Objectives and concerns

In 2018 community mental health teams from Oxford Health joined a national collaborative run by NHS Improvement to improve the quality of physical healthcare provision for patients with schizophrenia and psychosis.  These patients have increased rates of mortality, due to poor physical health, reduced quality of life and function and decreasing life expectancy. Many patients receive treatment in the form of antipsychotics which increase risk of cardiometabolic symptoms.

The quality improvement projects would use the Lester Tool to support the application of NICE (2009) guidance of annual physical health monitoring. Key areas of focus were smoking, lifestyle and life skills, BMI (weight), blood pressure, glucose regulation and blood lipids.

About this project

Together the teams set the aims for their projects and created a Driver Diagram to identify key areas that needed to be addressed. Mental health team doctors routinely asked GP’s to carry out the physical health checks, but many patients are reluctant to visit their GP or encounter barriers to accessing appointments. Physical health clinics were set up by the mental health teams, ran by nurses who had completed relevant training, however the clinic often had patients that would not attend so appointments were then made on a referral basis from patients’ CCs or doctors to prevent this.  Physical health equipment was identified as a being needed to achieve the project aim.  Culture was identified as a barrier of staff feeling that they were either not trained in physical health or did not see it as part of their role. As with any change the perception of extra burden was recognised as a potential barrier to be handed sensitively.

Next Steps

Please see attached poster for further information