Improving Physical Health Outcomes for people with Mental Health Conditions
News and updates from today's conference chaired by Dr Jonathan Campion Director for Public Mental Health and Consultant Psychiatrist South London and Maudsley NHS Foundation Trust & Visiting Professor of Population Mental Health University College London the conference took a practical case study based approach to assessing, monitoring and improving the physical health outcomes of people with mental health conditions. There is a focus on early intervention, through learning from organisations that have succeeded in addressing the challenge of improving the physical health of people with mental health conditions.
National Update: Improving Physical Health Outcomes for People with Mental Illness
Amy Clark Programme Manager Adult Mental Health Programme, Clinical Policy & Strategy Team, & Lead for EIP and Improving Physical Health in SMI and Dr Mary Docherty Clinical Advisor on Improving Physical Health Care for People with SMI NHS England
- increasing early detection and expanding access to evidence-based physical care assessment and intervention
- what does good evidence based physical healthcare look like?
- the national picture and moving forward
Amy and Mary comment: "Why are people with SMI are less likely to have health needs met? What are HNS England doing for us?
Case for change – NHS England should ensure that by 2020/21 280,000 people will have their PH needs met by increasing early detection.
The goal is to improve access to and quality of Physical health checks.
Spoke about the CQUIN Scheme what does it require?
Joint Working – Crucial that Shared care protocols and working across primary and secondary, vital that your talking to each other and third sector organisations. This is where we see that it is working."
Amy leads on implementing NHS England’s programme to improve physical healthcare for people with serious mental illness and Early Intervention in Psychosis. Amy recently joined NHS England in October 2017 having worked across King’s Health Partner’s in South London to establish an Integrated Heart Failure Service bringing together hospital, community and primary care services and working to integrate mental and physical health care. Amy began her career in the civil service and worked on a number of policy areas at the Department of Health including mental health, learning disability, and data security. Amy is passionate about improving access to and the quality of NHS care and, as a part time student of Health Economics, has a special interest in promoting the importance of service evaluation to spread good practice.
Dr Mary Docherty's Biography:
Dr Mary Docherty is an Expert Clinical Advisor to NHS England’s Mental Health Clinical Policy & Strategy Team. She has supported the development of a range of strategic and quality improvement approaches including CCG implementation guidance to help deliver improved physical health care for those living with SMI. In a previous role she worked with London’s Mental Health Strategic Clinical Network and Healthy London Partnership’s Mental Health Programme to design a London wide approach to reducing the premature mortality of people with serious mental illness. She established and ran the London Mental Health Trust Physical Health Leads Network (PHLN).
Physical healthcare in mental health settings: CQC Update and interview with Dr David Shiers ‘a father’s perspective’
Natasha Sloman Head of Hospital Inspection CQC with Dr David Shiers
- ‘a father’s perspective’’ an interview with Dr David Shiers
- national update
- expectations from the CQC
- advice for service providers moving forward
Natasha comments: "CQC – Improving Inspection of PH in MH
Spoke about the Key findings and Regulations
Supporting inspections of PH in MH.
Our mantra that inspectors must adopt ‘Screen and Intervene’
Good physical healthcare is not just about assessment and screening.
Good physical healthcare also involves timely follow-up and monitoring by appropriately trained and experienced staff.
Don’t just Screen INTERVENE."
Pre conferences abstract:
Despite many recent advances in our understanding of severe mental illnesses, those affected still lose 15-20 years of life on average compared to the general population. Cardiovascular disease (CVD) is the single biggest cause of dying earlier, far greater than suicide. Moreover the mortality gap is still widening as the reduction in CVD morbidity and mortality seen in the general population over the last three decades continues to elude people with severe mental illnesses, for whom the prevalence of CVD, obesity and diabetes are now of epidemic proportion.
High rates of tobacco use, physical inactivity and poor nutrition point to underlying health inequalities. Furthermore antipsychotic drugs may contribute to aggressive weight gain and metabolic disturbance particularly in the early treatment phase of psychosis. Yet often these adverse effects are not discussed, and remain unmonitored and untreated.
Twenty years of being a carer has convinced me that the early phase of major mental illness may provide a critical window of opportunity in which to prevent future life-restricting and life-shortening physical co-morbidities. Taking action only when individuals have established obesity or a physical illness like diabetes may be too late. Potentially modifiable risk factors provide natural targets for intervention from the onset of psychosis and its treatment. Extending the early intervention paradigm to embrace a far more holistic body & mind approach is overdue.
Rethink blog (2014): https://www.rethink.org/get-involved/what-would-it-take/david-shiers
Declaration of interest: I am an expert advisor to the NICE centre for guidelines. These are my views and not those of NICE
Natasha Sloman is a mental health social worker and approved mental health professional by background. For many years she worked for Camden and Islington Foundation Trust as a social worker predominantly with people who were street homeless and in assertive outreach services. In 2014 Natasha joined CQC as a head of inspection covering mental health, learning disabilities and substance misuse services in the South East. Natasha leads CQC’s parity of esteem work for the hospitals directorate.
Dr David Shiers Biography:
David qualified in medicine in 1974 to become a GP in North Staffordshire. His interest in mental health arose when his daughter developed schizophrenia as a teenager in the mid 90s. Derived from what he felt was lacking in her early experiences of care David co-led with Professor Jo Smith the UK’s National Early Intervention in Psychosis Programme (2004-10).
Now retired, David continues to challenge why people like his daughter should accept poor physical health, participating in relevant NICE guideline and quality standards, and as a clinical adviser to previous National Audits of Schizophrenia and the current National Clinical Audit of Psychosis. He has contributed to several peer-reviewed articles and book chapters on this topic as well as co-leading Healthy Active Lives (HeAL,2013), an international consensus on intervening early to protect people’s bodies as well as minds. David was awarded the OBE in the 2016 for services to vulnerable people, particularly those experiencing mental illness.
Future conferences of interest:
16 April 2018