Patient survey suggests benefit from common procedures varies markedly by NHS provider

– Comparative annual PROMs results published for first time

15 August 2012

*Regional information available from this report

The level of health benefit patients feel they gain from common procedures varies markedly between NHS providers, results from a patient survey suggest.

Final 2009-10 and 2010-11 results of Patient Reported Outcome Measures (PROMs) surveys in England are today published together for the first time by the Health and Social Care Information Centre (HSCIC); allowing the first ever year-on-year comparison.

They paint a picture of very little change in national scores and continued variation by provider in relation to hip, knee, varicose vein and groin hernia procedures (the four procedures in the PROMs programme).

Patients complete PROMs surveys about their health before and after surgery, with the difference between the two indicating how much or little they feel they have gained. Five different scoring systems are used; of which three are condition specific and two apply across all four procedures. The more detailed of these two – the EQ-5D Index score – captures the impact of treatment on a range of aspects of general health such as mobility, self-care, pain and depression.

Using the EQ-5D Index score to compare results across all four procedures, the report shows that in 2010/11:

Hip replacements

  • Nationally, 86.7 per cent of respondents recorded an improvement in general health after surgery, compared to 87.2 per cent of respondents in 2009/10.
  • Five healthcare providers were positive outliers (meaning their scores were significantly better than expected) compared to three in 2009/10.
  • Two providers – Shepton Mallet NHS Treatment Centre, Somerset; and the Horder Centre, East Sussex were positive outliers in both years; the only two providers to feature in this category in both years for any of the four procedures.

 

  • Nine providers were negative outliers (meaning their scores were significantly worse than expected) compared to zero in 2009/10. No provider was a negative outlier in both years for this or any of the other three procedures.

Knee replacements

  • Nationally overall, 77.9 per cent of respondents recorded an improvement in general health after surgery, compared to 77.6 per cent of respondents in 2009/10.
  • One provider was a positive outlier compared to two in 2009/10; while six were negative outliers compared to three in 2009/10.

Groin hernia surgery

  • Nationally overall, 50.5 per cent of respondents recorded an improvement in general health after surgery, compared to 49.3 per cent of respondents in 2009/10.
  • One provider was a negative outlier in 2010/11, but there were no other outliers (positive or negative) identified in either year.

Varicose Vein surgery

  • Nationally overall, 51.6 per cent of respondents recorded an improvement in general health after surgery, compared to 52.4 per cent of respondents in 2009/10.
  • There were no positive or negative outliers among providers in 2010/11; while in 2009/10 there were no positive outliers and two negative outliers.

The PROMS participation rate rose to nearly 70 per cent in 2010/11 compared to just over 66 per cent in the previous year. In total, 171,500 pre-operative questionnaires were completed in relation to 245,500 eligible procedures (compared to 158,300 pre-operative questionnaires for 239,700 eligible procedures in 2009/10).

Provisional data for 2011/12 has also been published today; this data is provisional as there is still time for further patient questionnaires to be returned and analysed before the dataset is finalised.

HSCIC chief executive Tim Straughan said: “The importance of patient survey information to the NHS has been made clear in recent years; and today’s figures represent a significant step in being able to gain a clear understanding on how people personally feel about their health after common procedures like knee and hip replacements and how this has changed in time.

“Patients and health professionals alike will have great interest in today’s results– which offer an unprecedented two year insight of not just the nuts and bolts of NHS activity, but the viewpoint of people who have experienced these procedures.”

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