Managing Independent Hospital PROMs (PHIN)


“Patient-reported outcomes are integral to the care we offer at HCA Healthcare UK. Health care that works responsively to a patient’s lived experience, that adapts to their needs, is a system that truly has the patient at the centre.”

— Dr Cliff Bucknall, Chief Medical Officer at HCA UK, July 2023

The Competition and Markets Authority (CMA) published a review of the UK private healthcare sector in 2016 that identified issues and proposed solutions for improving transparency, competition, and help patients to make informed decisions about their healthcare.


The Private Healthcare Information Network (PHIN)

In response to the CMA's findings and recommendations, the Private Healthcare Information Network (PHIN) was established. PHIN is an independent, not-for-profit organisation that works to improve transparency in the private healthcare sector. Its primary goal is to provide patients with accurate and comparable information about the quality and outcomes of care provided by private hospitals and clinics.

PHIN collects and publishes data on a range of metrics, including clinical outcomes, patient satisfaction, and price. By making this information publicly available, PHIN aims to empower patients to make informed decisions about their healthcare choices and encourage private healthcare providers to focus on improving the quality of care they offer.


PHIN PROMs Programme

The CMA has mandated the collection and use of Patient-Reported Outcome Measures (PROMs) for a specified group of medical and cosmetic procedures. PHIN publishes information on several of these PROMs, which are used to understand a patient's well-being, functional ability and aspects such as pain both before and after treatment, and can measure that treatment’s impact.

Initially guidance was in place such that hospitals were only deemed non-compliant for failing to submit PROM data on specified procedures if it performed more than 100 procedures annually, based on the assumption that statistically meaningful comparisons would not be feasible with lower volumes.

However, as of May 2023 PHIN now encourages the collection of PROMs on all eligible procedures, regardless of any minimum threshold. 

“Collecting and analysing outcome data is key to ensuring we continue to meet the needs of the patients we see every day. The partnership with My Clinical Outcomes promises to transform our ability to track, collect and monitor the performance of our hospitals and ultimately help us to continue offering outstanding care to the communities we serve.”

— Mr Peter James, Group Medical Director at Circle Health Group, June 2023

Procedures for which PROMs data collection for submission to PHIN is currently mandated are:

  • Hip replacement

  • Knee replacement

  • Shoulder replacement

  • Carpal tunnel release

  • Transurethral resection of the prostate (TURP)

  • Cataract surgery

  • Abdominoplasty

  • Augmentation mammoplasty

  • Blepharoplasty

  • Liposuction

  • Rhinoplasty

PHIN state that the benefits of PROMs are that they are the only standardised measure that produce outcomes from a patient perspective:  

  • There is an intrinsic value in routinely using PROMs as they facilitate a shift towards providing more patient-centred care.

  • They can flag patients who do not experience as expected health gains post-surgery, which can be investigated and additional support provided, if needed. 

  • They can be useful from a comparative perspective. By identifying above or below average PROMs scores, hospitals and consultants can share best practice, and look into underlying factors driving below-average performance.


MCO, Independent Hospital PROMs and PHIN

MCO has worked with hospitals in the private sector since 2011 and has been submitting PROMs to PHIN for private sector clients from the start.

Where private sector clients also do NHS funded hip and knee replacements, MCO also submits data to NHS England (formerly NHS Digital). Many independent hospital groups use MCO to collect data far beyond either requirement, including collecting longitudinal data beyond the mandatory post-op assessments, and collecting more granular data or broader data from other conditions and procedures.

In all cases, as well as providing regular reporting and analytics as well as transfer of all data back the client, MCO also takes care of all extracting subsets of data that are needed for submission to PHIN and NHS England.  

“We are thrilled to be working with MCO to introduce PROMs to measure our patient outcomes and see the value added to our patients’ lives. As a hospital, we look forward to learning more about the patient journey and how their treatment benefits them, whilst also monitoring any areas for improvement. We hope to use the data collected to improve our patient journey and the care we provide.”

— Stuart Hammond, CEO at St Joseph’s Hospital, March 2023
“A fantastic help to PHIN and completely supports all of our collective obligations to the CMA, but most importantly, facilitating the BEST outcomes for patients nationwide.”

— Dr Ian Gargan, Chief Executive at The Private Healthcare Information Network (PHIN)

MCO Independent Hospital Clients & Partners

 

Spire Healthcare

 

The London Clinic 

  • Harley Street London independent hospital

  • Focus on PHIN compliance, live since 2017

 
 

Cadogan Clinic

  • London Chelsea cosmetic surgery hospital, live since 2021

 

 

St Joseph’s Hospital

  • One of Wales’ largest privately owned hospitals, live since March 2023

  • More information can be found in the Partnership Announcement

 
 

Circle Health Group

  • UK’s largest independent hospital group with 55 private hospitals nationwide, since May 2023

  • All PHIN and NHS PROMs procedures

  • Circle’s Medical Director, Mr Peter James, describes the latest progress and the partnership with MCO to transform their ability to track, collect and monitor the performance of across their hospitals. The full Editorial article can be found on the ‘Independent Practitioner Today’.

 

HCA Healthcare UK

  • UK hospitals of the largest private healthcare provider in the world with 11 locations in central London and Manchester, live since August 2023 

  • Deep technical integration between MCO and HCA systems

  • Roll-out going far wider than PHIN requirements

  • More information can be found on HCA’s website

 
 

Hospital of St John and St Elizabeth

  • One of the UK's largest independent charitable hospitals, with any profits used to fund the on-site hospice, located in North London, live since August 2023

 

Manchester Private Hospital

  • Doctor owned and operated medical and aesthetic surgical facility, live since August 2023 

 
 

Spencer Private Hospitals

  • Spencer Private Hospitals, in Ashford, Canterbury and Margate, offer over 200 private treatments covering general surgeries, cosmetic surgery, non-surgical cosmetic treatments and physiotherapy

“Has been absolutely brilliant working with My Clinical Outcomes over the last 8 months to collaborate and launch electronic PROMs here at Circle Health Group.

We share a vision on what the future of outcomes and effectiveness looks like, and I’m looking forward to the continued development and increased utilisation of our data to both improve our patient outcomes and monitor consultant performance.”

— Dean Bennett, Group Clinical Effectiveness Lead at Circle Health Group
 

Links to more information:

  • For more information about independent hospitals' PHIN obligations please visit the PHIN website.

  • For more information about the NHS PROMs programme please visit the NHS Digital website.