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Awareness of inconsistencies and variability in the delivery of health services across the UK has heightened in recent years, leading to general acknowledgement that a move away from “health care by post code” is a strategic priority for the National Health Service (NHS). NHS Direct, a call centre service for patients and their carers, is unique in the NHS in that it represents an entirely new service concept, with a rare opportunity to design a single nation‐wide service from scratch, and to manage and co‐ordinate a delivery system consistently throughout the country. Evaluates the strategic alignment of NHS Direct during the first three years of implementation through an analysis of its service concept, its operational objectives, the design of its delivery systems and its volume and variety characteristics. The evaluation reveals an absence of a central design specification which has resulted in wide variation in the call centres’ service portfolios, resource bases, competences, telephony and clinical expert systems. Contends that variation and variability in the design of the call centres has severely compromised NHS Direct's ability to meet its strategic and operational objectives, resulting in strategic misalignment. Also identifies missed opportunities to learn from the growing call centre literature and from service shops in other industries.

This paper represents an initial investigation into the strategic implications of providing training to all employees of coffee shops in the UK, including baristas (coffee makers) on temporary or part‐time job contracts. In particular, the paper aims to investigate whether service quality can be significantly improved by devoting substantial resources to staff training.

Two focus groups were conducted to obtain a demand side picture of this market. One of these groups comprised customers under the age of 30 years and the other was made up of customers between 30‐50 years of age. Managers of two coffee shops were interviewed to get a supply side view.

The attitudes of the two focus groups were surprisingly similar. Generally, customers did not expect more than basic product knowledge from their baristas. On the supply side, it emerged that the coffee chains provided basic training to all of their employees. This training was firm specific and revolved around a workbook that employees completed in a matter of weeks.

This market is a highly volatile one and customer expectations may well change in the near future. Moreover, future research will compare the UK coffee market with other countries, to further contextualise the results.

Current spending by firms on front line staff typically amounts to approximately £200/person per year. This research suggests that coffee shops are behaving rationally in providing limited training to their staff. There is no evidence, on the demand side, that perceptions of service quality would be enhanced by spending significantly more on training baristas.

This paper adds insight to the discussion surrounding consumer perception of service quality in the context of a rapidly growing market.