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Revealed: How PCTs use undercover 'mystery shoppers' to assess GPs

By Steve Nowottny

Exclusive: Primary care trusts are aggressively ramping up use of ‘mystery shoppers' as a way of assessing local GP services, with some throwing tens of thousands of pounds at undercover projects.

A Pulse investigation reveals trusts have launched secret probes to test practices on everything from how easy it is to register to the ‘attitude' of front desk staff.

Information obtained under the Freedom of Information Act from 110 PCTs shows one in three have either already used mystery shoppers to assess GPs, or are likely to do so shortly.

Trusts are employing patients or using PCT staff to carry out covert checks, with one spending £25,000 on undercover checks over six months.

Eleven PCTs were currently using mystery shoppers, 16 were considering introducing them and nine others had used them recently.

Areas being checked include telephone answering, appointment availability, new patient registration, sexual health services, disabled access and customer service skills.

The controversial use of anonymous audits comes as part of a raft of new measures to assess patient experience, including a revamped patient survey, balanced scorecards and online practice ratings on NHS Choices, which launch next month.

In Milton Keynes, one mystery shopper was employed late last year to assess access at local surgeries.

A feedback form seen by Pulse shows practices took from between five seconds to four minutes to answer the telephone, while ‘staff attitude' was graded from ‘extremely good' to ‘helpful but abrupt'.

But Dr Julian Bradley, a GP in Milton Keynes, cast doubt on the validity of the audit:

‘Has the process been reviewed using NICE techniques? With the NHS facing a £20 billion black hole, is this how we want to spend our money?'

Heart of Birmingham Teaching PCT, which has used mystery shoppers since 2005, now uses the technique to check up on physical and telephone access, cleanliness and the greeting offered by reception staff. Some £25,000 was spent on training and paying mystery shoppers in the second half of 2008 alone.

A PCT spokesperson said reports from mystery shoppers were used to corroborate patient survey findings and for performance visits to practices.

‘Also, we have used the information to aid decisions around assessing new providers of GP services,' she added.

Birmingham GP Dr Vijay Abrol said: ‘When you're surveying every day of the week, and then feel the need for somebody to come and check on it, you haven't got trust and professionalism.'

PCTs are employing 'mystery shoppers' to anonymously assess GP practices PCTs are employing 'mystery shoppers' to anonymously assess GP practices GPs under scrutiny

NHS Richmond – has used mystery shoppers within primary care since 2003, now using a team of seven undercover PCT staff to carry out ad hoc inspections, assessing ‘compliance against contractual requirements' related to access and telephone messages

NHS Lewisham – uses a ‘junior member of staff' to mystery shop all of its 48 practices every month, assessing appointment availability

NHS Ealing – uses targeted mystery shopping to follow up patient complaints, addressing issues such as the patient registration process and the quality and content of answerphone messages

Heart of Birmingham Teaching PCT – has used mystery shoppers since 2005, including as part of the Darzi centres procurement

NHS Milton Keynes – mystery shopper was used to grade the ‘attitude' of front-desk staff, with some criticised as ‘quite abrupt'

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