The winners of a competition to identify outcomes indicators for stroke recovery, and children and young people’s experience of healthcare, have been announced.
The Innovation in Outcomes Competition set a challenge to identify ways of measuring two key outcomes – included in the NHS Outcomes Framework: improving people’s recovery from stroke, and improving children and young people’s experience of healthcare.
The NHS Outcomes Framework, published at the end of last year, was developed to:
1. set out measures that can be used to assess how well the NHS is doing
2. provide a mechanism by which the Government can hold the new NHS Commissioning Board to account for how well it is doing in achieving better outcomes for patients
3. acting as a catalyst for outcome measurement throughout the NHS
One of the challenges in creating the framework was to work out how the NHS would actually measure those outcomes – by developing the right indicators.
Two outcomes in particular, improving people’s recovery from stroke and improving children and young people’s experience of healthcare, formed a key part of a competition to help fill out those gaps in the framework.
Announcing the winners, Health Secretary, Andrew Lansley said:
“A focus on delivering improved outcomes for all patients is at the heart of this Government’s modernisation plans. But we can only do this by working collaboratively and fostering a culture which supports innovation to improve quality and productivity.
“The winners of the outcomes indicators competition for stroke recovery and for measuring children and young people’s experience of healthcare, will drive vital improvements in the NHS – helping to put patients first and developing outcomes that are consistently among the best in the world.”
• The British the British Association of Stroke Physicians
• the Stroke Improvement Programme
• the Intercollegiate Stroke Working party
• the Royal College of Physicians of London Joint Specialty Committee for Stroke Medicine
• the South East Quality Observatory, and
• the Cardiac and Stroke Networks in England
The winning entry proposed that the Modified Rankin Scale (mRS) should be developed as an indicator. This indicator uses the mRS to assess the patient’s recovery from stroke after six months, with scores ranging from:
• 0 – no symptoms/complete recovery; through to
• 3 – moderate disability requiring some help, but able to walk without assistance; up to
• 6 – where death occurs.
The mRS is an established measure of disability and sensitive to healthcare related interventions after stroke. It is already part of a routine data collection in older people (not just in those with stroke), and is used nationally and internationally. The indicator will become part of the routine data collection after stroke.
The second winner focused on the vital need to capture the experience that children and
young people have of healthcare. Historically, this area has been particularly difficult to measure. The winner for this element was submitted by the Picker Institute Europe, and involved using the Children’s Outpatient Experience Indicator. The indicator will measure the recent hospital outpatient experience of children aged 8 to 17 years and will compute a single indicator score from responses to questions about aspects of the hospital outpatient experience.
The Picker Institute Europe have developed a self completion survey (with option for parental/carer help) to gather specific and actionable information about the experience of young patients. The questionnaire examines the aspects of experience that matter most to children and young people.
Both the stroke entry and the children and young people entry will now undergo some further technical work to ensure they can be included in the national NHS Outcomes Framework.