NHS England sets the strategic direction for the national PROMs programme, having taken over responsibility from the Department of Health in April 2013. NHS England is responsible for the decision of what conditions and procedures should be included in the national collection and what measures are used to measure the outcome following treatment.
NHS Digital are commissioned by NHS England to collate, process and publish the data as Official Statistics, and the data is made data available on-line via the NHS Digital website. The Head of Profession for Statistics at NHS Digital is responsible for content, timing and overall assurance of all NHS Digital publications, with each individual publication, including PROMs, also having a responsible statistician accountable for content and quality in each individual area.
PROMs questionnaire services are de-centralised and care providers such as NHS Trusts and independent sector hospitals are free to contract with any approved PROMs questionnaire supplier. As arrangements and standards for data collection are managed by NHS England, companies wishing to offer questionnaire services must first meet these standards before contracting with individual care providers. These standards include holding a current Information Governance toolkit certificate, submitting evidence against each standard and passing test data submission checks.
Casemix adjustment methodology
The case-mix adjustment models were initially developed by the Department of Health and subsequently revised by NHS England. The models are periodically reviewed to ensure that the methodology remains sound over time, the most recent change being made to account the differences between primary and revision procedures for hip and knee replacements.
Before any proposed changes in methodology can be implemented, they must first go through NHS Digital approval process. This covers peer review and oversight from the NHS Digital Methodology Review Group, whose membership includes the Head of Profession for Statistics at NHS Digital as well as the NHS Digital Head of Data Quality.
The MRG then submit their recommendations to the Indicator Governance Board, who must approve the methodology which enables PROMs to be included as part of the Indicator Assurance Service (IAS). PROMs comes under the CCG Outcomes Indicator Set (OIS) Domain 3 (Indicator Portal Code 100761).
Documentation relating to the assurance of PROMs are available from the following links.