PROMs
22 Oct 2018

PROMs

Published Date: 22 Oct 2018

Understanding the experience of patients is a crucial part of providing quality health and social care. Standardised questionnaires, called Patient-Reported Outcome Measures (PROMs), capture this type of information from patients.

PROMs – and other forms of patient feedback – help understand how patients see their health and how treatments and services affect their quality of life. Using this information can help to redesign, renew or refine services, improving the quality of health and social care.

CLAHRC Oxford has been developing better ways of capturing, analysing, combining and communicating the evidence of patients’ outcomes and experiences.   The Musculoskeletal Health Questionnaire (MSK-HQ) and partnership implementation model is a new patient-reported outcome measure (PROM) designed to work across all musculoskeletal conditions. Since the publication of its validation study in August 2016, a new partnership model for implementing the MSK-HQ across difference services has been developed. The MSK-HQ itself and the implementation model serve as leading examples of how patient-reported measures could drive quality improvement within routine clinical practice. The Long-Term Conditions Questionnaire (LTCQ) is a new generic PROM designed to work across all long-term conditions (physical and/or mental health including multi-morbidity) and to be applicable within a range of services, including primary care and social care. The validation study was undertaken during the past year, with the published results forthcoming. The LTCQ could be used as a stand-alone measure or as a complement to existing measures, to fully capture what it means to ‘live well’ with long-term conditions. Enabling patients to live well with LTCs is a goal of person-centred care and a key focus of the NHS Outcomes Framework (Domain 2); the LTCQ could play a role in realigning services towards realisation of this goal.

The LTCQ is already being used as an outcome measure in the NIHR-supported Feeling Safe Study of management of schizophrenia and is being trialled for use in dementia services. Several NHS trusts have expressed interest in its use for planning and evaluating services. CLAHRC Oxford are currently in discussions with their host trust to explore embedding these measures into the STP’s in the region.

Contribution of CLAHRC Oxford

The work that it's being done in this theme is funded by CLAHRC Oxford. The CLAHRC funding has allowed the researchers to contribute to parallel added value projects with direct relevance to this work, which also have an applied research focus on patient-centred digital health, and public involvement. Theme 3 CLAHRC researchers worked in partnership with Keele University to develop MSK-HQ, and they have led on development and delivery of the partnership implementation model; they have also developed LTCQ in partnership with colleagues in the Quality and Outcomes of Person-Centred Care Policy Research Unit (QORU, funded by the Department of Health Policy Research Programme). Oxford CLAHRC researchers are leading on implementation of the LTCQ, initially with a feasibility study in dementia services.

What happened next?

MSK-HQ implementation: eleven partner providers were involved in interim interviews exploring emerging issues, experiences, successes and challenges.The output has led to a further grant awarded by ARUK, to Keele and Oxford Universities to develop and implement an electronic intervention which includes the MSK-HQ to support clinical care. A further grant application has been submitted to ARUK to develop case mix adjustment methodology and to develop benchmarks for patient outcomes that providers should aim to achieve. The LTCQ is already being used as an outcome measure in the NIHR-supported Feeling Safe Study of management of schizophrenia and is being trialled for use in dementia services. Several NHS trusts have expressed interest in its use for planning and evaluating services. CLAHRC Oxford are currently in discussions with their host trust to explore embedding these measures into the STP’s in the region.