Why the NHS recommends Recovering Quality of Life (ReQoL-10) for use in Community Mental Health services

Patient Reported Outcome Measures (PROMs) are tools (usually in a questionnaire format) that help to assess an individual’s mental health and wellbeing needs and measure change. Measuring outcomes can help clinicians and services better understand the impact of 1:1 interventions; ensure services are meeting the needs of different service users; and monitor and improve effectiveness, efficiency and quality of the service offered to its service users.  It is important as it helps to understand the benefit and impact people receive from their mental health services.

In October 2021, NHS England and NHS Improvement established a task and finish group to look at a consistent approach to outcome measurement and recommend which PROMs should be used across CMH services for adults, including older adults, with severe mental illness. The group looked at a large number of PROMs and assessed against agreed selection criteria which included acceptability; validity; reliability; interoperability; and burden.

The group recommended the use of three PROMs, including Recovering Quality of Life (ReQoL-10).  ReQoL-10 was chosen because:

• It is recovery focused and can be used to assess the key recovery domains of connectedness, hope, identity, meaning and empowerment (CHIME) for people with different mental health conditions.  

• It was co-produced and tested with over 6,000 service users.  

• It provides an understanding of the factors contributing to service user’s own personal recovery 

• Nationally, it can be used to benchmark and build evidence and demonstrate good quality.  

The other PROMs recommended by the group were Goal Based Outcomes (GBO) and DIALOG. Each fulfils a different purpose and it is not expected that all three will be used at the same time and by the same care professional. The goal is for services to start embedding at least one of three PROMs in their systems in 22/23 with the aim of embedding all three in CMH services by the end of 23/24. Nationally, there will be an analysis of the data through the Mental Health Services Data Set (MHSDS) along with the development of supporting resources. 

The ReQoL-10 questionnaire has been developed into a visualisation tool which can now be accessed online https://reqol-visualisation-tool.group.shef.ac.uk/ Further resources can be accessed here: https://www.reqol.org.uk/p/overview.html 

One of the aims of the YH ARC Health Economics, Evaluation and Equality Theme has been to support NHS Trusts to meaningfully implement the data in the NHS to improve health outcomes for patients with mental health conditions through the implementation and use of the ReQoL. 

This blog was written by Dr Lizzie Taylor Buck and Amanda Lane, Health Economics, Evaluation and Equality theme, Yorkshire and Humber ARC.

Applied Research Collaboration Yorkshire & Humber - Health Economics, Evaluation and Equality Theme

The Applied Research Collaboration Yorkshire and Humber (ARC-YH) supports people powered research that aims to tackle inequalities and improve health and well-being for the communities. The ARC-YH is focussed on six key themes: https://www.arc-yh.nihr.ac.uk/what-we-do. The Heath Economics, Evaluation and Equality (HEEE) theme is being delivered by the University of Sheffield and the University of York. Dr Tracey Young and Dr Laura Bojke co-lead the team.

 The Health Economics, Evaluation and Equality theme aims:

 1. To improve local providers’ understanding of the importance of economic and inequalities evaluations to inform and support decisions regarding provision of new services and disinvestment in those not representing value for money or potential to reduce inequalities.

 2. To work collaboratively with core themes and local partners to develop new applied research and implementation initiatives for further funding from NIHR and non-NIHR streams.

3. To apply distributional effectiveness and cost-effectiveness methods to assess the impact of interventions on health inequalities.

4. To apply and enhance our recent methodological advances for conducting cross sector evaluations.

This research is important as it will help improve efficiency and equity in the use of public resources by providing research capability in health economic evaluation to NHS, public and social care partners. This will benefit local NHS, public health and social care collaborators.

This work augments research conducted during the 5-year NIHR Collaboration for Leadership in Applied Health Research and Care – Yorkshire and Humber project that concluded on the 30th September 2019  http://clahrc-yh.nihr.ac.uk/home. 

For further information on the Applied Reseach Collaboration Yorkshire & Humber please visit: https://arc-yh.nihr.ac.uk/