The benefits thousands of patients say they have gained from their health care is, for the first time ever, captured in a ground-breaking report published today by The NHS Information Centre.

Based on questionnaires completed by patients both before and after undergoing one of four procedures in NHS hospitals in England, the report provides a detailed picture of the extent to which patients report that they benefit from their care and in what ways.

It is believed to be the first time anywhere in the world that such a large-scale and comprehensive study of patient-reported health outcomes has been carried out.

Provisional Monthly Patient Reported Outcome Measures (PROMs) in England - April 2009 to April 2010. Pre and post operative data: Experimental Statistics.considers groin hernia surgery, hip replacement, knee replacement and surgery on varicose veins.

It uses five different systems for evaluating patients' reports of their health before and after treatment. Two of these systems apply across all four operations with the more detailed one – called the EQ-5D Index score - capturing the impact of treatment on a range of aspects of general health such as mobility, self-care, pain and depression. The other three systems are condition-specific and relate to hip replacement, knee replacement and varicose veins.

Because each of the methodologies are based on a different set of questions, they each paint a different picture of a procedure's impact on a patient's health. For example, patients reported greater levels of improvement in the condition-specific scoring compared to those covering more general health issues.

Based on the EQ-5D Index score of general health, the report shows:

• 87 per cent of patients undergoing hip replacements reported better general health after their procedure compared to before.
• 77 per cent of patients undergoing knee replacements reported better general health after their procedure compared to before.
• 49 per cent of patients undergoing hernia surgery and 52 per cent of varicose vein surgery reported better general health after the procedure compared to before – however a substantially higher level of general health before treatment was reported by these patients compared to, for example, hip replacement patients.

Of the four procedures it shows:

• Patients undergoing hip replacements reported the worst level of general health before having surgery.
• Hip replacement brought about the biggest reported general health gain compared to the other three procedures.
• Patients undergoing groin hernia surgery reported the best levels of general health both before and after their procedure compared to patients undergoing any of the other three treatments. The high level of general health before the operation limits the scope for measurable improvement

Chief executive of The NHS Information Centre Tim Straughan said: “PROMS are a very exciting development in the way we consider the quality and value of care being delivered to patients.

“This is the first time this type of information has been gathered on such a large scale and it will be of enormous interest to those charged with planning services and ensuring patients get the best quality care.”

The report is at www.ic.nhs.uk/pubs/provisionalmonthlyproms.

ENDS

Notes to editors.

• The NHS Information Centre for health and social care (The NHS IC) is England's authoritative, central, independent source of health and social care information. It works with a wide range of health and social care providers nationwide to provide the facts and figures that help the NHS and social services run effectively. Its role is to collect data, analyse it and convert it into useful information which helps providers improve their services and supports academics, researcher, regulators and policymakers in their work. The NHS IC also produces a wide range of statistical publications each year across a number of areas including: primary care, health and lifestyles, screening, hospital care, population and geography, social care and workforce and pay statistics.
• The PROMs programme utilises a number of tested and well-established methodologies to enable patients to rate their health status.

1. The EQ-5D Index score reflects general health status, capturing condition specific issues in a broad way through five weighted questions. This measure is more disaggregated than the EQ-VAS.
2. The EQ-VAS score asks patients to score their health on a scale of 0 (worse) to 100 (better) on the day that they complete the questionnaire and therefore provides an indication of the patient's health that may not necessarily be associated with the condition for which they underwent surgery and may be affected by factors other than health care.
3. The condition specific measures (Aberdeen Varicose Vein Questionnaire score and Oxford Hip and Knee scores) focus on clearly defined aspects of the patient's clinical condition which would be expected to be affected by their procedure. The Aberdeen Varicose Vein score, on a scale between 100 (worse) and 0 (better), is based upon 13 weighted questions specifically related to varicose veins. The Oxford Hip and Knee scores, on a scale between 0 (worse) and 48 (better), comprises twelve multiple choice questions including the patient's experience of pain, ease of joint movement and ease of undertaking normal domestic activities such as walking or climbing stairs

• Statistical models were developed by contractors (CHKS Ltd in conjunction with Northgate Information Solutions Ltd) on behalf of the Department of Health as part of the PROMs programme. Further information regarding the methodology can be found at: [http://www.northgate-proms.co.uk/documents.html]

Any and all copyrights in the EQ-5D questions, their order, layout and images vest in the EuroQol Group. The EuroQol Group reserves all rights. © 1992 EuroQol Group. EQ-5D™ is a trademark of the EuroQol Group [http://www.euroqol.org].

Any and all copyrights in the Oxford Hip Score and Oxford Knee Score questions, their order and layout vest in Isis Innovation Limited. Isis Innovation Limited reserves all rights. © 1996 Isis Innovation [http://www.isis-innovation.com/licensing/healthoutcomes/oxford_hip_and_knee.html].

Except where expressly stated to the contrary, the Department of Health PROMs questionnaires are protected by Crown copyright. © Crown copyright 2008.

• Where percentages are given indicating how many patients reported a change in their general care following treatment, they are based upon the number of questionnaire pairs (pre and post-operative) where a change could be measured.
• Post-operative questionnaires are sent out to patients three months (for groin hernia and varicose vein surgery) or six months (for hip and knee replacement surgery) after the procedure date recorded on their HES record. If the pre-operative questionnaire is not linked to HES and the procedure data is not available, the three- or six-month count is started 12 weeks after the scan date of the pre-operative questionnaire. This is to try and ensure that the post-operative questionnaire is sent out after the procedure has occurred. The patient can then return the questionnaire at any time.
• “Experimental statistics” are new official statistics that are under going evaluation. A key part of the “Experimental statistics” label is user engagement in the evaluation of those statistics. The NHS IC invites readers to comment on this publication, which will help inform the next report. Comments may be sent to enquires@ic.nhs.uk.
• For further information, call Sarah Dahlgren or Kristina Fox on 0845 257 6990