Researcher Dr Michael Anderson tells of his work on understanding the enablers and barriers that could improve the uptake of Patient Reported Outcome Measures (PROMs) in private healthcare.

The Private Healthcare Information Network (PHIN) has a huge role to play in improving transparency in private healthcare. Publishing data on the sector is a strong enabler to protect patient safety as well as promote choice. One way in which PHIN is really pushing for this is through its ambitious Patient Reported Outcome Measures (PROMs) programme.

PROMs are the only standardised measure that produce outcomes from a patient perspective. There are several benefits in using them:

  1. There is an intrinsic value in routinely using PROMs as they facilitate a shift towards providing more patient-centred care.
  2. They can flag patients who do not experience as expected health gains post-surgery, which can be investigated and additional support provided, if needed.
  3. They can be useful from a comparative perspective. By identifying above or below average PROMs scores, hospitals and consultants can share best practice, and look into underlying factors driving below-average performance.

PHIN’s ambition is to use PROMs nationally to inform patient choice. It recently started reporting private hips and knees PROMs in 2019, which is a step towards achieving this. The programme should be widely acknowledged and contributed to, but the completion rate for hips and knees PROMs to the network remains significantly below what is achieved in the NHS.

This formed the basis of my project’s key question: what are the enablers and barriers to improving PROMs uptake in the private healthcare sector?

To help answer this question, I will be focusing on behaviours and attitudes related to the collection, submission and use of PROMs data at eight different hospitals who work with PHIN. I have selected a combination of hospitals which reflect both high and poor performance in collecting and submitting PROMs data to get a broad range of perspectives. And I will be engaging with consultants and members of hospital staff at different levels, beginning with consultants, then speaking to nurses, administrators, managers and others. Each interview will follow a set questionnaire covering 14 areas, from belief about capabilities and optimism, to reinforcements and social influences.

I have already begun the process of contacting these hospitals and interviewing consultants. It is too early for me to comment on the findings, but there are key areas I am looking at. These include:

  • Awareness – or lack thereof – of the PROMs programme among consultants and among staff at the hospitals;
  • Whether there is clear responsibility for collecting PROMs within hospitals;
  • To what degree data is used at site level; for example, whether staff are reviewing the data frequently and that consultants have access to the right insights from the data.

My project will have two main outcomes. Firstly, an overarching policy report for PHIN to use with consultants and hospitals to work through the barriers to collecting and using the data. Secondly, a separate academic publication which will lean heavily on the questionnaire framework. I aim to complete this work by Autumn 2021, with potential for a presentation of some provisional findings this summer. However, this timeline is dependent on the level of engagement from the hospitals I will be working with.

It is exciting to be involved with this collaboration with PHIN, not least because the London School of Economics and Political Science, where I work, is the first academic institution the network has partnered with. It has also been eye-opening to begin to understand the real complexity of the processes and data that PHIN works with. I hope this work will also be of real benefit to patients and the wider private healthcare sector, as we look at developing strategies to maximise the value of PROMs data in understanding the impact of treatment on patients.


Dr Michael Anderson (above), a research officer at the LSE, is working with PHIN as a clinical fellow as part of a new partnership. This blog was originally published in Independent Practitioner Today. The original can be accessed here: https://www.independent-practitioner-today.co.uk/2021/06/how-we-can-better-conduct-the-proms/

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