Private hospital group Bupa, now owned by Spire Healthcare, has been collecting patient reported outcome (PROMS) data for the past decade. In this sense, they are ahead of the NHS, which has recently agreed to collect data in four areas: hip replacement, knee replacement, inguinal hernia, and varicose veins.

The initial motivation was to make systems more robust in the wake of the serious malpractice of NHS consultant gynaecologist Rodney Ledward, who also treated patients in the private sector. Andrew Vallance-Owen, Bupa group medical director, explains: “I went through [Ledward’s] details and there were no deaths, no readmissions, no complaints—there was nothing to tell us about him. …