Applying gap analysis in the health service to inform the service improvement agenda

Purpose – The need to better understand patient priorities in order to provide higher levels of patient care is an ongoing challenge for managers across the UK NHS. Indeed, the failure of service providers to understand patient priorities can lead to action plans, investment and management decisions which are internally rather than externally focused. This paper seeks to report on the development and evaluation of a tool for measuring the gap between patients’ priorities and their perceptions of an NHS service, and the match between the patient and management perspective. Design/methodology/approach – The tool, an adaptation of the renowned SERVQUAL measurement methodology, is tested in UK NHS breast‐screening unit. The tool is used to measure the perceptions of two different types of patients, as well as those of three different types of staff. Findings – The study suggests that the tool can be used to quantify the gap between patient priorities and their perceptions of health service performance. The tool may also be used to measure staff's perceptions of patient priorities and perceptions, with a view to identifying those functional staff who best understand the patient perspective. Originality/value – The methodology facilitates the identification of key differences in the expectations and perceptions of different health service market segments, which could have direct implications for service design and delivery at an operational level. Furthermore, it can be applied to identify differences in functional perspectives and thus expose valuable opportunities for intra‐organisational learning.