them and act on their advice:

  • Recruit them well. Not every consumer makes a good consumer representative, nor do all consumers want to be one. A good representative may have both their, or a family member’s own experience to draw from, along with a broader picture of the sector. They may also be aligned with a patient or peer support groups, and/or consumer networks. A good place to start is often those living with chronic illness, or who are frequent users of your service.
  • Train & resource them. Representatives will benefit from specific training:
    • Induction into the organisation so they understand the full range of service provided
    • Skills-gap training, if required, e.g. writing, presenting, understanding board reports…
    • Relevant accredited training specific to consumer representatives, e.g. courses provided through the Health Issues Centre of Victoria ( around clinical governance, consumer leadership, co‑production…
  • Establish governance & reporting structures that allow you to ‘keep your fingers on the pulse’ of your service through your consumer representatives.

Tip 3: Get raw feedback from the public about your service via social media: know what others really are saying about you

The internet and social media, in particular, are key influencers and opinions makers. And this applies to traditional health and NFP services as much as any other product or service. There are a plethora of forums and platforms (Facebook, etc.) upon which people casually share their experiences – and these shared experiences play a major role in decision making/consumer behaviour. Consumers regularly seek the opinion and experience of their connected social media peers in relation to services and products. It is, therefore, critical that board members have a realistic insight into how the end users of their organisation’s services report their experience online.

Here’s an example of how this looks online in reality. I’ve chosen Werribee Mercy Hospital not to call it out because of its fairly ordinary reviews, but because of the way the hospital responds to feedback.

A search for Werribee Mercy Hospital on Google returns the following results (try this for your own service):

The service’s Facebook page details individual experiences. Note: For larger services Google Reviews is one place to look for consumer experience.

Such sites are an invaluable source of raw feedback, and importantly provide an opportunity to respond and do something about it!

How do you ensure your board has what they need at the board table?

Remain in touch with what matters to the community you’re servicing

  • Ask how many consumer representatives currently work or volunteer with your organisation. Who are they? Where are they? Are they demographically representative? What’s their reporting structure so you can hear from them?
  • Recruit at least consumer representative to your Board
  • Check comments about your organisation on social media platforms
  • Enrol your service in or

Ensure the information coming from management is current & relevant

  • Obtain information from various sources, not just management
  • Speak with individual consumer representatives and volunteers within your organisation
  • Be a ‘mystery shopper’, or get in cahoots with one…
    • Dress casually and sit in one of your waiting rooms
    • Try phoning your service – during & after-hours

Direct resources to areas of greatest impact to end-users

  • Avoid evaluating data purely through an ‘Institutional’ lens
  • Assess the significance of data (KPIs, surveys, focus groups, formal feedback mechanisms) in partnership with consumer representatives
  • Co-design your solutions and ideas together

Ensure Board decisions are being interpreted & acted upon effectively

  • Check back with consumer representatives that agreed actions are happening on the ground
  • Organise a follow-up ‘mystery shopper’ experiences