I agree with the spa comment - I've given up trying to get an appointment. More often or not they are fully booked and that is with 3 hours to go to the flight.

I occasionally travel First, when circumstances allow and I do wonder why I pay the premium. It is just the small things that make all the difference, that many people have pointed out on here so far. If you are paying £10k for a return ticket to LAX (or anywhere for that matter) there should be a specific channel for you to get through security quickly and smoothly, that you should be able to get served quickly in the lounge, that you should be given priority treatment in the spa, that you shouldn't have to board a bus to get to the plane etc etc. All those small things do make the difference.

In the air - well, I had one complaint once - when I thought the staff were a bit miserable in First. A quick word with the CSD and it all changed. I agree with the food choice - it should be better, but it wouldn't take much to do this. I think that is the point.... they could get this a lot better by making small, but important changes.