Monitoring Operation Satisfaction Rates

The NHS is funded with public money and for this reason there is a growing move towards making it more transparent and accountable with the ultimate aim of improving services. But as the recession deepens it is becoming more important for private health insurance companies to show that they are providing value for money both for individuals taking out medical cover and for companies who are insuring their staff.

From 2009 patients having hip replacements, knee replacements, groin hernia surgery and varicose vein surgery on the NHS will be invited to fill in a pre-operative PROMs (patient reported outcome measurements) questionnaire.

Health Minister Lord Darzi said: "While a surgeon may judge a hip replacement successful because the procedure has been performed perfectly on the day, the patient will rightly disagree if they are still in pain and continue to have a poor quality of life six months down the line.

"The beauty of PROMs is that it measures the success of operations as reported by patients themselves. This programme is the first of its kind in the world and the information collected will empower patients to choose a hospital that achieves the best results for the operation they need."

The UK is the first country to implement such a scheme. Bupa is calling for private medical insurance companies to do the same as they feel that it would provide 'fair comparisons and true patient choice.' Bupa used to use PROMs in their own hospitals.

Andrew Vallance-Owen,medical director at BUPA, said: “As a national programme this is undoubtedly the first - I don’t think anywhere else is routinely reporting patient outcomes in this way. While consumers may find this interesting, the biggest impact can be on the surgeons themselves, they are very competitive.”

Surgeons are traditionally very reticent in providing information but there is a move towards greater openness. Tim Baker managing director of Dr Foster, a health informatics company that has partnered with the NHS to produce publically available data, said that “This is not going to happen overnight. But increasingly we will get to greater levels of granularity about the information that consultants are willing to publish. It’s got to be done in some kind of cooperative way rather than forcing this to happen. But I think there is much more of a consensus emerging.”

Mr Baker warned of the need to approach the statistics sensibly and to take into account that much of the evidence provided will be subjective and anecdotal. There needs to be four dimensions to the measurement of patient care: Patient safety, outcome measures as well as patient satisfaction and patient reported outcomes

“If you don’t come out of hospital any better as an end result of your treatment, it is a nil sum game, isn’t it? Actually measuring the benefits and outcomes of treatment is important and you can do that from a clinical perspective. It’s a very important dimension of the whole quality framework.”

Currently HSA International , a group of London hospitals, offer comprehensive data but other private medical insurance companies do not have comparative data available for the hospitals they use. As more and more people access new NHS data there are likely to be calls for the medical insurance business to be more open with information about standards of care and outcomes provided by their hospitals and staff.

Clarity about the outcomes of medical procedures can only benefit the consumer whether it is within the public or the private sector and can only serve to improve the quality of care available.