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Notes the increased emphasis on community care in the NHS and suggests that “informal welfare” models of delivering such care pose particular quality and quality assurance problems. Consumer satisfaction in the community context is taken to mean both user satisfaction and carer satisfaction. Presents results from a Northern Ireland study of carers. The carers interviewed drew a distinction between quality and quantity of services received. Individual services were rated highly but there was demand for more and anxiety about future needs. Personal costs of care in lost employment, relationship and financial opportunities were also indicated. Concludes that carers are a valid and useful source of quality feedback.

Explores the value of focus group methodology in a patient satisfaction initiative intended to identify quality improvement targets in a large general hospital. Analyses the transcripts from ten focus groups selected from hospital discharge lists, using simple cut‐and‐paste techniques. Finds that the focus group methodology was successful in amplifying feedback previously gleaned from surveys. Highlights patients’ tolerance of shortcomings and their appreciation of staff providing high quality care while under pressure. Concludes that patients regard the National Health Service as deteriorating generally.