Monday, 4 February 2013

Mystery shoppers.

The problem with our hospitals is that they don’t seem to learn from anyone else’s mistakes. It would be a start if they learnt from the catastrophic failures that result in public enquiries or scandals. The fact that these keep happening suggests they don’t. The Stafford scandal report comes out on Wednesday. It will be full of regret and apology – what will change?

But it’s more everyday than that. Whenever anyone makes a complaint (and I’ve seen a few now as a result of this site) you get a standard word processor letter. It is top and tailed with your details but the profuse apologies and promises to learn from their mistakes are cut’n’pasted in from a standard response. It’s meaningless, believe me. They just go on doing the same.

They don’t learn from experiences outside the health service either. There is a whole organisation designed to persuade us away from complaining called PALS – the patient liaison service. I’m sure it is full of well-meaning people who want to help, the problem is that they aren’t.

They should be encouraging complaints, not discouraging them. However, their job is to reduce formal complaints because these end up in the annual report as a measure of a hospitals failure. Does good management deal with complaints or bury them?

The thing is complaints are an early warning system; how else do you work out what’s going wrong before it becomes catastrophic? 

Take Tesco’s or any other big, successful retailer – are they getting rid of people who complain? Well, the ones who do go bust.

The successful ones have pioneered the concept of the ‘mystery shopper’ – there are whole businesses who supply anonymous people who travel round the country visiting shops to go shopping or try out services.

Then they write a report about the store; the stock, the service, the attitude of staff. Then the manager gets a copy and it either changes or s/he goes. Does that not seem like a good idea for the NHS?

Every hospital has visiting times; many people don’t have visitors and would welcome a chat. In comes the mystery shopper, has a chat to a patient on the ward, has a look round, chats to a few patients, other visitors and the staff.

Are elderly people being fed, given drinks? Are they being washed? Is there blood etc lying around? Is everybody washing their hands? Do patients understand their treatment/options?

These are basic things that indicate whether the care is good or bad. Right now it isn’t happening.

Then they write a report and the management change or go. The mystery shoppers don’t need to be qualified, in fact it is probably better that they aren’t. Sometimes a bit of common sense goes a long way.

At the moment there is a rapid ward round (and I mean rapid) where the Doctors avoid interfering with the care and the Nurses avoid the Doctors. Everyone avoids the patients.

If you are unusually lucky, the ‘men in suits’ zoom around the wards, once in a while, as if hanging around talking to anyone could result in a nasty infection.

So, a small, determined body of mystery shoppers could cover the whole NHS quite often and much cheaper than an inspection once in a blue moon. Unlike official inspections, no one can spot my mystery shopper or ring ahead to warn the other departments.

Half the point of the mystery shoppers is deterrence – if you never know when they are coming you do your job.

Managers may only care about money and yet bad care costs more than good to clear up.

And I do mean in terms of money as well as suffering.


Neil Harris

(a don’t stop till you drop production)

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