Patient Reported Outcome Measures

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Patient Reported Outcome Measures
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Background

• Standard NHS contract for Acute Services
  introduced in April 2008 included a requirement
  for all providers to report PROMS from April 2009
  for 4 areas
• Unilateral hip replacements
• Unilateral knee replacements
• Groin hernia surgery
• Varicose vein surgery
• Patients undergoing one of these procedures are
  to be invited by NHS providers to complete a pre
  and post operative PROMS questionnaire

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What are PROMS?

• PROMS measure a patients health status before and
  after surgery. The use of short pre and post
  operative questionnaires
• Supports Benchmarking and Contract Monitoring
• Evaluate clinical quality
• Used by patients and GPs with regards to choice
• Evaluate cost effectiveness of technical
  operations
• Assess appropriateness of referral
• Support reduction in inequalities
• Empowers Commissioners
• Intention is the link payment to PROMS

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Process for collecting Data
PROMS Administration Contractor
Commissioners
Commissioners
Providers
PROMS Administration Contractor
NHS Information Centre
PROMS Aggregation and Analysis Contractors
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Roles of Organisations

• Providers
• Nominate contact point and link with PROMS admin
• Ensure data collected is representative of the
  population
• Administer pre-op questionnaires
• Detach and retain consent forms
• Return competed questionnaires to PROMS admin
• Make use of record level data produced
• Commissioners
• Work closely with providers to establish
  participation rates
• Hold providers to account where performance does
  not meet agreed levels
• Make use of aggregate data

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• PROMS Administration Contractor
• Ensure Providers have enough questionnaires
• Handle patient queries
• Post out the post-operative questionnaires
• Collect questionnaires, convert record level
  PROMS data to electronic records for onward
  transmission to IC
• NHS Information Centre
• Convert PROMS responses to health status measures
• Link record level data to existing data including
  HES
• Removes patients ID
• Distribute non-identifiable record level data to
  Contractors, Providers, Commissioners and other
  stakeholders
• Keep records of data collected and processed each
  month

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• PROMS Aggregation Contractor
• Aggregates monthly batch of record level data
• Uses case-mix and risk analysis methodology
• Enables data to be compared across organisations
  by Provider, Commissioner and at a National level
• PROMS Analysis Contractor
• Adds value to the aggregate data set produced by
  aggregation contractor
• Adds value to record level data from NHS IC
• Produces standard reports for the Department of
  Health

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Questionnaires

• Include generic measure of health status to
  enable comparisons within and between procedures
• Condition specific measures - these are more
  sensitive to changes in health status
• Questions on patients living conditions
• Questions related to whether patients needed help
  completing the questionnaire and disability
• General questions on patients health
• Consent forms to be completed by patient before
  data can be used

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• Guidance The latest guidance on PROMS is now
  available along with sample questionnaires
• Charlotte.Wood_at_yorksandhumber.nhs.uk