1. The use of PROMs
in a community setting
26 March 2015
Iain Cockley-Adams
Gloucestershire Care Services NHS
Trust

2. PROMs (Patient Reported Outcome Measures) in Gloucestershire
• Podiatry
 Generic general health & well being PROM EQ5D
 condition specific PROMs
 Plus PREMs (Patient experience)
 5,141 individual returns to date
• MSK Clinical Assessment & Triage Service (MSKCAT)
 Generic general health & well being PROM EQ5D
 condition specific PROMs
 Plus PREMs (Patient experience)
 3,345 individual returns to date
• Reablement
 Generic general health & well being PROM EQ5D
 social care quality of life PROM ASCOT
 Plus PREMs (Patient experience)
 Pilot started February 2015.

3. What we get from PROMs
• Quality
 Measure effectiveness of what we do - from the patient/service users point of view
 Evidence to help improve service delivery
 Evidence for others in the health and social care community
 Triangulation data for PREMs
• Patient Engagement
 50% response rate to a postal survey.
 Impact on Shared Decisions Making (perhaps?)
• Staff Engagement
 Relevant and useful data
 Positive and rewarding
 Ownership

4. Targets and other metrics
“As a basis for assessing the value of the
more than £100 billion of taxpayers’
funds currently spent on the English
NHS … these measures are
hopelessly inadequate.”
(Getting the most out of PROMs; Kings Fund,
2010)
Volume 87, Number 4, April 2009
“…measuring (patient experience) … may be of
limited use as a basis for quality improvement
and health system reform.”
(How does satisfaction with the health-care
system relate to patient experience?
Bulletin of the World Health Organisation,
2009)

5. Measuring what we actually do

6. PROMs to inform clinical practice
Net loss Negative

7. 51.2
41
58
0
10
20
30
40
50
60
70
new referral 90 days 12 months
Higher=Worse
MOXFQ (Foot) - steroid injections MSKCAT +
Podiatry
35
36.6
33.2
31
32
33
34
35
36
37
new referral 90 days 12 months
Higher=Worse
OSS (Shoulder) - steroid injections
22.5
27.5 24.2
0
5
10
15
20
25
30
new referral 90 days 12 months
Higher=Best
OKS (Knee) - steroid injections
27.6
31.4
45
0
5
10
15
20
25
30
35
40
45
50
new referral 90 days 12 months
Higher=Best
OHS (Hip) steroid injections

8. Bimonthly GP clinical newsletter
NICE guidelines
reinforced by our
PROMs evidence
- and shared
with the GPs via
the newsletter

9. Gloucester City PLT 9 July 2013
Activity Data:
To March 2013
Iain Cockley-Adams
MSKCAT Service
• Reporting always
includes some
PROMS data
• GP PLT sessions
always have
hand-outs with
PROMs
evidence.

10. PROMs in social care: Evaluating Reablement

11. Reablement: impact on general health & wellbeing EQ5D

12. Reablement: impact on “social care quality of life” ASCOT

13. ASCOT Domains (Adult Social Care Outcomes Toolkit)

14. Patient Engagement 50% response rate for postal survey

15. Thank you
Iain Cockley-Adams
Gloucestershire Care Services NHS Trust
Iain.cockley-adams@glos-care.nhs.uk
0300 421 1613
March 2015