Health of the Nation Outcome Scales for People with Learning Disabilities

Roy, Ashok; Matthews, Helen; Clifford, Paul; Fowler, Vanessa; Martín, David

doi:10.1037/t66797-000

“…1994). At 12 years, we added the Health of the Nation Outcomes Scales for people with intellectual disabilities (HoNOS‐LD, Version 2, Roy et al. 1998), comprising 22 ratings of behavioural and cognitive problems, communication, activities of daily living and physical problems, from 0 (no problem) to 4 (very severe problems).…”

Section: Methodsmentioning

confidence: 99%

Service Use and Costs of Support 12 Years after Leaving Hospital

Hallam

¹

,

Beecham

²

,

Knapp

³

et al. 2006

Research Intellect Disabil

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Background There have been major changes in the provision and organization of services for people with intellectual disabilities in England over the last 30 years, particularly deinstitutionalization and the development of the mixed economy of care. The experiences of the people who participated in the Care in the Community Demonstration Programme in the mid-1980s provide evidence of the immediate and longer-term effects of the reprovision policy. Methods Cross-sectional and longitudinal evidence was gathered on service use and costs for over 250 people 12 years after they left long-stay hospitals for community living arrangements. Comparisons were made with the situation in hospital, and 1 and 5 years after leaving. Relationships between costs after 12 years and individual characteristics assessed before people left hospital were explored. Results Community care at the 12-year follow-up remained more expensive than hospital-based support, although the average cost was lower than at either of the 1-or 5-year community follow-up points. Service users were living in a wide variety of accommodation settings.Management responsibility fell on National Health Service (NHS) trusts, local authorities, voluntary agencies, or to private organizations or individuals. After standardizing for users' skills and abilities, costs in minimum support accommodation were significantly lower than those in residential and nursing homes, costs in staffed group homes significantly higher, and costs in hostels slightly lower. When looking at differences between individuals, no relationship was found between costs and outcomes although, overall, people were better off in the community than they had been when in hospital. Conclusions Reprovision planning for hospital and other institutional modes of care requires major and long-term commitment of resources. Quality of life improvements can be achieved at a cost little different in the long-run from that for hospital care. The link between needs and costs (reflecting the services intended to meet those needs) would be made stronger through the individualization of care.

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“…At the 5-year follow-up, 19 further skills and behaviour items were added (Cambridge et al 1994). At 12 years, we added the Health of the Nation Outcomes Scales for people with intellectual disabilities (HoNOS-LD, Version 2, Roy et al 1998), comprising 22 ratings of behavioural and cognitive problems, communication, activities of daily living and physical problems, from 0 (no problem) to 4 (very severe problems). Results from applying these instruments are described in a companion paper .…”

Section: Methodsmentioning

confidence: 99%

Service Use and Costs of Support 12 Years after Leaving Hospital

Hallam¹,

Beecham²,

Knapp³

et al. 2005

View full text Add to dashboard Cite

Background There have been major changes in the provision and organization of services for people with intellectual disabilities in England over the last 30 years, particularly deinstitutionalization and the development of the mixed economy of care. The experiences of the people who participated in the Care in the Community Demonstration Programme in the mid-1980s provide evidence of the immediate and longer-term effects of the reprovision policy. Methods Cross-sectional and longitudinal evidence was gathered on service use and costs for over 250 people 12 years after they left long-stay hospitals for community living arrangements. Comparisons were made with the situation in hospital, and 1 and 5 years after leaving. Relationships between costs after 12 years and individual characteristics assessed before people left hospital were explored. Results Community care at the 12-year follow-up remained more expensive than hospital-based support, although the average cost was lower than at either of the 1-or 5-year community follow-up points. Service users were living in a wide variety of accommodation settings.Management responsibility fell on National Health Service (NHS) trusts, local authorities, voluntary agencies, or to private organizations or individuals. After standardizing for users' skills and abilities, costs in minimum support accommodation were significantly lower than those in residential and nursing homes, costs in staffed group homes significantly higher, and costs in hostels slightly lower. When looking at differences between individuals, no relationship was found between costs and outcomes although, overall, people were better off in the community than they had been when in hospital. Conclusions Reprovision planning for hospital and other institutional modes of care requires major and long-term commitment of resources. Quality of life improvements can be achieved at a cost little different in the long-run from that for hospital care. The link between needs and costs (reflecting the services intended to meet those needs) would be made stronger through the individualization of care.

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“…For example, the Health of the Nation Outcome Scale (HoNOS), originally developed by the Department of Health to help measure and monitor the health and social functioning of people with severe mental health needs, has become the most widely used clinical outcome measure within mental health services (Royal College of Psychiatrists, 2014). The HoNOS-ID was developed by Roy et al, 2002 to be used for people of all levels of ID, who have mental health needs. It was designed to address gaps in the generic HoNOS that neglected to attend to some issues felt to be pertinent within ID, such as communication skills and movement disorders.…”

Section: Introductionmentioning

confidence: 99%

“…The HoNOS-ID is designed to measure change across a global set of outcomes including behaviour (to self and others), communication, mental health, physical health, self-care and activities of daily living (Pearce, 2011). It is described as a reliable measure of change across time, for all levels of ID, and its excellent inter-rater reliability between different professional groups means it can be used reliably within multidisciplinary team (MDT) environments (Roy et al, 2002). In addition, items within the scale have been shown to have high agreement between pairs of raters, and using either informants or clinical notes as the source of information provides adequately reliable scores (Roy et al, 2002).…”

Section: Introductionmentioning

confidence: 99%

“…It is described as a reliable measure of change across time, for all levels of ID, and its excellent inter-rater reliability between different professional groups means it can be used reliably within multidisciplinary team (MDT) environments (Roy et al, 2002). In addition, items within the scale have been shown to have high agreement between pairs of raters, and using either informants or clinical notes as the source of information provides adequately reliable scores (Roy et al, 2002). Douglass and Hurtado (2013) describe using the HoNOS-ID to evaluate clinical outcomes from their assertive outreach team for people with ID and mental health problems or challenging behaviour, finding that clients’ HoNOS-ID scores were significantly reduced after 6 months.…”

Section: Introductionmentioning

confidence: 99%

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Clinical needs and outcomes of adults with intellectual disabilities accessing an inpatient assessment and treatment service and the implication for development of community services

Sandhu

¹

,

Tomlins

²

2015

J Intellect Disabil

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The role and future of assessment and treatment units for people with intellectual disabilities is once again the focus of debate and government policy. Reviewing the admissions to inpatient services can provide useful information about the characteristics, needs and clinical outcomes of clients. Data were collected retrospectively for all 36 referrals accepted to an inpatient assessment and treatment unit for people with intellectual disability, between January 2013 and April 2014. Clinical and demographic characteristics of service users were identified through descriptive analysis. Male service users, mild intellectual disability and diagnosis of autistic spectrum disorder were frequent, and a high proportion of admissions had complex and multiple needs. The Health of the Nation Outcome Scale-Intellectual Disabilities was used as a clinical outcome measure. We conclude with recommendations for service development following closure of our inpatient service.

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Health of the Nation Outcome Scales for People with Learning Disabilities

Cited by 7 publications

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Service Use and Costs of Support 12 Years after Leaving Hospital

Service Use and Costs of Support 12 Years after Leaving Hospital

Service Use and Costs of Support 12 Years after Leaving Hospital

Clinical needs and outcomes of adults with intellectual disabilities accessing an inpatient assessment and treatment service and the implication for development of community services

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