Patient reported outcome measures may be public next year

The NHS began collecting patient reported outcome measures for all hip replacement, knee replacement, groin hernia surgery and varicose vein surgery patients in April, in the biggest programme of its kind in the world.

There is a huge difference between performance management and quality improvement

Patients are reporting on their condition before and three months after the intervention. The results can also be used to compare the average condition of patients being referred for procedures in different areas.

DH head of choice and system management levers Katy Peters told a King’s Fund conference last week the collection was happening as planned.

She said: “We are pretty pleased with the roll-out so far - it seems that we are getting large sample sizes.”

Ms Peters said it was hoped the first results would appear early next year. They first have to be adjusted for case mix - for example in trusts where older patients or those with more complex conditions are being treated. The DH has to decide how much adjustment to make, she said, and how to present the results to trusts and the public.

Ms Peters said ultimately the DH may be able to use the results, through world class commissioning assurance, to assess whether primary care trusts are “getting the best efficiencies out of the system”. They might be paying for procedures which appear to have little benefit for patients, for example.

King’s Fund director of policy Anna Dixon said the DH should clarify how it intends to use the data: “There is a huge difference between performance management and quality improvement. The buy-in will depend on the signals that are given about that.”

Calculations reported in HSJ, based on data from the NHS trial of patient reported outcome measures, suggested at least £144m is being spent yearly on operations for people who either have no significant complaints about their health before surgery, or who report their condition is unchanged or worse afterwards.