There is a growing consensus within the NHS of the importance of obtaining feedback from patients in order to improve the quality of health care; consequently, many patient satisfaction surveys are now undertaken. However, much research is based on provider-held assumptions about service quality. This study focuses on patient satisfaction with coronary bypass surgery, starting with the concerns expressed by patients and using these as a basis for evaluating different aspects of care. The paired comparison technique was employed to produce a ranked list of aspects of care that were perceived to be in greatest need of improvement. Some difficulties were encountered in administering the ranking technique to patients in a highly specialized health-care setting; however, results were obtained and validated for follow-up patients. The item of most concern to these patients was a lack of sensitivity about when patients felt ready for discharge.