PROMs and PREMs book

Tim Benson has written a new book: Patient-Reported Outcomes and Experience: measuring what we want from PROMs and PREMs. This will be published by Springer in April or May 2022. It covers how to improve patient outcomes and experience of healthcare services. It is aimed at clinicians, managers, analysts and policymakers seeking an up-to-date reference on the latest developments in this rapidly expanding field. Part I covers the core principles of PROMs and PREMs. The chapter titles are: Why PROMs and PREMs matter, History, Terminology, Why PROMs are hard: people, Noise and complexity, Using the results, Sharing data, and Value of health and lives. Part 2 covers specific measures. The chapters cover: Patient-reported measures, Patient experience, Health status, Wellbeing, Patient-centred care, Individualised measures, How people live, Innovation evaluation, Staff-reported measures, and Proxies, caregivers and care home residents. If you want to see any chapters, please let us know and we will be glad to send you them.


Alex Benson joined R-Outcomes as Project Manager in January 2021. He comes with a broad background of working in customer-facing roles in the mobile phone, gaming and banking sectors.

Supported Self-Management

Supported self-management (SSM) is a core part of the NHS Long Term Plan. This says that personalised care should become business as usual across the health and care system. In July 2021, R-Outcomes won places on the new Health System Support Framework (HSSF) for both: • Service line 1: Self-Supported-Management Measures. • Service line 2: Expertise, advice, support and training in the use of measurement in supported self–management. The HSSF makes it simpler for NHS bodies to procure R-Outcomes. It covers all our measures and services. R-Outcomes is one of two companies to be awarded places on both service lines.


In April 2021 we signed a three-year contract with Crossover Health, based in California to use the Health Confidence Score. Crossover is one of a new generation of US primary care providers. It has contracts with major employers, such as Apple, Amazon, Meta and Microsoft, to maintain people’s health and wellbeing.

Social Contact and Loneliness

We published a full peer-reviewed paper on our re-named Social Contact and Loneliness measures.
Both measures address the core issue of loneliness. Social Contact asks questions in a positive way
(Figure 1). Loneliness is more negative, based on ONS guidelines (Figure 2).

  1. Benson T, Seers H, Webb N, et al. Development of social contact and loneliness measures with validation in social
    prescribing. BMJ Open Quality 2021; 10: e001306.

Figure 1 Social contact measure

Figure 2 Loneliness measure

Person-Specific Outcome (PSO)

PSO is an individualised measure. It asks people to enter two issues that they most want help with
and scores each.
2 Typically PSO is used on first referral and after the intervention (Figure 3).

Figure 3 Person-Specific Outcome measure

2. Benson T. Person-specific outcome measure (PSO) for use in primary and community care. BMJ Open Quality 2021; 10:

Social determinants of health

Social determinants of health (SDoH) are factors such as poverty and housing, which are known to
affect people’s health and wellbeing. We have developed a new measure to capture this for
individual patients (Figure 4). This is based in part on the work of Sir Michael Marmot.

Figure 4 Social Determinants of Health measure


Donald Kirkpatrick developed a simple framework for evaluating all types of training course.
4 This
has four aspects – Reaction, Learning, Behaviour and Results. It is the basis of a short training
evaluation measure (Figure 5).

Figure 5 Training measure

More information

Please contact us for more information about anything mentioned here, or anything else.

Tim Benson
R-Outcomes Ltd
078855 682037


3. Marmot M. The health gap: the challenge of an unequal world. London: Bloomsbury 2015.
4 Kirkpatrick DL, Kirkpatrick JD. Evaluating training programs: the four levels. 3rd Edition, San Francisco CA: Berrett-Koehler