Reducing inappropriate referrals with Aneurin Bevan

Learn how together we've achieved a 78% remote completion rate, having collected over 13,000 outcomes from patients.


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About Aneurin Bevan Health Board

Aneurin Bevan University Health Board is a local health board in Wales, headquartered in Caerleon. The total catchment area for healthcare services contains a population of approximately 600,000. Acute, intermediate, primary and community care and mental health services are all provided by the Health Board.



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Remote collection of patient-reported outcome measures, with support from clinical teams, is helping to achieve completion rates above 70%.

The Value-Based Healthcare programme is innovative in its approach, using technologically- driven methods in the pursuit of better patient outcomes and prudent use of resources. In keeping with this ethos, the programme invested in a digital platform (DrDoctor) to support the electronic collection of patient outcomes, linked to direct patient care. Not only does this alleviate the burden on staff, studies have found that remote data collection can be more effective than manual collection.

Technology informing care

Our vision is to implement the ‘right’ technology that enables patients to easily access and respond to requests for information relating to their care regardless of the type of handset or devices that they may use. 

The DrDoctor platform gives patients the ability to view and manage upcoming appointments and view hospital maps through their smartphones and mobile devices. By integrating PROMs data collection into this existing system, patients understand that responding is an integral part of their care: PROMs are not a satisfaction survey, the data are used by clinicians to power patient care, enabling patient-led discussions around shared goals.

  • 17,067 patient reported outcomes sent
  • 50% patient reported outcomes completion rate
  • 13,218 patient reported outcomes completed
  • 78% patient reported outcomes completed remotely

The health board uses the DrDoctor system to share important information with patients and send appointment reminders by SMS or email. Patients are becoming increasingly familiar with this platform, making it an ideal tool for PROMs collection. Through DrDoctor, patients are requested to complete PROM assessments prior to appointments and at other key points within their care pathway. 

From the time the system went live, completion rates have been above 60%, often reaching 70% for some projects, well above industry norms. The system is now used across 13 condition areas. Total response rates (for remote and manual data collection) have reached 72% with four in 10 responses coming through remote PROMs collection.

How Aneurin Bevan use PROM data

Collecting patient feedback through the DrDoctor system allows services to better understand patients’ needs. The VBHC programme is now working with clinical teams to use this data to optimise follow-up care. 

For example, in some condition areas, patients are brought back for appointments at intervals of four-to-six weeks. Using PROMs and clinical data, it will be possible to arrange appointments based on patient need, ensuring that the right patients are being seen at the right time e.g. speedier access for patients who become symptomatic. 

This has the twin benefits of sparing patients an unnecessary trip and freeing up appointments for those with greater need. Clinicians can use these insights to improve services and further enhance outcomes. The more effectively outcomes data is used to guide service enhancement, the more motivated patients will be to engage with remote PROMs data requests.

Listening to service users

To ensure we have a holistic view of how service users experience value-based healthcare initiatives, we have established a VBHC User Group. This has directly helped to shape our communication with patients and improve completion rates. 

When remote PROMs collection began, patients were asked to complete a questionnaire or survey. The VBHC User Group explained that patients view this as of low importance; they receive multiple communications of this kind from various sources and were unlikely to engage with something that appeared to have low relevance to them. However, by reframing this as an assessment that was part of the patient care pathway, engagement rose significantly.

The team has also worked with patient focus groups to personalise text and/or email messages. This makes patients feel more engaged in their care – further increasing response rates.

"Clinician and patient engagement are vital. It’s very powerful for patients to know the data is used to inform care.”

Dr Robert Letchford, Clinical Lead, Aneurin Bevan University health board

Key takeaways

  • Remote PROMs data collection can be used to achieve high response rates
  • Patients appreciate that clinicians use PROMs data and clinical data in care decisions, enabling patient-led discussions around shared goals
  • Patient focus groups and user groups can guide communication with patients and boost engagement

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