ABSTRACT
This chapter highlights the point that the question of value within an National Health Service context is far more multi-dimensional than in a commercial one. The role of the customer as value specifier lies at the heart of the Lean philosophy. The chapter argues that 'self-care' is based on the belief held by healthcare providers that patients can positively affect their condition when placed in a position that facilitates self-management. As a concept, self-care has been shown to be effective in improving the quality of life of patients and promoting appropriate utilisation of services. By identifying customer value, Lean operations put pressure on the provider to be efficient and effective in the provision of their services. Traditional customers are generally seen as autonomous, powerful and knowledgeable people, driven by aspirational wants and actual or perceived needs. The argument for many is that customer value in healthcare may mean improvements in areas such as medical mistakes, waiting times and patient satisfaction.
