Recording of mental health outcome measures (WHC/2025/006)

Status:

Action.

Category:

Performance and assurance.

Title:

Recording of mental health outcome measures.

Date of expiry / review:

31 December 2027.

Action by:

• Health boards.
• Mental health teams.

Required by:

Ongoing.

Sender:

Matt Downton,
Deputy Director for Mental Health, Substance Misuse and Vulnerable Groups,
Welsh Government.

Ciara Rogers, National Director - Mental Health, Learning Disability and Neurodiversity,
NHS Wales Executive.

Welsh Government contacts:

Mental Health and Vulnerable Groups: mentalhealthandvulnerablegroups@gov.wales

To:

• directors of primary community and mental health
• assistant medical directors
• mental health general managers
• strategic programme for mental health
• NHS Wales Joint Commissioning Committee (mental health and vulnerable groups)
• NHS Executive (quality, safety and improvement).

Dear Colleague,

To support the ambitions of the forthcoming mental health and wellbeing strategy for Wales and its commitment to embed routine access, outcome and experience measures into practice, this letter sets out guidance in relation to adopting the use of Patient Reported Outcome Measures (PROMs) in mental health services. These expectations are grounded in our commitment to placing person-centred care firmly at the heart of services. This focus is at the core of the quality standards and our commitment to provide, safe, effective, efficient, equitable and person-centered care.

To support a consistent national dataset, ReQol (Recovering Quality of Life), a cluster 1 tool from the outcome measures framework for Wales on Public Health Wales' website, has been recommended for use across adult and older adult mental health services across Wales. Further work is being done to agree a tool for children and young people’s services.

We are grateful for the work that has been undertaken with teams across Wales to support the adoption of a single national PROM ^{[footnote 1]} for use within adult and older adult mental health services including the feedback given on the impact of using ReQol in services.

By consistently using a national tool, ReQol as noted on the Public Health Wales website, across the breadth of a patient’s journey, particularly across transition points, we will be able to monitor reliable change throughout. Ensuring we are seeking and reporting on the views of our patients to understand what works well and how we can tailor the care we provide to meet their needs, is essential. Of equal importance is the opportunity to consider what has helped patients to improve, and what could also be improved.

There will be two approaches to support implementation. Reporting on:

• the administration of ReQol
• baseline and end of intervention ReQol scores to demonstrate change

It is planned, from June 2025, that all adult and older adult inpatient mental health services across Wales shadow report on their use of PROMs and all other adult and older adult services shadow reporting from April 2026. It is expected ReQol will be completed at the start and end of a period of care and if this is for longer than 12 months, reviewed at that point. To report on the administration of ReQol data will be initially collected in pilot form and to support this collection a proforma has been attached which can be submitted to the du.inbox@wales.nhs.uk mailbox in line with the timescale advised.

To fulfil the second reporting requirement, it is suggested that organisations arrange for the ReQol tool to be embedded within their local PROMs platform as soon as feasible (all health boards will have mechanisms for collecting PROMs more broadly, typically using the 'promptly' system). This will enable practitioners, patients and health boards to demonstrate progress over time in improved mental wellbeing. The tools should also be used on an individual basis to further inform patient centered care.

These outcome measures will form part of the Mental Health Core Dataset that is being developed with Digital Health and Care Wales (DHCW) and is currently going through the Welsh Information Standards Board (WISB). National approval of this new national PROM pathway is to undergo the agreed scrutiny process undertaken by NHS Executive Welsh Value in Health Centre, which will oversee the development of relevant Data Standards Change Notices (DSCNs) and Fast Healthcare Interoperability Resources (FHIR) standards to allow local implementation by health boards.

We have asked the NHS Executive to work with each health board to enable a delivery plan to be put in place, to provide quality improvement support for implementation if needed, and to monitor and report on the results.

We would like to thank you for your ongoing commitment to sustain and improve outcomes for people receiving mental health services across Wales. Being able to demonstrate impact and have data to support both individual care and service transformation is key to our shared ambition.

Yours sincerely

Matt Downton,
Deputy Director for Mental Health, Substance Misuse and Vulnerable Groups,
Welsh Government.

Ciara Rogers,
National Director - Mental Health, Learning Disability and Neurodiversity,
NHS Wales Executive.

[1] National reporting of ReQol does not preclude the use of other tools within the framework in clinical practice.