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The national PROMs programme

Patient Reported Outcome Measures (PROMs) are a means of collecting information on the effectiveness of care delivered to NHS patients as perceived by the patients themselves. PROMs is a Department of Health (DH) led programme supported by a number of key partner organisations, including the Health and Social Care Information Centre (the HSCIC).

Since 1 April 2009, providers of four key elective interventions have been required to collect and report PROMs, under the terms of the Standard NHS Contract for Acute Services. In practice, this means that all providers of NHS-funded unilateral hip and knee replacements, groin hernia and varicose vein surgeries are expected to invite patients undergoing one of these procedures to complete a pre-operative PROMs questionnaire in accordance with the relevant guidance. Post-operative questionnaires are then sent to patients following their operation after a specified time period.

An overview of the PROMs dataset

PROMs comprise a pair of questionnaires completed by the patient, one before and one after surgery (at least three months after for groin hernia and varicose vein operations, or at least six months after for hip and knee replacements). Patients' self-reported health status (sometimes referred to as health related quality of life) is assessed through a mixture of generic and disease or condition-specific questions. To add to the value of the PROMs questionnaire data, it is linked routinely with Hospital Episode Statistics (HES) episode-level information.

A list of all of the items in the PROMs dataset is included in the PROMs Data Dictionary.

Analysis of the differences between the pre-operative and the post-operative PROMs data can be used to determine the outcome of the operation as perceived by the patient in terms of its impact on their self-reported symptoms and functional status.

In addition to the presentation of raw data, adjusted post-operative scores and measures of health gain are included together with standard deviations. An adjusted measure has been included to allow the comparison of trusts with national figures based on health gain. The adjusted measure, based on models developed by contractors on behalf of the Department of Health, takes into account the fact that organisations deal with patients with a differing casemix. Casemix models are applied in this publication in advance of a planned cycle of further refinement to the methodology. It should be noted that the methodology has not at this stage gone through the HSCIC's Indicator Pipeline process. Further information regarding the methodology can be found at the Caspe Healthcare Knowledge Systems and PROMS websites.

Feedback and comments are welcome on the methodology and should be sent to: [email protected].

When interpreting the organisational-level results, it is important that the trends shown are taken to be a starting point for further investigation rather than giving a definitive conclusion on organisational performance. Extreme results may not be down to clinical reasons. They could also be caused by random variation (irregular and erratic fluctuations or chance factors that, in practical terms, cannot be anticipated, detected, identified, or eliminated); by data quality issues; or by differences in patients' ability to benefit from the surgery that cannot be identified from the data.

PROMs publication

Between April 2010 and August 2010 PROMs data was published on a monthly basis and considered data from pre-operative questionnaires only. Between September 2010 and July 2011 data continued to be published on a monthly basis but also included the analysis of data from post-operative questionnaires. During these periods, data was reported cumulatively, that is, each month saw a further month of data added to the dataset. These previous publications are available in the PROMs data archive.

In August 2011 the first annual refresh of PROMs data was published. This finalised the data for PROMs pre-operative questionnaires completed in the period April 2009 to March 2010 and any associated post-operative questionnaires that had been returned. Key findings from this period and published documents are available from here.

From August 2011 on, data will be spilt by financial year to enable comparison. Provisional data for each financial year will continue to increase in size until the next annual refresh covering the period April 2010 to March 2011.

National headline figures (Key Facts) will continue to be produced on a monthly basis and will be published here. Spreadsheets produced as part of the PROMs publication (including participation rates, provider and commissioner tables, the score comparison spreadsheet and associated CSV files) will only be produced on a quarterly (three month) basis. Please note that Business Objects HES interrogation and extract service users will continue to have access to the latest data.

Dates for the publication of provisional monthly/quarterly PROMs data can be found in the HSCIC's publication calendar here.

Special topics

Special topics are available here from November 2011 on a quarterly basis. Suggestions are welcome on their future content via the contact us section of this website.