title: Look who's taking notes in your clinic: mystery shoppers as evaluators in sexual health services.
abstract: OBJECTIVE
  To test the feasibility of professional patients as a tool for sexual health service evaluation. Professional patients are paid to use services specifically for audit or evaluation purposes without disclosing their identity as evaluators.
  
  
  METHODS
  Professional patients visited five large sexual health departments used by 3000 clients per week in two inner London Boroughs with very high rates of sexual ill health. They recorded their experience on a structured evaluation form. Semi-structured telephone interviews were completed with seven service providers to document their experience of the programme.
  
  
  RESULTS
  Recruitment and training for professional patients is described. Forty professional patients made 105 visits during two rounds of visits 9 months apart. After 47% (round 1) and 62% (round 2) of visits, the professional patients felt that they would recommend the service to a friend. The professional patients provided detailed and specific feedback on all aspects of service provision. This information was highly valued by service providers who reported few objections from staff to the visits. A small number of examples of very poor care were documented.
  
  
  CONCLUSIONS
  Professional patients are a useful tool for sexual health service evaluation. They provide high quality feedback because they are both 'experts' on sexual health service provision and users of sexual health services. This method of evaluation raises ethical issues about the acceptability of deception as part of the evaluation process, the right of staff to anonymity and to refuse to be visited. Professional patient programmes provide an opportunity for regular cycles of user feedback to monitor quality improvement.
authors.affiliation: Lambeth and Southwark Sexual Health Modernization Programme, London, UK. paula_baraitser@mac.com
authors.forename: Paula
authors.initials: P
authors.lastname: Baraitser
authors.forename: Vikki
authors.initials: V
authors.lastname: Pearce
authors.forename: Nathalie
authors.initials: N
authors.lastname: Walsh
authors.forename: Richard
authors.initials: R
authors.lastname: Cooper
authors.forename: Kirsty Collander
authors.initials: KC
authors.lastname: Brown
authors.forename: Jo
authors.initials: J
authors.lastname: Holmes
authors.forename: Lovelle
authors.initials: L
authors.lastname: Smith
authors.forename: Petra
authors.initials: P
authors.lastname: Boynton
mesh_terms: D000293:Adolescent; D000328:Adult; D003151:Community Health Centers / Q000592:standards; D003625:Data Collection / Q000379:methods; D005240:Feasibility Studies; D005246:Feedback; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008131:London; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011369:Professional-Patient Relations; D011785:Quality Assurance, Health Care / Q000379:methods*; D034121:Reproductive Health Services / Q000592:standards*; D014566:Urogenital System