Measuring patients’ experiences and outcomes

Dear Sir,

I read with slight bemusement Nick Black and Crispin Jenkinson's
assertion
that 'until recently, patient reported outcome measures have been used
only
in research'. The Spire group of 36 hospitals, including the ex-Classics
and
ex-Bupa hospitals, have operated a PROMs programme for the past 12 years,
with a large and growing database of results for many procedures and
techniques. Our hospitals access their own PROMs reports on a quarterly
basis, with results discussed at local clinical governance committees and
reported via Spire's national clinical scorecard.

We use PROMS results to identify and learn from hospitals which may
be
delivering care in a way that results in higher post operative health
status,
whether as a result of preparation, technique or follow up arrangements.
Hospitals use PROMs as a means of introducing new services in a safe and
responsible manner, as well as making results available to consultants to
enable clinical governance. We have also published our results for hip
arthroplasty, knee arthroplasty, hysterectomy, cataract surgery, hernia
repair
and cholecystectomy online since 2006 - before the advent of NHS Choices,
World Class Commissioning and Lord Darzi's Next Stage Review.

Our experience of using PROMs in a practical, rather than an
academic,
manner in a clinical setting over many years, was the principal reason for
the
invitation in 2006 by the London School of Hygiene and Tropical Medicine
to
contribute to their invstigations that eventually resulted in the
introduction of
PROMs into the NHS in April, twelve years after the launch of our own
PROMs
programme.

Competing interests:
Director of Clinical Services for
Spire Healthcare