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Delivering effective physical health checks in practice

Dr Sheila Hardy Education Fellow UCL Partners & Honorary Senior Lecturer UCL spoke at today’s Improving the Physical Health for People with Mental Health Conditions conference on:

• ensuring everyone receives a lifestyle MOTs to patients as well as assessing psychological health
• how we have implemented physical health checks and the results we have seen
• monitoring improvement in practice

Abstract: Delivering effective physical health checks in practice
It is important that everyone with a severe mental illness receives screening for physical health problems and lifestyle advice. This is because they are more likely to die early, have a number of modifiable risk factors for cardiovascular disease or have a comorbid physical condition. They are less likely to have their physical health monitored or have a physical examination, be diagnosed promptly for a physical problem, given help to change unhealthy behaviour, be screened for cancer or offered a surgical intervention.

In this presentation, some of the ways to ensure people with severe mental illness get an effective physical health check are described: financial incentives, preparing clinicians and providing appropriate guidance and tools. Some examples of how physical health checks have been implemented and their results are given. The need for research to determine what contributes to the quality of a health check is advocated.

In her presentation Sheila asked;

"why are the nurses really great at measuring for diabetes and not mental health?"

ans said; "People with mental health issues are not automatically told they are at risk of cardiovascular disease but people with diabetes are. T

That's what worries me about data sometimes, is that we can collect all this data, but if we aren't actually doing anything with it, it means nothing" 

Resources
Department of Health. (2010) Enhanced Services. http://webarchive.nationalarchives.gov.uk/+/www.dh.gov.uk/en/Healthcare/Primarycare/Primarycarecontracting/DH_4126088  

Hardy S. (2014) Mental health and wellbeing survey: A snapshot of practice nurses’ views regarding responsibility and training. http://uclpstorneuuat.blob.core.windows.net/cmsassets/Mental%20health%20and%20wellbeing%20survey%2020%20Jan%202014.pdf   

Hardy S and Huber J. (2014) Training practice nurses to care for people with severe mental illness. Primary Healthcare. 24 (3) 18-23.

Hardy S, Hinks P and Gray R. (2013) Screening for cardiovascular risk in patients with severe mental illness in primary care: a comparison with patients with diabetes. Journal of Mental Health. 22 (1) 42-50.

Hardy S, Hinks P and Gray R. (2014) Does training practice nurses to carry out physical health checks for people with severe mental illness increase the level of screening for cardiovascular risk? International Journal of Social Psychiatry. 60 (3) 236-242.

Hardy S, Deane K and Gray R. (2013) The Northampton Physical Health and Wellbeing Project: The views of patients with severe mental illness regarding their physical health check. Mental Health in Family Medicine. 9 (4) 233-240.

Hardy S and Gray R. (2012) Is the use of an invitation letter effective in prompting patients with severe mental illness to attend a primary care physical health check? Primary Health Care Research & Development. 13 (4) 347-352. 

Harvey SB, Newton A and Moye G. (2005) Physical health monitoring in schizophrenia: the use of an invitational letter in a primary care setting. Primary Care & Community Psychiatry. 10 (2) 71-4.

Mitchell A and Hardy S. (2013) Surveillance for metabolic risk factors in patients with severe mental illness vs diabetes: National Comparison of Screening Practices. Psychiatric Services. 64 (10) 1060-1063.

Norman P and Conner M (1993) The role of social cognition models in predicting attendance at health checks. Psychology & Health 8 (6) 447 – 462.

Website: http://physicalsmi.webeden.co.uk/ 

Sheila’s full presentation is available for download at the end of this page. 

Sheila is Education Fellow at UCLPartners, Honorary Senior Lecturer at UCL and Visiting Fellow, University of Northampton. She has twenty years of experience in primary care where her clinical work included caring for patients with physical and mental health problems. Sheila is keen to improve the care of people with mental health issues and has carried out research and developed training in this area. She writes educational articles for nursing journals and has co-authored two books and a book chapter. Sheila sits on a number of expert reference boards including NICE QOF Advisory, CQC GP co-production, NHS England (mental health), ministerial roundtable (mental health and premature mortality), RCN Mental Health steering group and the national mental health CCG leadership programme.

Future conferences of interest:

Masterclass: The Legal use of Control and Restraint
Wednesday 14 January 2015 
Hallam Conference Centre, London

Positive and Proactive Care: Reducing the need for restrictive interventions
Tuesday 3 February 2015 
Colmore Gate, Birmingham

Meeting the National Access and Waiting Time Standards for Mental Health
Monday 9 February 2015 
Hallam Conference Centre, London

Psychological Therapies in the NHS 2015
Wednesday 11 February 2015 — Thursday 12 February 
Millennium Gloucester Hotel & Conference Centre, London

Safeguarding Vulnerable Adults in Mental Health Services Including Implications of the New Care Act 2014
Tuesday 24 February 2015 
Hallam Conference Centre, London

Bipolar Disorder in Adults
Monday 2 March 2015 
Hallam Conference Centre, London

Positive and Proactive Care Meeting the New National Guidance on Reducing Seclusion
Tuesday 10 March 2015 
Hallam Conference Centre, London

Measuring and Monitoring Quality in Mental Health
Monday 23 March 2015 
ICO Conference Centre, London

Deprivation of Liberty Safeguards: Ensuring Compliance in Practice
Wednesday 25 March 2015 
ICO Conference Centre, London

Implementing the national objective to end Prone/Face Down Restraint: Examining Restraint Positions in Practice
Tuesday 21 April 2015 
ICO Conference Centre, London

Improving Mental Health Crisis Care
Thursday 30 April 2015 
ICO Conference Centre, London

Smoking Cessation in Mental Health
Monday 11 May 2015 
Hallam Conference Centre, London

Information Governance in Mental Health: Implementing Caldicott2 & the New Code of Practice on Confidential Information
Monday 11 May 2015 
Hallam Conference Centre, London

Stronger Code: Better Care Implementing the Changes to the Mental Health Act Code of Practice
Tuesday 12 May 2015 
Hallam Conference Centre, London

Masterclass: The Mental Capacity Act and Advance Decisions
Wednesday 13 May 2015 
Cavendish Conference Centre, London

Improving the Quality of Perinatal Mental Health Services
Tuesday 19 May 2015 
Hallam Conference Centre, London


Download: Sheila Hardy

9 December 2014

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