The potential of PROMs: An opportunity for digitally-enabled patient-repo
Abstract
NHS Wales is currently experiencing the darkest period in its 23 year history, with rapidly deteriorating wait times, inequalities, staffing shortages [1], and public dissatisfaction driven by unforgiving UK Government budget cuts and a total lack of agility in the service’s organisation and planning [2–5]. The last decade has brought several iterations of ineffective Welsh Government policy and a misguided myriad of national improvement programmes — all of which failed to gain more than micro-scale success in practice. Change is afoot for the service, however, with a raft of recent policies from the latest Government finally putting technological improvement and innovation at the front-andcentre whilst shifting the service’s prime directive from ruthless frugality to improving the quality of patient care. At the core of this redesigned approach is the need to redevelop the service to one that is more preventive than it is reactive, with a large emphasis on enabling homebased and self-managed care and hospital referral only “when it is essential” [6,7]. To achieve this, NHS Wales is to adopt a PCH model of practice1 whereby practice “focus[es] on meeting the goals and preferences of our patients through involving them in decision making” [9] (see Figure 1.1). The primary strategic foci of this redesigned approach is the total integration of PROMs into the service; PROMs are subjective.