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The use of the term customer is new in the Health Service. Its use should be made clear and not be used interchangeably with consumer. Organisations have customer‐supplier chains. Focusing on these chains can assess the effectiveness of services to the customer. All organisational processes influence service to the external customer. A successful organisation must satisfy external customer needs. Wants, needs and expectations need clarifying. Patients′ needs are often rationed by the professionals. Because of the complexity of National Health Service (NHS) business and the relative lack of choice of external customers, the responsibility of NHS staff to meet their needs and expectations is greater than in the private sector.

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