Surgical Outcomes
This page outlines College and external resources available to surgeons and surgical services to benchmark care and support quality improvement.
Quality indicators
A variety of indicators and datasets are routinely collected and are available to download. The table below lists some of these.
| Publisher | Title | Details | Data level | Area |
|---|---|---|---|---|
| Care Quality Commission | Intelligent monitoring | Searchable database of online reports per provider | Hospital level | England only |
| NHS England | Outcome and monitoring measurements | Reports incl A&E waiting times, cancelled elective procedures, consultant led referral to treatment times, never events, cancer waiting times | Hospital level | England only |
| NHS England/ RightCare | Commissioning for value packs | CCG level intelligence on activity and spend against outcomes | Clinical Commissioning Groups (CCGS) | England |
| National Audit Office | Mapping between different commissioners of healthcare | Estimates of overall health funding at an area-level, taking into account the different geographical variants between commissioners | Area level | England |
| Nuffield Trust | Infographics and NHS in numbers | Analysis based on routine activity data | Across devolved nations, longitudinal | All UK |
| Department of Health | NHS References costs 2014/15 | Tariff costs for procedures and treatments | All NHS | England |
| Public Health England | Spend and outcome tool (SPOT) | An online tool that compares acute hospital activity, clinical coding and payment by results data. Free to all in NHS | Acute hospitals | England |
| North East Quality Observatory System | Regional Repository of Quality Metrics | Microsoft Access database which can be used to identify useful metrics | Health and social care | All UK |
| NHS Digital |
Acute inpatient activity data | Detailed provider level analysis of acute inpatient care | Hospitals, commissioning | England |
| Health Foundation & Nuffield Trust | Quality Watch | A joint research programme monitoring how the quality of health and social care is changing over time. Over 270 indicators reviewed | Hospital level | England |
| Dr Foster | My hospital Guide | Online access to HES based data at provider and commissioner level, mortality, weekend care | Hospitals, commissioning | England |
| The Audit Commission | National Benchmarker and assurance portal | Compares acute hospital activity data, clinical coding and Payment by Results (PbR) related measures with other organisations | Hospital, Area team, CCG, GP level | England |
| NHS Scotland | Quality Indicators | Quality dashboards, activity funnel plots and PET tools that can be interrogated | Hospital level | Scotland |
Patient Reported Outcome Measures (PROMS)
What is a PROM?
A patient-reported outcome measure (PROM) is a series of questions that patients complete about their own health.
PROMs can either be generic or procedure-specific. Their viability for widespread use is assessed through the evidence of their reliability, validity, responsiveness, precision, acceptability to patients and feasibility.
Completion of PROMs pre- and post-operatively allows for a measurement of change in how patients feel, which is then attributable to the surgical intervention.
Further information on resources and databases of PROM tools are available here.
Current practice
Currently PROMS are routinely used in surgical practice within four surgical areas; knee replacement, hip replacement, groin hernia and varicose vein surgery. Further details on this national programme are available on the NHS Digital website.
The Royal College of Surgeons are publishing guidance on recommended PROMS for cosmetic practice soon. More information on the work of the college on setting standards for cosmetic surgery is available here
Finding a PROM tool
Oxford University have a bibliography of research related to Patient-Reported Outcome Measures (PROMs) and Patient Reported Experience Measures (PREMs). Included in this website are several meta-analyses of PROMS tools that are available for use within surgical practice.
National PREMS
The Friends and Family Test (FFT)
It is now routine practice at the end of treatment or discharge from a hospital, that patients are asked to complete FFT. This programme was launched in 2013 and has now been rolled out across many of the services within the NHS, including primary care.
Children's Surgery
RCPCH and The Picker Institute have developed PREMS for urgent and emergency care for children to be used within GPs surgeries, ambulances and Emergency departments.