Improving recording of outcomes information for people receiving treatment

What this data shows:

There are currently limited measures of outcomes in secondary care mental health settings. Health of the National Outcome Scales (HoNOS) can provide an insight into whether treatments are effective. This indicator measures the proportion of people on Care Programme Approach (CPA) who have had a HoNOS score recorded within the past 12 months with the aim of improving recording of information which can be used to measure outcomes for patients in future.

How the data is gathered:

The Care Programme Approach (CPA) is the national system which sets out how secondary mental health services should respond to and co-ordinate care for people with the most complex needs.

Currently, there are limited measures of outcomes in secondary care mental health settings, but there is increasing use of the clinician reported Health of the Nation Outcome Scales (HoNOS). Although not patient-reported, these scales can provide an insight into whether treatments are effective, particularly for people who have been admitted to hospital or treated in the community as a result of a mental health crisis. Many of these people will be on CPA.

This indicator currently looks at the proportion of people on CPA who have had a HoNOS score recorded by their clinician within the past 12 months. Therefore, with this indicator we aim to identify whether providers are regularly recording outcomes for this group of patients.

This indicator does not provide any information on the actual outcomes recorded, simply whether or not a score had been recorded at some point in the past 12 months. It does not show whether this was recorded at the start or end of treatment (or otherwise), just that a score was, at some point, recorded.

It should be noted that HoNOS scores are more sensitive to certain care environments than others. For example, an inpatient who was experiencing a mental health crisis at the start of their inpatient stay will likely have significantly improved on several areas of HoNOS at the point of discharge (i.e. by which time their mental health will have improved sufficiently to not warrant inpatient treatment). In comparison, a patient accessing a community service on a longer term basis might have less obvious changes between their HoNOS scores at start and end of care spell or treatment episode. Therefore, caution should be taken when interpreting these results.

When the data is shown:

This indicator is scored based on the highest and lowest performing 20% of trusts. The top 20% of providers with the highest percentage of HoNOS scores recorded in the past 12 months will be given a Green Tick, and the bottom 20% with the lowest proportion of people on CPA having HoNOS scores recorded in the past 12 months will be given a Red Exclamation Mark. The remaining 60% will be given a Blue OK.

More information about the data source:

For further information about this data please the metadata file on the HSCIC website at: http://www.hscic.gov.uk/searchcatalogue?productid=16903&q=mhmds+&sort=Relevance&size=10&page=1#top For further information on HoNOS visit http://www.rcpsych.ac.uk/clinicalservicestandards/honos/generalinformation/faq.aspx

Data Source:

Health & Social Care Information Centre (HSCIC) – Mental Health and Learning Disabilities Dataset (MHLDDS). Previously Mental Health Minimum Dataset (MHMDS).

Data Period:

Monthly: May 2018

Further Information:

Health & Social Care Information Centre (HSCIC) – Mental Health and Learning Disabilities Dataset (MHLDDS). Previously Mental Health Minimum Dataset (MHMDS).

"Numerator: number of people on CPA with an HoNOS score recorded in the last 12 months Denominator: number of people on CPA"