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It was a chance meeting earlier this year with Professor Paul French, Clinical Psychologist at Greater Manchester West Mental Health Trust that opened my eyes to the fact that thousands of people with long-term mental illnesses are dying prematurely. We’d both been at a national meeting hosted by NHS England for clinical leads. That one conversation made me realise that we had a solution in Lancashire that could potentially save many lives.
In my role at Lancashire Teaching Hospitals I’ve been lucky enough to have the space to explore how diagnostic testing can revolutionise the patient pathway. Back in 2001, we knew there were high numbers of people from the Gujarati community who weren’t getting a timely diagnosis for diabetes or CVD. The problem was that people from this community just weren’t going to their GP or accessing other health services in a way that would enable them to be picked up, either as being at risk or where they’d already developed the disease.
So, with the support of colleagues, we decided that if we couldn’t get people to come to us for testing and diagnosis, we would go out to them – and held the first Health Mela in Preston, in partnership with the local community, taking pop-up testing clinics to local people. As well as continuing with the Health Mela at Preston every year since then, we now regularly support similar events in places such as South Manchester, Bradford, Blackpool, Leyland and Carlisle.
With advances in technology there are now mobile or wearable diagnostic devices that can perform a wide range of tests and I genuinely believe there is no reason why diagnostics cannot be delivered anywhere. Big centralised and state-of-the art labs such as the one where I am based offer expertise and economies of scale – but some groups and communities need something else.
That first conversation with Professor French was the start of an on-going exploration of how to develop the approach we’ve taken with Black, Asian and Minority Ethnic communities and adapt the model for people living with long term mental illness. We have already started to do this for patients with Learning Disabilities and have an event in Chorley Hospital on 24 June.
It’s shocking that someone with mental illness is at risk of dying on average 15-20 years earlier than the rest of the population, due to avoidable physical illness. And there is a considerable impact on health services, as this group is five times more likely to be admitted to hospital as an emergency case, due to physical health problems.
We now have the support of NHS England to extend this testing to people with mental health problems and for people with learning disabilities. The Strategic Clinical Network, local commissioners and the local council are also keen to see this extended. We’re going to start by taking pop-up clinics out to clinics where mental health service users attend appointments to get their drug injections and take it from there. The aim is to take testing out to people, rather than relying on them to attend GP or hospital appointments.
I think this is a positive step towards ensuring that people who may not be accessing testing through their GP or the usual routes are spotted and life-threatening conditions such as diabetes are identified early enough.
Martin Myers, Consultant Clinical Scientist and Laboratory Director of Clinical Biochemistry, Lancashire Teaching Hospitals NHS Foundation Trust