Keeping the Patient in the Picture: Patient Reported Outcome Measures

Keeping the Patient in the Picture: Patient Reported Outcome Measures


[Dan Wellings:]
You can’t just design the system from the top-down. You need to understand what users and patients think of the system, you need to understand what’s working for them; You CAN deliver a more effective system if you’re working with people, rather than just thinking that you’re working for their best interests but actually not knowing that. [Crispin Jenkinson:] Patients Reported Outcome Measures are questionnaires, effectively, that ask patients about their own health and well-being and how they feel before and after treatment, for example. It’s fair to say that most people,
if they’ve ever been ill, know that the person who’s most important… in evaluating their aspects of treatment is really going to be them. [Andrew Price:] Measurement has always happened, it’s just, it’s being defined and more clinically relevant now. [Jill Dawson:]
Because hip and knee replacement is so common, the demand to get some kind of standard information and insight into how the operations turned out for patients, — given how much money was being thrown at the operations — became increasingly important. Before these measures, there wasn’t any standard information collected within the NHS that allowed people within the NHS to make this assessment of value for money and potential variation in the results
from different centres. If you get people to complete them, you can find out, way ahead of when revision surgery occurs, that something is going wrong with this joint. [Crispin Jenkinson:] So it’s not just that this group develops outcome measures and leaves it there, what we also do is, we get involved with trying to see whether a given treatment works. [Ray Fitzpatrick:]
Because these are simple, standardised questions we now have a really good handle on the quality of services for joint replacement surgery in the NHS. [Dan Wellings:]
What can we learn from those that are doing well that we can transfer on to others? And that’s where I think the PROMs programme was completely revolutionary. [Jill Dawson:] In 2009, the NHS mandated the use of these particular Oxford Hip and Knee Scores for all patients in England and Wales who were going ahead with hip or knee replacements. So they’re very, very widely used. They’ve also been translated into a number of
different languages and are being used worldwide. [Dan Wellings:] In many ways, the NHS was seen
as a pioneer for introducing this. From speaking to colleagues in Australia, it’s
something they’re really interested in; in the US, especially with the Oxford
Hip and Knee Score, they’re using that within their systems as well. The academic community is making sure that we’re doing things the right way. We’re making sure we’re doing things which are valid, which are reliable. And one can’t underestimate how important that is and the value of what that gives us, that we can use it at the scale we do free of charge and we’re working with the academic community — in this case Oxford University
Innovation — to really use those tools as far as we can.

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