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.

 Extending the QALY beyond health – the EQ-HWB (Health and well-being)

Professor John Brazier

Join us online for a monthly online masterclass by one of our health research experts based in The School of Health and Related Research

Join the live session by clicking the link below

https://eu.bbcollab.com/guest/fbae374ad6ed4eeea1ed792b69c

Abstract
Measures for estimating Quality Adjusted Life Years (QALYs) (e.g. EQ-5D, SF-6D) attempt to capture the health of patients but miss broader wellbeing considerations such as autonomy and relationships that are important to patients and users of social care. Furthermore these measures do not consider the impact on carers’ quality of life. This limitation of existing measures led to the joint MRC and Euroqol Research Foundation funded Extending the QALY (E-QALY) project.
On behalf of the E-QALY team, John Brazier will describe the idea for a new and broader measure of health and wellbeing (i.e. why it was needed) for use in health and social care, some of the conceptual issues encountered and how they were approached in a large international programme of work. He will also present the mixed methods empirical work to develop the new measure called the EQ Health and WellbeingTM (EQ-HWB). Please come along and join in the discussion about the empirical research and the policy questions this new measure raises.
Bio
John Brazier is a Professor of Health Economics in the School of Health and Related Research (ScHARR) at the University of Sheffield. He was the first Director of the Economic Evaluation Policy Research Unit (EEPRU) which is a joint Sheffield and York Unit funded by the Department of Health in England to undertake applied and methodological research to inform health policy in England. Professor Brazier is currently a NIHR Senior Investigator (Emeritus).
Professor Brazier has more than 25 years’ experience of conducting economic evaluations of health care interventions for policy makers and has published over 200 peered reviewed papers. His special interest is in the measurement and valuation of health for economic evaluation where he has published widely.
Perhaps best known for his work in developing a preference-based measure of health for the SF-36 (SF-6D), but with colleagues he has further developed and extended these methods to a number of specific condition including measures in asthma, cancer, overactive bladder, diabetes, mental health, dementia and epilepsy.
https://www.sheffield.ac.uk/scharr/people/staff/john-e-brazier
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