Using Patient-Reported Outcomes (PROMs & PREMs) in NHS-Commissioned Services

Patient-reported outcomes and experience measures are now firmly on the NHS radar. Commissioners increasingly expect providers to demonstrate not just clinical or operational outcomes, but how people experience services and whether support genuinely improves their day-to-day lives.

Providers that can evidence both outcome and experience — and show how the two interact — are far more likely to be viewed as delivering meaningful, person-centred care.

This sits directly within NHS outcomes and impact measurement and NHS community service models and pathways, where lived experience is increasingly recognised as a core component of quality and effectiveness.

This topic also links closely with making safeguarding personal and recording and evidencing person-centred care.

Services seeking stronger governance evidence can refer to the clinical governance and community services integration hub for structured guidance.

What PROMs and PREMs actually measure

PROMs (Patient-Reported Outcome Measures) and PREMs (Patient-Reported Experience Measures) capture different but complementary aspects of service quality.

PROMs focus on outcomes from the person’s perspective, such as:

• perceived improvement in health or functioning
• confidence and independence
• ability to manage daily activities
• progress against personal goals

PREMs focus on experience, including:

• feeling listened to and involved in decisions
• clarity and consistency of communication
• dignity, respect and emotional support
• overall satisfaction with care delivery

Together, they provide a more complete picture of service impact.

Why commissioners value patient-reported data

Commissioners increasingly use PROMs and PREMs to validate and contextualise other forms of evidence.

They help to:

• confirm whether quantitative outcomes reflect real improvement
• identify variation in service quality and experience
• detect emerging risks that may not yet appear in performance data
• understand whether services are genuinely person-centred

They are particularly valuable where clinical or activity data alone does not capture lived experience.

Using PROMs proportionately

One of the most common pitfalls is overuse. Excessive or poorly designed surveys reduce engagement and data quality.

Effective providers focus on proportionate, meaningful collection:

• using short, relevant tools aligned to service objectives
• timing collection at appropriate points in the care journey
• ensuring accessibility for different communication needs
• avoiding duplication with other feedback mechanisms

Quality of insight matters more than volume of responses.

For system-facing services, it is important to evidence impact through outcome frameworks aligned with NHS and ICB priorities.

Designing meaningful PROMs and PREMs

Strong providers ensure measures are clearly linked to service purpose and outcomes.

This includes:

• selecting validated tools where appropriate
• aligning questions to intended outcomes and experiences
• ensuring language is clear and accessible
• testing tools with service users before implementation

Poorly designed tools produce unreliable data and weaken assurance.

Interpreting and using the data

Commissioners expect providers to move beyond data collection and demonstrate active use.

This means clearly explaining:

• what the data shows and how it is interpreted
• what has changed over time and why
• what actions have been taken in response
• how those actions have influenced outcomes or experience

Raw scores without interpretation or follow-up provide limited assurance.

Operational example: using PROMs to improve community support

Context: A community-based service introduces a simple PROM to measure confidence and independence following support.

Approach: The tool is completed at baseline and review points, supported by staff where needed.

Findings: Data shows improvement in most cases, but identifies a subgroup with limited progress.

Action: The provider reviews support approaches for this group and introduces targeted interventions.

Outcome: Subsequent data shows improved outcomes, demonstrating learning and adaptation.

Embedding PROMs into service delivery

High-performing providers integrate PROMs and PREMs into everyday practice rather than treating them as standalone exercises.

This includes using them within:

• care planning and review processes
• supervision and reflective practice discussions
• team meetings and service reviews
• quality improvement planning

This ensures that patient voice actively informs delivery and decision-making.

Triangulating PROMs with other evidence

PROMs and PREMs are most effective when combined with other data sources.

Providers should triangulate with:

• clinical or operational outcomes data
• risk and incident information
• staff feedback and observations
• complaints and compliments

This creates a more robust and credible evidence base.

What commissioners look for

Commissioners assess PROMs and PREMs based on relevance, consistency and use.

They typically look for:

• measures that are clearly aligned to service purpose
• consistent and proportionate data collection
• evidence that findings inform improvement
• honest reflection on limitations and variation

They are assurance tools, not tick-box exercises.

Common pitfalls to avoid

• over-surveying leading to poor engagement
• using overly complex or irrelevant tools
• failing to act on findings
• presenting data without interpretation
• treating PROMs and PREMs as isolated from wider systems

These issues reduce both credibility and usefulness.

Stronger commissioner conversations often begin by clarifying what meaningful outcomes look like in NHS-commissioned services.

Conclusion

PROMs and PREMs provide essential insight into how services are experienced and whether they deliver meaningful outcomes from the person’s perspective.

The strongest providers use them proportionately, interpret them clearly and embed them into practice and governance.

By doing so, they strengthen assurance, improve quality and demonstrate a genuinely person-centred approach that commissioners increasingly expect.

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