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Improving physical healthcare in mental health settings

Dr Bill Tiplady, CNWL Consultant Clinical Psychologist and Dr Ed Beveridge, Consultant Psychiatrist presented an innovative pilot project to improve physical healthcare in services for people with long-term mental health needs at the final showcase event for the Health Foundation Shine programme last week. The Health Foundation is an independent charity working to improve healthcare. The Shine programme provides funding to look at new approaches to delivering healthcare which are aimed at the key issues facing the UK health service today.

The project, entitled Improving physical healthcare in mental health settings, ran over 15 months and involved developing new systems for assessing the physical health of people with Severe Mental Illness (SMI). People with SMI have a life expectancy which is 13-30 years shorter compared with the general population, attributable to cardiovascular disease associated with disproportionately high rates of obesity and tobacco use.

The project team worked on Danube Ward at St Charles Mental Health Centre, and aimed to improve routine assessment of core physical health risk factors, along with developing new tools for feeding this information back to patients along with tailored lifestyle advice and signposting, and appropriate referrals and follow-up.

The team systematically tested new systems to translate targeted assessment into meaningful treatment.

Dr Tiplady, said:

“Our initial baseline data showed that key physical health was often not recorded consistently: we estimated that only 1 in 20 patients had enough information recorded to enable the calculation of a cardiovascular risk score. We worked with the ward team to improve systems and processes, and by the end of the trial we had improved the frequency of collection of basic physical health measures dramatically!

“We also worked with service users to co-develop a physical health booklet to make sure that physical health information was fed back to people using services in a meaningful way. This new tool “My Physical Health Explained” has been adapted by a team in Brisbane, Australia, and we have had considerable external interest in other applications.. The key to the success of this pilot is that we developed new processes with those that use the service and trialled small tests of change using Plan-Do-Study-Act cycles to give the best opportunity for success. We hope to extend this pilot to other sites and services to improve CNWL’s performance in addressing the physical health needs of people who use mental health services.”

Dr Tiplady and Dr Beveridge were joined by Sandra Jayacodi, service user project team member, to present the project to an audience of fellow award winners and other guests at the Health Foundation event.

You can download a copy of the research poster online. (opens pdf)