HoNOS-LD is an appropriate instrument for measuring outcome in people with learning disabilities with additional mental health needs.

Summaryrating instructions: (a) Complete the front sheet including ICD–10 diagnoses and subjective rating. (b) Rate each in order from item 1 to 18. (c) Do not include information rated in an earlier item. (d) Rate the person over the previous 4 weeks. (e) Rate the most severe problem that has occurred during the period rated. (f) All items follow the five-point rating format similar to other HoNOS instruments: 0=no problem during the period rated; 1=mild problem; 2=moderate problem; 3=severe problem; 4=very severe problem.

The implementation of the Care Programme Approach (CPA) in English mental health services has been slow to proceed despite general support, both in England and in other countries, of its principles of good practice. This study set out to evaluate the implementation of the CPA directly from patients’ experience using the “Your Treatment and Care” assessment tool. The results of a survey of 503 patients across five NHS Trusts in England showed that many patients did not have a copy of their care plan and had not been involved in the care planning procedure. Many reported shortcomings in their experience of their key worker and their psychiatrist. However, there was substantial variation in experience across services. “Your Treatment and Care” showed good internal reliability, was acceptable to users, and appeared to be able to access actual experiences better than a traditional “satisfaction” item. It appears to be very useful as a benchmarking tool and is now being used in services across the UK, the USA and Australia.

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