Improving the quality of mental health services using patient outcome data: Making the most of HoNOS

Abstract

Efforts to assess and improve the quality of mental health services are often hampered by a lack of information on patient outcomes. Most mental health services in England have been routinely collecting Health of the Nation Outcome Scales (HoNOS) data for some time. In this article we illustrate how clinical teams have used HoNOS data to identify areas where performance could be improved. HoNOS data have the potential to give clinical teams the information they need to assess the quality of care they deliver, as well as develop and test initiatives aimed at improving the services they provide.

Desperately seeking outcomes: quantifying the effectiveness of community mental healthcare using Health of the Nation Outcome Scales

“…Tracking individual scores for each of the 12 questions included in HoNOS may give a better understanding of the impact our interventions have on patients’ health and wellbeing. Other studies have examined the HoNOS in this way, 2 but this method is expensive as more work is required to analyse the data.…”

“…Each domain is graded by the treating clinician from zero to four: where zero means no problem, one means there is a problem probably requiring intervention, and two, three and four correspond to ‘mild’, ‘moderate’ and ‘severe’ problems. 2 A score of nine is allocated if the clinical state is unknown. Currently, HoNOS is the most widely used clinical outcomes tool used by psychiatric services in England.…”

18th Latest Advances in Psychiatry Symposium

“…C u r r e n t l y t h o u g h , m o s t patients with personality disorders receive 'usual care', which is sporadic and often even leaves patients with worse problems to do with their condition than when they started treatment. 10 'We need to avoid misdiagnosis, overmedication and stand-alone psychological treatments,' said Professor Crawford. 'Instead, we need to facilitate the use of evidence-based treatments and ensure treatment is given out by a thoughtful and coordinated team.…”

Measurement properties of the Health of the Nation Outcome Scales (HoNOS) family of measures: protocol for a systematic review

“… 3 In addition to its application in clinical practice, the HoNOS has also been used by researchers and policy-makers to monitor mental health service quality and effectiveness. 4 …”

“…The HoNOS, HoNOSCA and HoNOS 65+ are now the most widely used routine outcome measures in mental health services in England. 4 11 In Australia, these three measures have been implemented in inpatient, residential and ambulatory settings within public sector mental health services 12 and the HoNOS is used in private hospitals with psychiatric beds. 13 In New Zealand, the HoNOS, HoNOSCA, HoNOS 65+, HoNOS-LD and HoNOS-secure have been mandated for routine collection in mental health services.…”