The Department of Health has published new guidance to help the National Health Service collect patient reported outcome measures (PROMs), which are designed to help rate the quality of services.

The idea of turning to patients to measure the success of clinical operations was cemented by Lord Ara Darzi in his NHS Next Stage Review report, High Quality Care for All, launched in June last year, under the wider strategy of giving patients more influence over NHS resources and more power to drive improvements.

As part of this, hospital funding will, in part, be conditional upon on the quality of care patients receive, and so performance in terms of safety, clinical outcomes and patient experience and views on the success of treatments is to be measured in various ways, such as PROMs.

Under the initiative, patients will be asked to fill out a questionnaire on their quality of life before and after an operation, so that the data can be used to calculate a numerical value for improvement to health.

First of a kind
“The beauty of PROMs is that it measures the success of operations as reported by patients themselves,” explained Lord Darzi. “This programme is the first of its kind in the world and the information collected will empower patients to choose a hospital that achieves the best results for the operation they need,” he stressed.

From April this year, providers of hip and knee replacements and groin hernia and varicose vein surgery are required to invite patients to complete a pre-operative PROMs questionnaire, after which a contractor will collect the data as well as administer post-operative questionnaires.

"While a surgeon may judge a hip replacement successful because the procedure has been performed perfectly on the day, the patient will rightly disagree if they are still in pain and continue to have a poor quality of life six months down the line,” Lord Darzi explained.

NHS Confederation Policy Director Nigel Edwards has welcomed the move: “PROMs are part of the next big shift for the NHS as it moves from simply taking people in, performing operations and counting the numbers to measuring the extra value treatment has made to a patient’s quality of life,” he said.

“Massive potential”
“There is massive potential here to properly define what successful NHS treatment looks like and improve services, but it must be done in such a way that collecting all this information does not impose unnecessary bureaucratic burdens on the NHS,” he warned.

According to Lord Darzi, implementation of PROMs should also help to strengthen commissioning across the NHS, as it will enable primary care trusts to choose which services to buy based on patient experience. “What's more, routine collection of PROMs will enable clinical teams to benchmark their performance and research the success of different treatment options,” he added.

Although PROMs will initially only be used in the areas mentioned, research is currently underway to identify others where they could be implemented, the DH notes.