Proposed Working Title

Does Customer Relationship Management (CRM) build stronger bonds with the customers and help provide quality services in a doctor's surgery at Camden? ---- A case study of NHS

Research Background and Context

I have chosen this topic in order to find out what are the key issues that are important for successfully running a doctor's surgery. We have been seeing that there are always patient dissatisfaction and complain about the services, both clinical and non-clinical.

Hypothesis

The hypotheses that will be tested in this research are as follows:
1. To analyze what aspects of CRM strategies are missing in running this doctor's surgery.
2. To identify what benefits can be attained by completely implementing CRM at PPCC
3. To what extent the employees are playing their role according to CRM strategies.
4. To look in various models, strategies, theories and methods that can be used to make the services effective at doctor's surgery.

Organisation Background – Partnership Primary Care Centre (PPCC)

The Surgery has been established in 1973 for the people who are living in the housing. It was named Fairweather House Surgery. Initially it had 250 patients from the housing. Dr. Morris Davies was founder General Practitioner (GP). In 1976, Dr. Diane Rosenthal, Dr. Jonathan Rosenthal, Dr. Enid Greenbury and Dr. Wil Cupola took over from Dr. Morris Davies and this Surgery was under Camden and Islington Primary Care Trust (PCT). In 1976 Camden and Islington PCT allocated more patients and gave a practice boundary that is a catchment area. In 1976, GP's appointed a practice nurse who used to do child immunisation, dressing, and cervical smear.

In 1988 Dr. Wil Cupola left the surgery and Dr. Ian Hopkinson joined the surgery as a partner and there were 8 sessions of doctors and 5 sessions of nurses. GP's decided to register more patients and in 2003 total registered patients were 1900.

It was difficult to offer more services from the small premise, so GP's had several meeting with the PCT to move to a bigger building. During this time, Camden and Islington PCT divided into two and this surgery came under Islington PCT who decided to move the Surgery in a bigger premises. Meanwhile, one of the local GP died and another GP went for retirement.

In 1st October of 2003, Fairweather House Surgery shifted to newly built premises and named the surgery as Partnership Primary Care Centre (PPCC). After moving to this new premise, there are now 16 consulting session of doctors, 10 nurses session and 5 health care assistant sessions. Now the total registered patient is 3300 and growing everyday.

(Source: Mr. Rashidul Hasan: Practice Manager and Mrs. Heather Johnson: Ex-Practice Manager at PPCC)

Services Offered at PPCC

Services that are offered by PPCC are personal doctoring, urgent medical problems, out of hours emergencies, home visits, talking to a doctor or nurse on the telephone, family planning services , antenatal care , child health surveillance, screening and health promotion, travel immunisations & advice, sexual health for teenagers & adults, quit smoking advice, alcohol advice , advice on drug problems, test results, repeat prescription service, interpreting services, careers' needs and special nurse-led clinics available that include asthma/COPD clinics, diabetic clinic, cervical smears, childhood immunisation, family planning, heart disease/stroke prevention, well person checks. (Source: PPCC leaflet)

Customer Relationship Management System at PPCC

The surgery uses patient data storage system called "VISION" that is the most popular GP data storage system in the country. It has been maintained by the company called INPS. It holds all the information about the patients who are registered with PPCC. It holds the name, date of birth, address, telephone numbers and obviously the medical information. This system is also linked with the Whittington Hospital in order to receive test results including X-rays that are transferred electronically to the surgery.

Rationale for the chosen topic

I have selected Customer Relationship Management (CRM) because it is one of the best and most popular methods of developing stronger bonds with customers (in this research my customers are the patients who come to the doctor's surgery). It can be said that if there is no patients then there is no need of doctor's surgery, that is – no patient, no business. By the implementation of CRM strategies, PPCC can become one of the role model for other doctor's practices. Customer satisfaction is the core of any business and when it comes to patients, it is a must.

Research Questions- Formulation of researchable questions

Like all research, my research also has an objective and to achieve that objective I have prepared a researchable question. The most important question to me is:
‘How effective will be customer relationship management strategies in providing quality services in doctor's surgery?'

I will be focussing on this question through out my analysis of this research. Some of the important concerns that will arise while answering this question are as follows:

• What is CRM?
• Usage of CRM?
• What are the organisational benefits of CRM?
• How successful CRM can be in providing quality services?
• To what level can customer satisfaction can be achieved?
• How the organisation can achieve competitive advantage by CRM?

Research Aim

The aim of this research is to determine the relationship between the CRM and the quality of services and does it build a stronger bond with customers.

Research Objectives

The main objective behind this research is to understand and identify the root cause of customer dissatisfaction with the services provided at the doctor's surgery. This research will focus on the real life example of a London based doctor's surgery called Partnership Primary Care Centre (PPCC). I will discuss about the implementation and benefits of CRM to PPCC.

In order to achieve the above aim, the following research objectives have been set:

• To understand and identify the root cause of customer dissatisfaction with the services provided by the doctor's surgery,
• To determine the variable factors that could influence customer satisfaction level,
• To determine how CRM can bring a positive change in the quality of service,
• To identify how implementation of CRM can benefits PPCC.

Literature Review

A literature review discusses published information in a particular subject area, and sometimes information in a particular subject area within a certain time period. For the purpose of this research, the literature review is on Customer Relationship Management (CRM).

Customer Relationship Management (CRM)

The better a business can manage the relationships it has with its customers the more successful it will become. In order to have a better understanding and knowledge about the customers' needs and demands, customer relationship management strategies can be used. Customer relationship management (CRM) is not just the application of technology, but is a strategy to learn more about customers' needs and behaviours in order to build up stronger relationships with them. As such it is more of a business philosophy than a technical solution to assist in dealing with customers effectively and efficiently. (www.xicom.biz , Accessed: 21/08/09)

According to Armstrong and Kotler (2005) customer relationship management (CRM) is managing detailed information about individual customers and carefully managing customer “touch points” in order to maximize customer loyalty. CRM involves all of the corporate functions (marketing, manufacturing, customer services, field sales, and field service) required to contact customers directly or indirectly. The term “touch points” is used in CRM to refer to the many ways in which customers and firms interact. (Gray and Byun, 2001)

The foundation of customer relationship management CRM is based upon identifying; understanding and being able to provide a better service to customers. CRM allows build a better relationship with customers, improving customer satisfaction and maximising profitability. It is about understanding, anticipating and responding to the exact needs of customers with a constant eye for making the services to them the best it can possibly be. The main target of CRM is to improve long-term growth and profitability through a better understanding of customer behaviour.
(Source: www.customerrelationshipmanagementcrmuk.co.uk, Accessed: 21/08/09)

CRM consists of three basic components: customer, relationship and management. (Roberts-Witt, 2000)

Customer

If there is no customer then there will be no profit now or in the future. But a good customer, who provides more profit with less resource, is always scarce because customers are knowledgeable and the competition is fierce. Sometimes it is difficult to distinguish who is the real customer because the buying decision is frequently a collaborative activity among participants of the decision-making process (Wyner, 1999). Information technologies can offer the skills to distinguish and manage customers. CRM can be thought of as a marketing approach that is based on customer information (Wyner, 1999).

Relationship

The relationship between a company and its customers involves continuous bi-directional communication and interaction. The relationship can be short-term or long-term, continuous or discrete, and repeating or one-time. Relationship can be attitudinal or behavioural. Even though customers have a positive attitude towards the company and its products or services, their buying behaviour is highly situational (Wyner, 1999).

Management

CRM is not an activity only within a marketing department. Rather it involves continuous corporate change in culture and processes. The customer information collected is transformed into corporate knowledge that leads to activities that take advantage of the information and of market opportunities. CRM required a comprehensive change in the organization and its people (Wyner, 1999).

Specific software to support the management process involves: Field Service, E-Commerce Ordering, Self Service Applications, Catalogue Management, Bill Presentation, Marketing Programs, and Analysis Applications. They can be used to take the advantage of CRM, but keeping in mind that CRM is not about just technology but more about quality service.

(Source: http://www.tupublicas.com/docs/12-44-15-02-2004-leyva.pdf, Accessed: 17/08/09)

The core components of customer relationship management

The content of a CRM strategy consists of six mutually dependent criteria (Donaldson and O'Toole, 2002)
1. Emphasis on quality: if we provide poor service we will lose our customers and ultimately business. The core product alone is no longer sufficient, and service quality is considered as the key to successful business.

2. Measure customer satisfaction but manage customer service: This implies understanding and defining the various benefits that a prospect expects prior to purchase and the management of the gap between expectations and performance after the purchase process.

3. Invest in people: Both internal and external relationships are important. Implementation of a relationship orientation can only come from the people in the organisation understanding the objectives set and meeting the required standards.

4. Maintaining dialogue with customers: Building long-term relationships is the key issue in CRM. Companies that listen and adapt to preferences of individual customers have a higher chance to retain them and make them loyal.

5. Setting realistic targets and assessing performance: Organisations must have an understanding of customer views of the various elements in the offering and the elements important to each individual customer.

6. Relationship-based interfaces: This means being in touch with both internal and external customers in a responsive and flexible manner. In practice, there is a gap between what firms do, what they should do, and what is most desirable to do. The means of communication should be adapted to the needs of the individual customer. (Donaldson and O'Toole, 2002)

Types of Customer Relationship Management

There are different variations in CRM approaches and they are all in different software packages focusing on different aspects. Some of the main types of CRM are as follows:

Operational CRM

Operational CRM is for “front office" business processes. It interactions with customers to gather and stored customer information, so that later staff can retrieve customer information as necessary. The reasons for storing this information are as follows:

• Managing campaigns
• Enterprise Marketing Automation
• Sales Force Automation
• Sales Management System

Analytical CRM

Analytical CRM makes strong use of data mining and other techniques to create useful results for decision-making
Analytical CRM analyzes customer data for a many reasons and they are:

• Designing and executing targeted marketing campaigns
• Designing and executing campaigns,
• Analyzing customer behavior in order to make decisions relating to products and services
• Management information system

In this stage the importance of fully integrated CRM software becomes most apparent because the more information the analytical software has available for analysis, the better is the predictions and recommendations are.

Sales Intelligence CRM

Sales Intelligence CRM is more or less like Analytical CRM, but is intended as a more direct sales tool. Features include alerts sent to sales staff regarding:

• Cross-selling/Up-selling/Switch-selling opportunities
• Customer drift
• Sales performance
• Customer trends
• Customer margins
• Customer alignment

Campaign Management

Campaign management includes elements of Operational and Analytical CRM. The functions include:

• Target groups formed from the client base according to selected criteria
• Sending campaign-related material to selected recipients using various channels.
• Tracking, storing, and analyzing campaign statistics, including tracking responses and analyzing trends

Collaborative CRM

Collaborative CRM consists of a company's dealings with customers that are handled by various departments within a company, such as sales, technical support and marketing. Staff members from different departments can share information collected when interacting with customers. Collaborative CRM's main focus is to use information collected by all departments to improve the quality of services provided by the company. (Edwards, 2007)

Consumer Relationship CRM

Consumer Relationship System is mainly for a company's dealing with customers handled by the Consumer Affairs and Customer Relations contact centers within a company.

(Source: http://en.wikipedia.org/wiki/Customer_relationship_management, Accessed: 24/08/09)

Benefits of Customer Relationship Management

Exceptional customer service is about being aware of customer needs and reacting to them effectively. CRM facilitates to understand, anticipate and respond to customers' needs in a consistent way, through out the organization.

Practicing CRM requires an efficient and integrated internal business system. Many businesses benefit from the organizational discipline CRM imposes, as well as from the technology itself.

CRM will help business if we view it as a set of tools that let us do more for, and get more from, our customer.

CRM can:
• Develop better communication channels
• Collect vital data, like customer details and order histories
• Create detailed profiles such as customer preferences
• Deliver instant, company-wide access to customer histories
• Identify new selling opportunities

To better serve customers, organizations must ensure that information can be accessed through one single source throughout the enterprise.
(Source: http://www.is4profit.com/business-advice/it-telecoms/crm-customer-relationship-management_2.html, Accessed: 16/08/09)

Business benefits of CRM

Setting customer relationship management (CRM) solution in practice requires substantial time and expense. However, there are many potential benefits. A major benefit can be the development of better relations with the existing customers that leads to:

• Increased sales through better timing due to anticipating needs based on historic trends,
• Identifying needs more effectively by understanding specific customer requirements,
• Cross-selling of other products by highlighting and suggesting alternatives or enhancements,
• Identifying which of the customers are profitable and which are not.

This can lead to better marketing of the products or services by focusing on:

• Effective targeted marketing communications aimed specifically at customer needs,
• A more personal approach and the development of new or improved products and services in order to win more business in the future.
Finally this leads to:
• Enhanced customer satisfaction and retention, ensuring that the good reputation in the marketplace continues to grow,
• Increased value from existing customers and reduced cost associated with supporting and servicing them, increasing overall efficiency and reducing total cost of sales,
• Improved profitability by focusing on the most profitable customers and dealing with the unprofitable in more cost effective ways.

Once the business starts to look after its existing customers effectively, focus can be shifted on finding new customers and expanding the market. The more we know about our customers, the easier it is to identify new prospects and increase our customer base.
(Source: http://www.businesslink.gov.uk/, Accessed: 16/08/09)

Customer privacy is an important issue in CRM. CRM deals with large amounts of customer data throughout various touch points and communication means. The personalization process in CRM requires identification of each individual customer and collections of demographic and behavioural data, this is the very information that most customers consider personal and private. The individual organisation gets into an ethical dilemma as it wants to collect as much information as possible about each customer to further its sales. It is a must to have the customer consent to avoid any future problems. Authorized personnel should only have the access to the stored information and data.

Drawbacks of CRM

As of any other topic there are some negative sides about CRM. According to a research study released in March, 2001 by the Meta Group (cited in Connor 2001), between 55% to 75% of CRM projects fail to meet management objectives. However, research undertaken by CRM Guru (The Blueprint for CRM Success 2002) indicates that the failure rate of CRM projects is 35 %. About 50 % of projects get a payback within 18 months.

Research Methodology

The two most common methods of data collection for any research are qualitative and quantitative. It is important to define qualitative and quantitative methods. Quantitative data is the term given to data that can be quantified where as qualitative data is the term given to data based on meanings which are expressed through words and language (Anderson, 2004). Both these methods will be used to gather data and information for this research.

Interviews will be conducted with the staff members to learn about their ideas and opinions on what they can add to the existing services that they provide. If possible and permitted, then a group of patients will be selected and will be interviewed about what their expectations from the doctor's surgery. A questionnaire will be prepared for conducting this research which will be given to the patients who come to take service to the surgery. All these descriptive, exploratory, ethnographic, qualitative and quantitative methods will be used to fulfill the requirements of this research.

Data Collection Methods

This study draws on both primary and secondary data, such as past customer satisfaction levels, as well as both qualitative and quantitative data. The main focus will be on the qualitative approach as well as observation. This is because my data analysis will be based on words rather than figures. In addition to this, an interview will be conducted on a focused group of patients as primary data source.

Primary Data Collection Methods

Primary sources are original works of research or raw data without interpretation or pronouncements that represent an official opinion or position. Included among the primary sources are memos, letters, complete interviews or speeches (in audio, video, or written transcript formats), laws, regulations, court decisions or standards, and most government data, including census, economic, and labour data, (Cooper and Schindler, 2003). For the purpose of my research, qualitative method of data collection is more appropriate. Qualitative research is centrally concerned with the understanding rather than the measurement things (Hague & Jackson, 1996). Moreover it is believe that qualitative research provides data that is open to interpretation and argue. (Brassington & Pettitt, 1996). The search will use a combination of structured and unstructured questionnaires during face-to-face in-depth interview that provide a mixture of closed and open-ended questions for ease and for the acquiring optimum data. The interviews will be with the parties, the service providers and the service receivers that is the patients.

Questionnaire and Interview

Questionnaire will be one of the most important approaches that would be used in this research as it provides the simplest and fastest way of primary data collection. A questionnaire will be design to handout to all interviewees and this will give me the data I need to base my theories on.

Interviews will be taken to collect data in which selected participants are asked questions in order to find out about their activities, thoughts or feeling about relative issues.

The sample size will be 50 plus and of both sexes and of different age groups.

Secondary Data Collection Methods

Studies made by others for their own purposes represent secondary data, (Cooper and Schindler, 2003). This will include both qualitative and quantitative data as well as descriptive and exploratory research.

Books, magazines, articles, journals and other kinds of publications will be used to gather the data. The libraries that will be used for resources are London School of Commerce Library, the British Library, City Business Library and Online Library of University of Phoenix. As this report is a case on NHS (National Health Service), the web sites of the NHS and PPCC will be used to get information about the doctor's surgery. The information gathered on the secondary research will be presented in the literature review part of this research.

Data Analysis

The primary data that will be gathered through questionnaire as a form of quantitative analysis will be analysed by using the Microsoft Excel spread sheet. To have a better understanding of the data, they will be presented in Pie chart and Bar charts. The findings will be also put as percentage of the total sample size. The interview will be analysed as qualitative data as there will be opinions, suggestions and views of the participants.

Resource Requirements

Some of the expenses that would incur during the primary data collection would be for light refreshments for the interviewees and the expenses for secondary data would be for buying the referral books, magazines, printing and binding of the research. There will be also some additional transportation cost for travelling to the libraries.

Time Scale

Time is a crucial element for any kind of work and I believe that the dissertation can be completed according to the following time scale.

Time Scale Week

Activity 1 2 3 4 5 6 7 8 9 10 11 12
Submission of the Proposal

Literature Review

Interviews
Updating Literature Review
Data Collections and Questionnaire
Data Analysis
First draft of dissertation
Revising draft
Second draft of dissertation
Final editing and preparing
Final report ready