Mental Health Nursing

32 Acute Mental Health Nursing
In Australia, a large government-funded study to look at the measurement
of outcomes in mental health services (Steadman et al., 1997) has also
recommended the use of HoNOS as a service provider-rated measure
across all service settings, as one of six possible measures.
HoNOS in today’s NHS
Across the UK there has been a significant uptake of HoNOS. A telephone
survey of 140 English trusts providing mental health services was conducted
between October 1997 and May 1998 (Bishop, 1998). It showed
that 17% had implemented HoNOS in more than one locality or service
setting and were committed to a full implementation. A further 16% had
gone beyond the piloting stage and had implemented in a single locality or
service setting. Training of staff in the use of the scales who were involved
in some sort of pilot scheme on the use of HoNOS had occurred in a further
26%, and 7% had plans to do so, giving rise to a cumulative total of
66%. At that time, the remaining 34% had no plans to use the scales.
A more recent postal survey of English mental health service providers
(James, 2002) showed that 34% of services still had no use of HoNOS.
However, many organisations had increased the number of service areas
using HoNOS and overall use had risen. Forty-nine per cent of services
had implemented HoNOS in more than one locality or service setting
compared to 17% in the previous survey. By 2002, 11.5% of the sample
was using HoNOS in all service areas and a further 11.5% within
75–99% of service areas. Thirty-four per cent of the organisations were
using HoNOS routinely in over half of all service settings. In the organisations
where routine use was identified, 79% of nurses were using
HoNOS. Within other staff groups 59% of occupational therapists,
53% of social workers, 26.5% of psychologists and 23.5% of medical
staff were using HoNOS routinely. Within services with routine use of
HoNOS, 68% were undertaking ratings at CPA reviews, and ratings were
undertaken at ward admission and ward discharge in 59% of these
services (James, 2002).
In addition, the CRU has sent out in excess of 10,000 scales and glossaries
to around 90 services over the last few years and continues to coordinate
training, providing training services to a further 25 trusts. In
addition, HoNOS has now achieved an international profile, having been
translated into a number of different languages (Wing et al., 2000).
It might perhaps have been anticipated that take-up of HoNOS would
have been more widespread by 2002 but a number of factors may have
militated against this. The most obvious being the change of government
in the UK during the intervening period from commissioning to completion