First day of the PROMs

The Department of Health has issued instructions to the NHS on the action that needs to be taken to deliver Patient Reported Outcome Measures from April.

The use of PROMs in the health service was first outlined by Lord Darzi in the NHS Next Stage Review. Now commissioners and service providers have been given detailed guidance on how the system should work.

PROMs will collect information on the clinical quality of care as reported by patients, who will be asked to answer the same set of questions before and after an operation. The comparable data will then be used to calculate a numerical value for the improvement to their health.

From April, all licensed providers of hip replacements, hernia surgery, and varicose vein surgery will be expected to invite patients to complete a pre-operative questionnaire. About 250,000 patients are expected to be asked to fill out a PROMs questionnaire in 2009-10.

A contractor will then be responsible for collecting the pre-operative data and administering post-operative questionnaires.

The DH has said it is proceeding with Northgate Information Solutions as its preferred bidder for administration and data aggregation and MORI as its preferred bidder for analysis. Contracts are due to be signed this month.

Health minister Lord Darzi said the beauty of PROMs was its ability to measure the success of operations as reported by patients themselves.

He added: “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 said the programme would be the first of its kind in the world and empower patients to choose a hospital that achieves the best results for the operation they need.

He added: “It will also strengthen commissioning across the NHS by offering primary care trusts the evidence they need to buy the best services based on patient experiences.”

The NHS Information Centre is to play a central role in delivering the PROMs programme, converting the PROMs questionnaires into health status measurements, and linking the identifiable record-level data to existing routinely collected data such as hospital episode statistics.

The questionnaires will be provided in a booklet and include a patient consent form and patient information sheet. Pre-operative questionnaires will include questions on general health status and condition-specific health status.

Post-operative questionnaires will include questions about complications, re-admissions to hospital and re-operations. The questionnaires are available on the DH N3 website.

The NSR indicated that there is an intention to link payments to PROMs data. The DH says research was underway to identify other areas where PROMs might be feasible.