Implementing PROMs in routine clinical care: a qualitative exploration of GP perspectives

Background: The recently announced long- term plan for the NHS is based on a model of personcentred care, which relies on the sustained engagement of patients, shared decision making, and capability for self- management. For a primary care service under increasing pressure from an ageing and chronically ill population, Patient Reported Outcome Measures (PROMs) appear capable of supporting many of the requirements for person- centred care, yet little is known of the circumstances of their current implementation or how their use might be optimised. Aim: To begin the conversation about how successfully PROMs have been integrated into primary care and how their use might be supported. Design & setting: A qualitative investigation of the perspectives of GPs exploring the use of PROMs as part of routine clinical care in England. Method: Semi- structured telephone interviews were conducted with GPs from across England. The data were analysed using the Consolidated Framework for Implementation Research (CFIR). Results: A total of 25 interviews were conducted and GPs described the potential benefit of PROMs in a range of circumstances, but also voiced concerns about their reliability and their potential to constrain consultations. Their flexibility meant they had the potential to be incorporated into existing care processes but only with the requisite logistical support. Conclusion: Areas that need to be addressed include the creation of a compelling body of evidence of the benefit of PROMs, appropriate training for staff and patients, and a coherent implementation strategy from policymakers and funding bodies.