New tool to give people with mental illness better care for their physical health

The Lester Tool will help frontline staff make assessments of cardiac and metabolic health, helping to cut mortality for people with mental illnesses

NHS England today launches a vital new tool aimed at helping front line staff make key interventions and treatment for people with mental illnesses.

The Lester Tool is a summary poster to guide health workers to assess the cardiometabolic health of people experiencing psychosis and schizophrenia, enabling staff to deliver safe and effective care to improve the physical health of mentally ill people.

Geraldine Strathdee, NHS England’s national clinical director for mental health said, “NHS England is committed to making sure that mental health is treated the same way as physical health.

“People with severe mental illness, including schizophrenia, are at risk of dying up to 15-20 years before the general population, and the case for closing the gap in mortality and quality of life for people with severe mental illness is clear.

“It is our hope that by publishing this downloadable resource, in partnership with Public Health England , that doctors and nurses will be able to consult it regularly to monitor, and intervene to improve the health of service users, thus helping reduce premature mortality in people experiencing serious mental illness.”

The Lester adaptation 2014 is a useful summary poster of the key interventions and treatments that front line staff working with people with mental illnesses can use to guide them in safe, effective care.

The poster guides health care workers through the assessment of a person’s smoking history, lifestyle, body mass index, blood pressure, glucose regulation and blood lipids, offering appropriate interventions and targets to improve that person’s physical health.

The poster is available in a printable downloadable format and clinicians may find it helpful to have a copy in every clinic and team meeting room. It may also form the basis of team learning and CPD events. It has been produced in collaboration with NHS England’s clinical directors for cardiovascular disease, diabetes, liver and renal disease.

Gregor Henderson, National Lead for Wellbeing and Mental Health, Public Health England said, “Public Health England wants to make a real difference to improve the shocking and unacceptable disparities in life expectancy and poor health experienced by people living with mental health problems. We are examining the wider determinants of mental health and wellbeing, as well as providing new and updated resources and guidance to help improve the public’s mental health.

The Lester Tool has attracted significant interest from other countries. This updated resource adds further improvements to this welcome innovation. I urge healthcare and public health workers to use this updated Lester Tool to help better meet a person’s physical health needs and significantly improve their quality of life and wellbeing.”


  1. Tracey Fox says:

    Can you tell me if there is an equivilent tool to the Lester Tool for use with patients with a learning disability please? with kind regards, Tracey

  2. Elizabeth archer says:

    I am hoping to do a piece of research at introducing the Lester Tool within an NHS Forensic Centre.

    Can you tell me whether I would need a licience to use this tool.

    Thank you

    • NHS England says:

      Dear Ellz,

      You do not need a licence to use the Lester tool and NHS England will be very interested to see the outcome of your research, please email We would request you acknowledge the original authors and those involved in developing the tool.

      Kind regards,

      NHS England

  3. Mary Warmington says:

    Husband has been diagnosed with Alzheimer’s for 5 years now but prior to this suffered most of his life from untreated mental disorder. He always worked very hard and tried to overcome his dyslexia etc. He was born a low birth weight premature twin 82 years ago and as he was not expected to live he was taken from the oxygen to be christened as was the custom in those days. We have been married for over fifty years with three wonderful children,grandchildren and great grandchildren. He has always been emotionally dependent and I understood this from the start and in spite of many problems we have made it through thus far. However the family and friends say that now he must be in permanent care as he was sectioned whilst on respite care. It would be interesting to hear views with regard to different drugs administered for memory loss where there has been previous suspected schizophrenia and to research use of anti-physcotic drugs in older patients. So many elderly couples wish to look after each other for as long as they are able and to find the right cocktail of drugs which would enable them to live relative risk-free lives. I would appreciate hearing details about ongoing research etc.