The CSIP project is linking with local services to share best practice and learning.

The CSIP project is linking with local services to share best practice and learning.

The South London and Maudsley trust participated in a Department of Health pilot in 2002. Since then clinical teams from the trust have worked to embed health outcomes measurement in routine clinical practice.

A trust outcomes team, led by Professor Alistair MacDonald of the mental health older adults directorate, is working to improve the use of outcomes measurement across the trust. Health of the nation and outcomes scales - HoNoS and HoNoS65, adapted for older adults - are now widely used in the Southwark adult mental health directorate and the mental health older adults directorate respectively.

In directorates where the recording of HoNoS has improved, some preliminary analysis has started to provide benchmark data for patients on the enhanced care programme approach. This includes average scores on admission, on discharge, and when managed by continuing care, plus assertive outreach and home treatment teams.

The Southwark outcomes data suggests that HoNoS is a clinically useful measure of global functioning. HoNoS appears to be sufficiently sensitive to benchmark average patient scores at different stages in the patient's journey, and when managed by different types of clinical team.

The measure may also be sufficiently sensitive to demarcate patient groups based on diagnosis. The analysis of Southwark outcomes data has not demonstrated any significant difference in mean HoNoS scores based on gender or ethnicity at the time of hospital admission.

In Southwark there is a robust programme of feedback of outcomes data to the clinical teams for realistic evaluation and contextualisation. This is has helped to generate practice based evidence, facilitate reflective practice and demonstrate clinical effectiveness.

For further information contact, Kevin Smith, clinical projects performance manager at the South London and Maudsley trust at