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The Royal College of Psychiatrists Improving the lives of people with mental illness

What is HoNOS?

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.


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