2 Gether NHS Foundation Trust have a strong commitment to improving physical health outcomes for their service users with serious mental illness. One of the greatest risks to the physical health of this group of service users is the high incidence of cardiovascular disease (CVD) caused by the metabolic side effects of anti-psychotic drugs, high smoking rates and other lifestyle factors. To tackle the high premature death rate and impact on quality of life caused by this high incidence of CVD, the trust began a project to implement the Lester Cardiometabolic Health Resource (Lester 2014), initially for their inpatients but ultimately for all service users across the trust.
Lester 2014 is a tool which acts as a prompt for clinical staff conducting physical health checks with service users. The tool reminds staff which tests to request, summarises NICE guidance around interpreting the results and gives recommendations on the interventions which should be offered to each service user. To drive the implementation of this tool across the trust, 2 Gether, supported by NHS Improving Quality, have created the role of Physical Health Facilitator to lead the development and spread of the principles behind the Lester 2014 tool.
The project is now well underway and although the evaluation is not due to report on the results for some months, staff members on various wards have begun to report that the Lester 2014 tool is already having a positive impact on service users. Assessment using the tool as already identified several patients with existing type 2 diabetes who have been able to access the correct treatment to reduce their risk of developing complications, improve their quality of life and make them less likely to die prematurely.