Patient-reported outcome measures (PROMs) are probably the most important method available to show the effectiveness of treatments in healthcare. Simply put, they are standardised questions asked both before and after treatment. Patients complete them about aspects of their health and quality of life.

There are many hundreds of PROMs for everything from spinal surgery to mental health counselling. Most often they will include some questions relevant to the patient’s clinical treatment with a corresponding score or rating, for example ‘How would you describe the pain you usually have from your hip?’ from 0: Severe to 4: None.

These can tell us about a patient’s health status before treatment and show where improvements have been made after it has taken place. Did the treatment work? Or were there outcomes which were less than ideal?

When used at scale, PROMs allow us to see patterns and spot variations across a large population of patients. This can help manage patient expectations, though adjustments should be made for differences between them. For example, even though both have the same total knee replacement, a 20-year-old may make a better recovery after a sports injury than an 80-year-old who also has arthritis and diabetes.

Where are we at?

PHIN has been collecting PROMs responses for the past five years for a range of surgical and more recently cosmetic procedures. Survey results for hip and knee replacements have been published since 2019 as there were enough responses for them to be robust, however collection of other PROMs, other than cataracts, was lower.


To help understand how to improve the state of private PROMs, in 2021 the London School of Economics consulted with different stakeholders. Its research led to nine key recommendations. These were widely endorsed across the sector in spring 2022 by hospitals, professional bodies, insurers and system suppliers alike. The recommendations are now being worked through, led by a cross-sector working group to find ways to improve participation and value for all participants, including areas such as:

  1. Ensuring clear and easy-to-use resources are available to hospitals for their implementation of PROMs
  2. Promoting best practice in putting patients at the centre of PROMs
  3. Defining what forms of reporting and data insights would be most beneficial, depending on the uses different people have for PROMs
  4. Updating contact details for known PROMs system suppliers
  5. Reviewing alignment on PROMs measures with the NHS, clinical registries and professional bodies

A ‘benefits of PROMs’ slide deck has already been shared to illustrate the many ways in which PROMs can be practically useful for patients and clinicians, as well as others working in private healthcare, alongside illustrations of more detailed hip and knee PROMs results.

PHIN has recently published high-level PROMs results for hospitals participating in cataract PROMs collections, and plans to do the same for cosmetic treatments including augmentation mammoplasty, rhinoplasty and liposuction. More detailed information is also available on hip and knee replacement PROMs where average improvements can be shown for many thousands of patients for each of the questions.

To request a copy of the LSE PROMs report and a slide deck setting out the benefits of PROMs please contact us. 

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