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Outcome measures (DIALOG and HoNOS)

Measuring outcomes provide a way for patients, clinicians and the health and care systems to understand the impact of the care provided. Outcome measures can be used to identify patient needs and understand the effectiveness of any care or treatment. They can also be used to measure health outcomes for a local population through ‘system process’ outcome measures.

In London, we are supporting the implementation of DIALOG as the London patient reported outcome measure (PROM) which is an assessment of health status and health-related quality of life that comes directly from the patient.

What is DIALOG?

DIALOG is a set of 11 questions where service users are asked to rate their satisfaction and needs for care across different parts of their life and treatment. It helps to guide a structured conversation between a health professional and service user that is patient centred with a focus on change.

Why does DIALOG exist?

DIALOG is simple to use and it enables proactive, personalised conversations at an individual level, supporting self-management and helping service users move forward with their journey of recovery. It has also been used to help inform the redesign of care planning processes within mental health services.

Capturing this information also gives a powerful indicator of patient satisfaction levels where health and social care services need to focus for improvement.

How to use DIALOG

Service users are asked by health professionals to complete this survey using pen and paper, or on a computer, iPAD or phone.

Who is DIALOG for?

This survey was initially rolled out for people within early intervention services and for those receiving a Care Programme Approach (CPA) package of care. The use of DIALOG can be extended to other mental health services including adolescents, older adults and primary care.

How often should DIALOG be used?

As a minimum, it is recommended that DIALOG is completed at the start of an episode of treatment, at review and at the end of an episode.

What is DIALOG+?

DIALOG is the tool and DIALOG+ is a specific intervention that uses the DIALOG scale and a 4- step approach based on solution-focused therapy.

DIALOG+ helps the person and the clinician to structure a conversation to explore their needs and wishes, support their care plan and help service users to actively problem-solve to support their recovery.

DIALOG resources


New Models of Community Mental Health programme

What is the New Models of Community Mental Health programme?

 The New Models of Community MH Programme is a London-wide programme that supports all of London’s Integrated Care Systems (ICSs) to change the way that mental health services are delivered in the community so that it is more joined-up, uses whole-population approaches and supports care that is more personalised to a person’s mental health needs.

The programme has an overarching aim to support London ICSs to develop ‘robust models of community MH transformation’

Policy and background context

This programme of work has come from the Community MH Framework for Adults and Older Adults that was developed by NHS England that aims to support people with serious mental illness or complex MH conditions in the community. London Integrated Care Systems (ICSs) are committed to transforming the way community MH services are delivered to ensure that people with complex MH needs are supported well in the community.

To find out more read the NHS Long Term Plan

Overview of governance structures

The London MH Transformation Board agreed to establish this programme in July 2020. This Board has oversight and accountability for the delivery of this work.

As part of this programme, we have established a Community of Practice (CoP) to bring together London’s mental health leaders across different sectors and organisations including mental health providers, commissioners, ICS transformation leads, voluntary care sector and people with lived experience.

We will use this network to share learning on approaches, challenges, different expertise and experiences across all London ICSs.

Programme workstreams

There are a number of workstreams based on key themes. Click on the tabs below to find out more information about our work.