Table 2

Theme 1—uses and users of an LTC PROM

Uses and users of an LTC PROMA tool for improving care—through re-designed servicesYou could hold all the providers involved in that long-term condition (…) to account for what you're sort of getting back in the PROM (P3, NHS Policy and Commissioning)
Users: Practitioners, Individual Services, Provider Groups, CommissionersA system that is more focused around the patient and a contracting methodology that supports organisations to do that and aligns incentives, would also be a more cost effective system that gives us better value (…) for patients, the services and the tax payer (P13, CCG Manager)
A tool for improving care—through informing the patient—practitioner conversationIf [the PROM] becomes about changing the way that a patient is using their consultation, the relationship with the doctor, and making those people listen to each other and think about what the patient wants then that would be good (P1, GP)
Users: Patients, Practitioners, Individual ServicesIf we're measuring ‘doing to [patients]’, that promotes doing to and people will keep doing to. If we're measuring ‘doing with and working with [patients]’, that will promote doing with and working with (P17, Consultant)
What you're really aiming to do [in clinical practice] is optimise concordance between doctors and patients—you're trying to align what they're both after and I think that the tool [the PROM], the thing I would find it really useful for is a relatively swift way of getting to what the patient really thinks (P29, GP)
A means of involving people in their own careThere is a role for service users and patients and those in receipt of services actually using tools of this sort to affect, influence and shape services for their benefit (P15, PPI)
Users: Patients, Practitioners, Individual ServicesIf you have an instrument that gives, measures [a patient] with a score and you can feed back the score then I think that can have a very positive effect on empowerment (P22, GP)
I would use [a PROM] for a patient to reflect on how their condition has been over the last two years (…) you'd probably need to tie it to something; that something that they did at regular intervals (…) you'd probably want to have it as a tool to use as opposed to something that had to be done (P29, GP)
Capturing the outcomes of interventionsThe important thing is to be clear about what you're putting in, i.e. the intervention (…) [and] be sure that the measurement is connected to that. (…) [C]are planning is a process but it's a specific intervention (…) so what I would like to see is a PROM that measures the outcomes of the care planning (P10, Consultant)
Users: Patients, Practitioners, Individual Services, Provider Groups, CommissionersIt seems to me that if the future direction [of healthcare] is to have a model of care that is more than medicine, that's built around personalised care planning and that, you know, is all about enabling people to manage their lives and conditions as successfully as possible (…) then a PROM type measure that could be used on a regular basis by, you know, by the person and the key professionals co-ordinating their care (…) would have potential value (P20, Voluntary Organisation)
Using a PROM for multiple purposes[To use one measure for multiple purposes] feels very complex but at the same time one would hope that you'd be able to align them all so that you're not using different things with people (…) I think that there is a place to be doing it individually but also [at a] population [level] (P 6, GP and CCG)
Users: Patients, Practitioners, Individual Services, Provider Groups, Commissioners
  • GP, general practitioner; LTC PROM, long-term conditions patient-reported outcome measures; NHS, National Health Service.