Physical Health Checks For
Severe Mental Health Problems
The Physical Health Checks For Severe Mental Health Problems (SMHP) Programme supports the delivery of the core clinical programmes within the Long Term Plan and the Mental Health Implementation Plan 2019/20 - 2023/24 (the Implementation Plan) by connecting commissioners, providers, professionals, patients and the public across pathways of care with the aim of improving health outcomes. This is achieved by sharing best practice and innovation, assessing and benchmarking quality and outcomes and driving improvement where required, through targeted support.
What We Are Trying To Achieve
Improving access to physical health checks for people with severe mental health problems (SMHP) is part of the NHS Long Term Plan (LTP), with the aim of 390,000 people with SMHP receiving physical health checks by 2023/24.
The Yorkshire and the Humber Clinical Network key deliverables are in supporting Integrated Care Systems to:
- Enhance provision to better address physical health risks and needs for people with SMI complete recommended physical health assessments.
- Follow up delivery of or referral to appropriate NICE-recommended interventions.
- Follow up personalised care planning, engagement and psychosocial support.
- Implement a regional plan of action to support progress towards increasing the number of people with SMHP in Yorkshire and the Humber receiving physical health checks. This will include:
- Working with Integrated Care Systems (ICS) and Clinical Commissioning Groups (CCG) to monitor provision of physical health checks in line with set targets in the LTP.
- Identifying areas of best practice across the region and share this to increase learning and enhance service provision.
- Assist ICS’, CCGs, Providers and Experts by Experience to Network and connect to enhance learning and sharing.
Why It’s Important
The NHS Long Term Plan (2019) commits to creating new and integrated models of primary and community mental health care which supports both adults and older adults with (SMHP).
The Disability Rights Commission (DRC) undertook some research in 2006 and identified that unfortunately, people with SMHP face stark health inequalities and are less likely to have their physical health needs met, both in terms of identification of physical health concerns and delivery of appropriate, timely screening and treatment.
- The DRC found that compared to the general population, individuals with SMHP (such as schizophrenia or bipolar disorder): Face a shorter life expectancy by an average of 15 – 20 years.
- Are three times more likely to smoke.
- Are at double the risk of obesity and diabetes, three times the risk of hypertension and metabolic syndrome, and five times the risk of dyslipidaemia (imbalance of lipids in the bloodstream).
- There is a lack of clarity around responsibilities in healthcare provision in primary and secondary care.
- There are gaps in training among primary care clinicians.
- There is a lack of confidence across the workforce to deliver physical health checks among people with SMHP.
You can read the full report from the DRC at Disability Rights Commission. Equal treatment: Closing the gap. 2006
You can gain a greater understanding of the importance of physical health checks for people with SMHP by watching Mary’s story to learn of her experiences.
What We Have Achieved In The Last 6 Months:
The Yorkshire and the Humber Clinical Network have worked closely with clinical experts and patient/carer groups, to develop and continue to promote an e-Learning package to support the Primary Care Teams. The package aims to
- Explore why people with SMHP experience side effects, gain weight and die prematurely.
- Look at progress on implementation of annual physical health checks for this cohort of patients.
- Share a case study and good practice tools developed to equip you to undertake annual physical health checks with optimum effectiveness and efficiency
This e-Learning package is now live on the e-Learning for HealthCare platform and has been rolled out across Yorkshire and the Humber.
What We Have Achieved In The Last 6 Months:
- The Yorkshire and the Humber e-learning package has been identified as best practice and adopted by national colleagues. The Yorkshire and the Humber Clinical Network will work with NHS England national colleagues to roll out our locally developed e-Learning package across the country.
Helpful Resources and Links
Professionals – please contact us for details of our Future NHS page
- Improving Physical Health Care for SMI in Primary Care
- Improving Physical Health Care for SMI in Primary Care Annexes
- Improving Physical Health Care for SMI in Primary Care Technical Definition Document
- Interoperability: A Step by Step Guide
- Physical Health in SMI SDCS Guidance
- Quality and Outcomes Framework (QOF) Guidance for Stakeholders 2018-19
- Quality and Outcomes Framework (QOF) 2018-19 Summary of Changes
- Webinar Slides on Physical Health in SMI
- FINAL 2019-20 Technical Guidance
Tools and Templates
- Physical Health Checks for People with SMHP – Primary Care e-Learning tool
- Bradford Tool for EMISWeb and where to find it
- Bradford Template (EMIS)
- Physical Health Tool - E-Learning Module
- Lester Tool
- Physical Activity in Clinical Care - FREE Training for Healthcare Professionals
- NHS RightCare Toolkit: Physical Ill-health and CVD Prevention in People with SMI
- Public Health England SMI Profiling Tool