A pilot scheme that almost doubled the amount of physical health checks patients with serious mental illness (SMI) received is now being shared for adoption across the NHS.
Hundreds of patients with SMI were part of the two-year programme to improve physical care in mental health inpatient units across four mental health trusts.
It used the ‘Lester tool’, a poster and electronic clinical prompt system to support clinical teams to screen and intervene for cardiovascular conditions such as diabetes and high blood pressure, as well as smoking, lifestyle and weight.
The four different trusts took different approaches to the problem and final evaluation has shown:
- Inpatients receiving all five recommended cardiovascular disease screens increased from 46% across all sites at baseline to 83% at follow up.
- Interventions delivered to those who needed them as a result of appropriate screening increased from 79% to 94%.
- 89% of service users surveyed reported wanting one or more tests or support when in mental health hospital.
The programme was independently evaluated by the Royal College of Psychiatrists Clinical Care Quality Improvement Unit (CCQI).
Huon Grey, national clinical director for cardio vascular disorders at NHS England, Jonathan Valabhji, NCD for diabetes and Geraldine Strathdee, while NCD for mental health directed the programme.
Strathdee said: “It is a major cause for concern that people with a serious mental illness have a life expectancy of 20 years less because they so often suffer from lack of treatment of these physical illnesses.
“We have been very pleased by the results from this pilot which have shown that physical health care in mental health in-patient settings can be improved, as well as treating their mental health.
“We recommend that trusts and primary care teams, mental health trusts and commissioners use the Lester tool.
“We can no longer see patients with serious mental illness only through the prism of their mental health; we must ensure an integrated physical and mental health, as well as social care, approach to monitoring and treating equally.”
2gether NHS Foundation Trust, Northumberland Tyne and Wear NHS Foundation Trust, Mersey Care NHS Foundation Trust (Mersey Care) and Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) implemented the Lester tool (2014) which was updated for use in the UK by the Royal College of Psychiatrists and the Royal College of GPs and supported by the National CQUIN programme and National Audit of Schizophrenia in collaboration with NHS England and Public Health England.
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