Patient Reported Outcome Measures in Osteopathy

Data collection in osteopathy

Osteopathy has its roots in America where it was first practised by Dr Andrew Taylor Still.  Brought to the United Kingdom by Dr John Martin Littlejohn, its more recent developments include the passing of the Osteopaths Act in 1993 making the profession statutorily regulated thereby affording protection of title.  Although the profession has become more organised, it has lacked the capacity to describe itself to external audiences through demonstrating its scope of practice, and outcomes of care.

Robust outcome data, not prone to bias, and other markers of good quality care are increasingly being required by a range of audiences including patients, insurers, and other healthcare professionals.  These key requirements of clinical governance required by insurers and regulators are part of the newly-created Any Qualified Provider (AQP) system introduced via the Health and Social Care Bill (2012).  AQP affords the opportunity for osteopaths to bid for the widening range of different services commissioned by local Clinical Commissioning Groups (CCGs); such bids require a range of information and resources including the provision of PROM data.  Consequently there is a clear need for a facility for osteopaths to routinely collect high quality outcome data to meet the challenge of the AQP process, but also to reflect on current standards of care and services.

Describing osteopathic practice

To be a successful profession it is important for osteopaths to be able to describe what they do to any external audience.  This could include

  • existing patients;
  • prospective patients;
  • other healthcare professionals;
  • commissioners of services for local businesses;
  • commissioners of services in the NHS (http://www.england.nhs.uk/ccg-details/).

To address the profession’s ability to describe itself, a standardised data collection (SDC) tool was developed for the profession involving practising osteopaths and other osteopathic stakeholders.  This paper-based tool was piloted nationally for three months (Fawkes et al, 2013a; Fawkes et al, 2013b).  A copy of the final report of the study can be found at http://www.ncor.org.uk/wp-content/uploads/2013/05/standardised_data_collection_finalreport_24062010.pdf.

Information concerning the data collection tools can be found at http://www.ncor.org.uk/practitioners/standardised-data-collection/.

Although the SDC tool provided considerable data concerning current care in the profession, it highlighted the need for a facility to collect outcome data independently of clinicians.  Supported by funding from the Institute of Osteopathy, a data collection facility is in development being led by Carol Fawkes.  Full information concerning the project can be found here.

References

Any Qualified Provider (AQP). See http://www.ncor.org.uk/practitioners/practice-resources/any-qualified-provider/  for full details.

Fawkes, C., J. Leach, Mathias S, Moore AP. The Standardised Data Collection Project: Standardised data collection within osteopathic practice in the UK: development and first use of a tool to profile osteopathic care in 2009, Clinical Research Centre for Health Professions, University of Brighton. Available at http://www.ncor.org.uk/wp-content/uploads/2013/08/SDC-EXECUTIVE-SUMMARY.pdf.

Fawkes CA, Leach CM, Mathias S, Moore AP. Development of a data collection tool to profile osteopathic practice: Use of a nominal group technique to enhance clinician involvement.  Man Ther. 2013 Sep 4. pii: S1356-689X(13)00152-5. doi: 10.1016/j.math.2013.08.006. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/24119310

Fawkes CA, Leach CM, Mathias S, Moore AP.  A profile of osteopathic care in private practices in the United Kingdom: A national pilot using standardised data collection.  Man Ther. 2013 Sep 13. pii: S1356-689X(13)00154-9. doi: 10.1016/j.math.2013.09.001. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/24139392

Health and Social Care Act (2012).  http://www.legislation.gov.uk/ukpga/2012/7/contents/enacted.  (Accessed 01.09.2013).