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TRANSCRIPT
The use of PROMs in a community setting
26 March 2015
Iain Cockley-Adams
Gloucestershire Care Services NHS Trust
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.
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
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)
Measuring what we actually do
PROMs to inform clinical practice
Net loss Negative
51.2
41
58
0
10
20
30
40
50
60
70
new referral 90 days 12 months
High
er =
Wor
se
MOXFQ (Foot) - steroid injections MSKCAT + Podiatry
35
36.6
33.2
31
32
33
34
35
36
37
new referral 90 days 12 months
High
er =
Wor
se
OSS (Shoulder) - steroid injections
22.5
27.5 24.2
0
5
10
15
20
25
30
new referral 90 days 12 months
High
er =
Bes
t
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
High
er =
Bes
t
OHS (Hip) steroid injections
Bimonthly GP clinical newsletter
NICE guidelines reinforced by our PROMs evidence - and shared with the GPs via the newsletter
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.
PROMs in social care: Evaluating Reablement
Reablement: impact on general health & wellbeing EQ5D
Reablement: impact on “social care quality of life” ASCOT
ASCOT Domains (Adult Social Care Outcomes Toolkit)
Patient Engagement 50% response rate for postal survey
Thank you
Iain Cockley-AdamsGloucestershire Care Services NHS [email protected] 0300 421 1613
March 2015