People with severe mental illness (SMI) face health inequalities and live on average 15 to 20 years less than the general population. They are less likely to have their physical health needs met, including identification of health concerns and appropriate, timely screening and treatment.
People with SMI are three times more likely to smoke, have double the risk of obesity and diabetes and a higher risk of cardiovascular issues. The shorter life expectancy is due to the lack of support, including health information and prevention interventions, gaps in training and a lack of confidence in the workforce to carry out the physical health checks. The lack of integration and clarity of responsibility between primary and secondary care, and physical and mental health services all contribute to the health inequality.
NHS England’s Five Year Forward View sets out an objective to ensure that by 2020-21, 280,000 (60%) people will have their physical health needs met, by increasing early detection and expanding access to evidence-based physical care assessment and intervention. By 2023-24 an additional 110,000 people with SMI will be accessing health checks. Integrated care boards have been targeted to achieve 60% of the population with SMI on the GP register to be offered NICE-recommended screening and access to physical care interventions. The South West are not yet achieving the 60% target, with rates currently lying below 45%.
The Mental Health Clinical Network looks to support services to achieve the physical health checks for people with SMI target, support integrated care boards to achieve this standard and support improvement plans. The current work programme focuses on:
- Working with commissioners and providers to understand the data issues around physical health checks in SMI
- Reviewing models of care to develop improved access for patients.
- Establishing a South West physical healthcare in SMI forum.
- Sharing examples of best practices across primary and secondary care.
The South West Mental Health Clinical Network has continued to work closely with the regional team, as part of the regional delivery group and supporting the national ambitions on physical health in severe mental illness.