In 1993 the UK Department of Health commissioned the Royal
College of Psychiatrists’ Research Unit (CRU) to develop scales to
measure the health and social functioning of people with severe
mental illness. The initial aim was to provide a means of recording
progress towards the Health of the Nation target ‘to improve
significantly the health and social functioning of mentally ill
people’
Development and testing over three years resulted in an
instrument with 12 items measuring behaviour, impairment, symptoms
and social functioning (Wing, Curtis &
Beevor, 1996). The scales are completed after routine clinical
assessments in any setting and have a variety of uses for
clinicians, researchers and administrators, in particular health
care commissioners and providers. The scales were developed using
stringent testing for acceptability, usability, sensitivity,
reliability and validity, and have been accepted by the NHS
Executive Committee for Regulating Information Requirements for
entry in the NHS Data Dictionary. The scales also form part of the
English Minimum Data Set for Mental Health.
The use of HoNOS is recommended by the English
National Service Framework for Mental Health and by the
working group to the Department of Health on outcome indicators for
severe mental illnesses.
HoNOS is the most widely used routine clinical outcome measure
used by English mental health services. The CRU conducted a survey
of NHS mental health services in England in 2000 and found 34
services had implemented the use of HoNOS in one or more service
settings. A further survey by the Department of Health in 2002
found that 61 trusts were using HoNOS in their services with 5
having implemented the use of the scales across the whole
service.