AbstractThe provision of health and social care no longer can be regarded as different from other enterprises. The increasing demands from articulate, well-informed user groups are forcing practitioners and their managers to look outside their traditional boundaries for tools and techniques to improve what they do. The commercial world has long understood that genuine and sustained improvement comes about through continually evaluating performance in relation to customer needs. To understand the ever-changing relationship between performance and customer needs, leading edge organisations have sought tools to enable them to identify areas of success and areas for improvement. Clearly, no one tool or technique can be regarded as the panacea for all ills; however, the intelligent use of management tools and techniques has enabled organisations to understand the needs of their customers better and thereby drive improvements in what they do and what they produce. The use of these tools in health and social car...