Is mystery shopping in the NHS a good idea?

I think this is a good idea. I hope the NHS takes it up.
 Dr. Taleb Durgahee

Palm Court Centre of Excellence in Dementia Care
PREFERRED PROVIDER OF DEMENTIA CARE FOR EAST SUSSEX COUNTY COUNCIL
Provides Nurse Education and Overseas Nurse Programme
In Collaboration With Brighton University

17-19 Prideaux Road, Eastbourne, East Sussex, BN21 2ND
Tel: 01323 721911
Fax: 01323 410244

www.palmcourtnursinghome.co.uk

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HI,
Yes - yes - it is quality control - not snooping as one comment said in the Nursing Times.

I don't whether anyone knows but one of the objectives for A Dignified Revolution when we set ourselves up in 2007 was to call for an independent mystery visitor scheme for every hospital based on the mystery shopper model.
The idea came originally from Richard Hollingberry who is a gerontologist and with whom I worked when I was a Trustee for BASE (British Association for Services to Older People) way back in 1995. Richard wrote this article called 'You can't ring the bell' for a gerontology journal and I have been quoting it ever since. Richard also developed, when he was at the Helen Hamlyn Foundation the EPICS system (Elderly Care Intergrated Care System). This is a system that has been evaluated and really works - if only the public sector would use it.

I attach the orginal article re a mystery visitor - please do pass on to everyone you can.
The article is also on the ADR website.

I hope that in a little way we (A Dignified Revolution) influenced the NHS in some places to use this model - albeit using existing patients and staff. Not independent enough for us but at least it is a start.

Please DOH - make this way of monitoring and quality control mandatory - anything else means that it is laissez-faire.
We will continue to lobby for this model to be used. Why not pay people to become mystery visitors? A small cost compared with the medico-legal costs that sometime ensue following complaints.

Regards to all the other Champions,

Lorraine
A Dignified Revolution Founder member and a registered nurse

Lorraine Morgan
Tiwtor Staff/Staff Tutor

Y Brifysgol Agored yng Nghymru/The Open University in Wales
029 20 262760/Mobile 07 827895862
Fax: 029 20 388132
[log in to view email address]
http://www.open.ac.uk/wales
http://www.open.ac.uk/hsc

Great article! Yes, I'm in agreement - anything that is proactive works for me

Most definitely. I can only imagine that the staff who are against it are the ones who are likely to be found wanting if mystery shopping were adopted.

However, given the record of the RCN on the whistleblowing nurse, I shall be very surprised if the idea ever gets off the ground.

Hi All,

This is looking like a developing positive discussion.

DOH colleagues - can this be developed further by capturing and supporting people to use this model?

This would be a significant step but would really empower and enable nurses in particular to challenge and change practice effectively.

Regards,

Lorraine
A Dignified Revolution Founder member

Lorraine Morgan
Tiwtor Staff/Staff Tutor,

Cyfadran Iechyd a Gofal Cymdeithasol/Faculty of Health and Social Care
Y Brifysgol Agored yng Nghymru/The Open University in Wales
18 Stryd y Tolldy/18 Custom House Street
Caerdydd/ Cardiff CF10 1AP
Tel: 029 20 262760
web: http://www.open.ac.uk/wales
Mobile 07 827 895 862

Great....I hope the NHS takes on board the idea of mystery shopping because it will improve things massively.
 Dr. Taleb Durgahee

Palm Court Centre of Excellence in Dementia Care
PREFERRED PROVIDER OF DEMENTIA CARE FOR EAST SUSSEX COUNTY COUNCIL
Provides Nurse Education and Overseas Nurse Programme
In Collaboration With Brighton University

17-19 Prideaux Road, Eastbourne, East Sussex, BN21 2ND
Tel: 01323 721911
Fax: 01323 410244

www.palmcourtnursinghome.co.uk

E-mail is not a secure communication medium. Please be aware of this when replying. Although DFB Care Ltd has taken steps to ensure that this e-mail and any attachments are virus free, we can take no responsibility if a virus is actually present and you are advised to ensure that the appropriate checks are made.

I have just signed up as a dignity champion and I do feel that this is a good idea. The main thing is how the findings are followed up by the service and developed into transforming practice.
Regards
Sue

HI,
Heartily agree.

There are two 'M's to remember when assuring quality of care.

'M' for MANDATORY - people will not do it unless it HAS to be done i.e.
a code of conduct, a service framework with inspected actions, national
standards, legal requirement, an organisational policy etc.....
HOWEVER

'M' also stands for 'MONITORING' and unless Mandatory
standards/frameworks/rules in practice are actually monitored and
recorded and can be inspected then..........we have the situation we see
now.

Re nursing care in hospitals - Nurses need to be monitored at all
levels. This clearly supports staff who are passionate about their care
and are entirely frustrated about standards - but it also catches the
people who are found wanting. I am not actually talking about
performance management but about managers walking around wards and
hospitals - observing and talking to patients on a daily, weekly and
monthly level.

We need both 'M's not just one.

Regards
Lorraine
A Dignified Revolution

Lorraine Morgan
Tiwtor Staff/Staff Tutor

Y Brifysgol Agored yng Nghymru/The Open University in Wales
029 20 262760/Mobile 07 827895862
Fax: 029 20 388132
[log in to view email address]
http://www.open.ac.uk/wales
http://www.open.ac.uk/hsc

Hi everyone,
As a student nurse i witness many things and sometimes it is very difficult (as many staff view us as the lowest of the low (which is another matter entirely)) I do agree this would be extremely beneficial to both patients and staff and would encourage more staff to treat specific groups of patients with more dignity and respect.

hello everyone ,
I read the article you cant ring the bell and I agree whole heartedly with Lorraines points and comments . However I think it is so sad that a student nurse such as (Lauren) who is so obviously caring and wants to make a difference to patients lives is made to feel so disempowered by members of staff I truly think the whole culture of the organisation needs to change .

Hi All

I feel really passionately, that older people are given a really bad deal from many aspects of our society not just from health and social services. The problem is that often people do things because it has become the norm, new staff come on to a ward and take their lead from pre existng staff. This is especially true from novice assistant staff. Often the way staff behave is not mean't with malice, but with beneificiance, they feel thay are doing the right things for people, but with out actually asking first, and without thinking about the way they come across.
I find lots of older people are reluctant to put their concerns or complaints into effect because they feel that it will have a detrimental effect on their treatment, or the way they are treated by ward staff. Often it's just a passing comment with the added statement of " i don't want to get anyone in trouble but...." and these comment are not acted on.
Much to my concern I have witnessed older people asking about specific treatments and questionning the healthcare professional about why they have choosen that route, to then be labled as a trouble maker and let's get them out of hospital as soon as possible.
I think that having mystery shopper is an excellent way to go and can only bring about positive changes for all those involved.
Carol

Lauren's Nurse Executive at her organisation needs to know this?

But how??

This is where the barriers are

Any suggestions to make senior executives feel responsible and actually act?

Regards,

Lorraine

Lorraine Morgan
Tiwtor Staff/Staff Tutor,

Cyfadran Iechyd a Gofal Cymdeithasol/Faculty of Health and Social Care
Y Brifysgol Agored yng Nghymru/The Open University in Wales
18 Stryd y Tolldy/18 Custom House Street
Caerdydd/ Cardiff CF10 1AP
Tel: 029 20 262760
web: http://www.open.ac.uk/wales
Mobile 07 827 895 862

I totally agree.

Sally

>----Original Message----
>From: [log in to view email address]
>Date: 31/07/2009 11:14
>To: <[log in to view email address]>
>Subj: [Dignity Champions Discussion Forum] - Re: Is mystery shopping

in the NHS a good idea?

>
>Hi All
>
>I feel really passionately, that older people are given a really bad

deal from many aspects of our society not just from health and social
services. The problem is that often people do things because it has
become the norm, new staff come on to a ward and take their lead from
pre existng staff. This is especially true from novice assistant staff.
Often the way staff behave is not mean't with malice, but with
beneificiance, they feel thay are doing the right things for people,
but with out actually asking first, and without thinking about the way
they come across.

>I find lots of older people are reluctant to put their concerns or

complaints into effect because they feel that it will have a
detrimental effect on their treatment, or the way they are treated by
ward staff. Often it's just a passing comment with the added statement
of " i don't want to get anyone in trouble but...." and these comment
are not acted on.

>Much to my concern I have witnessed older people asking about

specific treatments and questionning the healthcare professional about
why they have choosen that route, to then be labled as a trouble maker
and let's get them out of hospital as soon as possible.

>I think that having mystery shopper is an excellent way to go and can

only bring about positive changes for all those involved.

>Carol
>
>
>
>
>

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_______________________________________________________________________

As i stated in an earlier post I don't think that student's perspectives are taken into account, and complaining about things can make things very difficult for students on placments. I have on many placements complained to my mentors (most of whom i have built good relationships with).
Maybe using student nurses as "mystery shoppers" would be beneficial in reducing bad practice passed on to students and also eleviate students stress of reporting incidence.

please can you tell me exactly what the mystery shopper will do?

Sorry for delay in reply, I have only just got back to using the pc. I
would hope they would talk to the patients and relatives about their
personal care in the ward.

Without doubt a good idea in principle. More information about how it might work would be helpful. Any system that allows patients, clients and relatives to talk confidentially and anonymously to a third trusted party would be helpful. Too many users feel threatened by the system to give an honest and often constructive opinion.

In Principle it is a good idea. However, if the mystery shoper is to be a student nurse they must feel empowered to ask and report back. Not all wards have student nurses on them, at any given time. A mystery shopper must be given the time and support to take on the roll, not 'oh just go and ask the patients if they are happy, so we can say we've done it'

Management must NOT see this as a paper exercise, take on board responses, (good and bad), form a plan to improve dignity as appropriate, and make sure it is followed through. Otherwise the whole process falls down like a house of cards. I suspect unfortunately, that if there are cost implications such as training eg in Dementia Care it won't be followed through properly.
Every member of staff, volunteer, should be a 'mystery shopper, and report bad practice.

Hi,

A Dignfied Revolution made the call in 2007 for a mystery shopper in the NHS. This was based on the Richard Hollingberry paper 'Don't ring that bell'.'

Mystery shoppers MUST have the experience behind them and the knowledge and expertise to spot poor quality in terms of:
A lack of values which underpin any practice in the area of observation.
A lack of equipment/staff etc...
Other issues which indicate that the organisation is not meeting its standards, regulatory standards and professional standards.

So - whereas student nurses may come with the right values - do they have the experience and appropriate knowledge to spot the right things.
We also may all know the results from talking with older people (see Help the Aged 2009 Measuring Dignity report) about quality in terms of low expectations of care e.g. 'The nurses are wonderful, they work so hard and they are so busy - I don't want to bother them.' Also - you really do not bite the hand that feeds you.

So - the MS model looks for and uses highly experienced people who are very knowledgeable, vigilant and astute.

Lorraine
A Dignified Revolution

yes i think this is a good idea to see how compliant staff are with the call