Used longitudinally, the HoNOS scales should be able to measure patient outcomes over time. In 2002, the Department of Health found that 61 trusts were using HoNOS in their services, with 5 having implemented the use of HoNOS across the whole service; most recent reports suggest that 21% of Mental Health Minimum Data Set records include HoNOS reporting (The Health and Social Care Information Centre, 2011). The HoNOS tool has also formed the basis of the Mental Health Cluster Tool, which is to be the assessment mechanism for Payment by Results (PbR) in mental health (see section 5.2).