Physical Health & Severe Mental Illness

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 LTP sets out an objective to ensure that by 2023/24, a total of 390,000 people with SMI will receive a physical health check.

To deliver this in Greater Manchester we have/are:

  • Mobilised innovative models of care to improve access for SMI patients and their physical health checks.  These models involve engagement workers and secondary care staff working into Primary Care proactively supporting people with SMI to receive their annual physical health check and facilitating and signposting onwards to other appropriate services and providing a holistic approach to care.
  • Encouraging innovative models of delivery through PCNs, for example holistic SMI health check events being carried out by some PCNs.  A key strength in GM is we are not being prescriptive about delivery of SMI health checks but instead, supporting primary care/PCNs to find what works best for them based on their own individual geography, practice populations and relationships.
  • Utilising principles of Making Every Contact Count whereby we are encouraging primary and secondary care to think about physical health whenever the individual patient touches the health service, irrespective of whether it is for a mental health of physical health need at that specific point in time.
  • Deployed point of care testing to support physical health checks in non-clinical setting closer to people’s homes
  • Sharing examples of best practices across primary and secondary care to better improve services and for people with SMI.