Health of the Nation Outcome Scales: a case study in general psychiatry

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Background Health of the Nation Outcome Scales (HoNOS) were incorporated in a data set recording the routine clinical activities of a mental health team in Liverpool.

Aims To evaluate the use of HoNOS in general adult psychiatry.

Method All consecutive patients who came in contact with the mental health team were administered HoNOS by the consultant psychiatrist.A cohort (n=204) of patients was identified over a period of 8 months. All patients (n=156) who had a repeat HoNOS after an interval of 6 months were included in the study.

Results There was an overall reduction in HoNOS scores after an interval of 6 months, more so among patients with psychotic and affective disorders.Patients scoring on other disorders showed no change on HoNOS. The measured change in clinical state based on the Clinical Global Impression scale was broadly consistent with HoNOS scores.

Conclusions It was feasible to administer HoNOS during routine assessments, but HoNOS data were of limited value in care-planning in day-to-day clinical practice. The widespread adoption of HoNOS for use in routine clinical practice would be premature.

Declaration of interest This was a joint project between the Mental Health Directorate, University Hospital Aintree and Liverpool Health Authority.

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