Getting real value from patient reported outcomes.
A key element of the data we collect are Patient Reported Outcome Measures – commonly known as PROMs.These are questionnaires a patient completes about their health before and after certain procedures. The results are compared to provide an indication of health improvement. They are one of the best measures of effectiveness of treatment and a vital source of information on the quality of services.
The NHS was one of the first health systems to implement PROMs on a large scale, and it’s just one of the ways in which the NHS serves as an exemplar to other health systems around the world. NHS England recently ran a consultation on how to get better value from their National PROMs Programme and asked PHIN to contribute from our experience developing a PROMs programme for privately funded patients in the UK.
Since 2014 we have worked with hospitals, consultants and private medical insurers to develop the programme for private healthcare. This aligns with and builds on the NHS programme to cover 11 procedures, beyond the four currently measured within the NHS. We based our response on our experience developing the PROMs programme for privately funded patients, with support from our Chairman Dr Andrew Vallance-Owen and board member Professor Nancy Devlin – both highly respected experts in the field of patient reported outcomes.
In our response we outline three key recommendations to improve the use of PROMs within the NHS:
1. Using PROMs as a clinical tool.
Currently PROMs are used at a statistical level – to measure trends and quality at a hospital or for a consultant, or for academic purposes. While PROMS have a clear benefit and use in this way, there is a practical use of PROMs in the care pathway. Using real time results during consultations can provide helpful information on the expected outcome of treatment. This helps inform conversations between patients and their clinician when considering treatment options, and indicates where further intervention may be required where the expected outcomes have not been achieved.
2. Moving over to electronic based systems.
While there is an initial financial cost on moving over to electronic based systems, ultimately this will save resource and time for front line staff. Most important, electronic systems support the real-time, practical use of PROMs within the care of individual patients.
3. Implement PROMs for a wider range of procedures.
Currently the NHS only measure PROMs for four procedures. As the most effective measurement of health improvement (and success of treatment) it makes sense to expand to a greater range of procedures. Within our response we have provided the criteria we used when accessing the value of PROMs for each procedure.