PROMs: number crunching or patient insight?

The High Quality Care Progress Report was issued a few weeks ago (June 2009). The report updates the public on the original report that came out in June 2008 and we at the Campaign Company were especially interested in what it had to say.

The original 2008 report stated that “we will make payments to hospitals conditional on the quality of care given to patients as well as the volume. A range of quality measures covering safety, clinical outcomes, patient experience and patient’s views about the success of their treatment – known as patient reported outcome measures or PROMs – will be used.”

The 2009 progress report attributes a whole chapter on ‘patient experience’ that talks about good practice, but does not specfically mention PROMs by name. However professionals are not worried as today (Wednesday 8 July 2009) sees a national conference being held on PROMs. It will explain that previous outcome measures have focused on indicators of failure such as mortality, complications and re-admissions. However PROMs are designed to take into account the physical and mental benefits of treatment as perceived by the patients themselves.

From 1 April 2009 the NHS will be the first health care provider in the world to routinely collect patient reported outcome measures, but many organisations are keen to find out how this can be done, which is why today’s conference will be packed, and what will they be told? The Campaign Company hopes it will be along the lines of the below:

‘PROMs are a good starting point for collecting data with regards to patient satisfaction, however there are a number of limitations to the scope of PROMs for example how do you measure the health –related quality of life for patients with long-term chronic illnesses?

Is patient satisfaction not based on patient experience? If so then surely we should be exploring the patient’s experience through the health care system as this will ultimately determine whether or not the patient is satisfied with the level of care provided/received. Patient experience needs to be at the heart of outcomes – an ‘end’ in itself not achieved through the ‘means’ of other measurements such as: ‘waiting times’ and ‘membership involvement’.

How we measure true, real time patient experiences is the challenge! We need to get under the skin of patient experience, explore the real issues, ask the questions that they don’t know how to ask, engage with patients on a micro-level i.e. follow and explore their care journeys only then will we be in a position to fulfil the true needs of patients.’

If this is indeed the right view being delivered at the conference then it is good for patients. It is only through empowering patients and following them through the care journey that effective changes can be made to the overall experience. The Campaign Company has a strong record in facilitating these exercises and driving through change based on systematic public participation in services.

It is only by investing in these activities, and not solely through interval consultations and sometimes impersonal quantitative surveying that PROMs can be implemented; resulting in NHS organisations achieving more positive indicators and a good excuse for Lord Darzi to heap even more praise on the sector come the 2010 review.

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