'Transparency is clear to see': a blog by Prof. Carl Philpott.

“Transparency isn’t an ambition, it’s a reality that will drive consistency in PROMs and quality of care for patients.”

Professor Carl Philpott

I am deeply encouraged by the momentum that is now starting to build in driving transparency in private healthcare. There is a growing chorus calling for greater transparency, from the Private Healthcare Information Network (PHIN), Royal College of Surgeons (RCS), and most recently from the Secretary of State for Health and Social Care, Jeremy Hunt, and if listened to, this increased transparency will help improve the quality of care for patients and drive patient safety.

In the work I undertake with ENT-UK and acting as Professionalism Lead at Norwich Medical School it is clear that for the next generation of healthcare professionals, transparency in performance data and patient health outcomes data will be commonplace. The professionalism and commitment that is being initiated and driven now will be even more evident in the next generation of medicine.

When the publication of consultant-level private healthcare performance information happens in July 2018, more validated data about consultants will be available in the public domain than ever before. So as transparency becomes a reality there is a clear and present need to better demonstrate the positive benefits that our procedures provide patients in day-to-day activity. Patient Reported Outcomes Measures (PROMs) enable this through focusing data on the patient experience and being able to build a much stronger picture of the longer-term patient journey.

As PHIN progresses the collection of PROMs data, this will help drive clinically validated outcomes data starting with private healthcare. For consultants working in private practice, I believe this means that we can start to measure patient outcomes in a more standardised way, and this is a major advancement in creating closer integration between NHS and private healthcare systems. Hospitals, consultants and procedures can be compared across NHS and private healthcare and opportunities for each to learn can be identified.

However, to do this more systematically we must overcome the notion that collecting PROMs data creates a perceived added workload, which places resistance in the path of progression. Health systems do, however, need to work harder at facilitating electronic data capture. This could be as straightforward as providing patients with iPads, for instance, so they can respond to questionnaires and measurements of health outcomes with the least inconvenience to both the patient and the doctor. However, we must consider data collection an absolute priority and continue to digitise at all levels. Undertaking PROMs data capture more routinely across practices would be a step-change in the level of outcomes measurements that we are able to measure across the patient journey and drive much more joined-up thinking.

Taking the specialty of ENT as an example, there has been much work undertaken to help develop and promote PROMs, for example the Sino-Nasal Outcome Test-22 questionnaire (SNOT-22) has been validated and used widely in practice since 2009. This has proved an effective tool to move beyond simple data and is of great value to patients and clinicians in understanding care and quality of life improvements. For nasal obstruction (specifically related to septal deviation), the Nasal Obstruction and Septoplasty Effectiveness (NOSE) scale, is a validated PROM that is currently going through an implementation process, and for which ENT-UK has confirmed their support. Furthermore, PHIN will be using NOSE as the PROMs performance measure being collected for ENT procedures, and it will later be published for work undertaken privately. This is significant because, with the roll-out of NOSE across the NHS and private healthcare, this is a great example of a specialty that will have an opportunity to create much stronger integration of PROMs data across both NHS and private practice.

PROMs data undoubtedly unlocks and evidences quality of care experienced by patients, so we must prioritise data standardisation and consistency in collecting this information more routinely. As transparency takes a significant step forward through the publication of initial consultant performance data in private healthcare, it will be up to us to continue to make transparency a reality and rally behind this so that future data on PROMs can be published and quality of care for patients can continue to be improved.

Professor Carl Philpott is Professor of Rhinology & Olfactology, Head of the Rhinology & ENT Research Group, and Honorary Consultant Rhinologist and ENT Surgeon. You can find his profile here. This blog was first published in Independent Practitioner Today.

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