A new system is being used across Bradford and Airedale in 80 GP surgeries with 5,000 patients with serious mental illness; across five new clinics; and within hospitals with 200 plus beds in order to help improve the physical health of patients.
The template system, produced in bespoke versions for primary and secondary care IT, makes sure patients get key physical checks they are entitled to such as blood pressure pulse and respiration, height weight and body mass index (BMI) and blood tests.
Kate Dale, mental health nurse and physical health project lead for Bradford District Care Trust (BDCT) which is behind the scheme, said: “We know that patients with SMI are at risk of dying up to 25 years younger than the general population due to physical health problems. “In our experience, the priority for these patients is their mental health and issues such as obesity, possible diabetes, cardiac risk and other lifestyle factors have not routinely been taken into consideration. “The types of medication patients are prescribed can lead to weight gain that may not be monitored, leading to the possibility of undiagnosed diabetes, raised blood pressure and other physical health problems. If this tool was used nationally it could save many thousands of lives.”
The template includes: taking blood pressure, pulse and respiration, height weight and body mass index (BMI), blood tests and electrocardiogram (ECG), lifestyle assessment to include diet, exercise and smoking status, any issues relating to sexual dysfunction and referral to appropriate services if needed. “Our data entry template system has seen a huge change in the perceptions and practicalities around treating this group of patients in primary and secondary care and we would be delighted to share it with the whole country and help save lives, reduce the risk of chronic physical health problems and ultimately lead to this population living healthier,” said Kate.
Dr Geraldine Strathdee, National Clinical Director for mental health for NHS England, said: “Improving the physical health care of people with mental illnesses is a major priority for NHS England and partners. The Bradford tool is a terrific, practical support tool to help every GP and practice nurse, and every psychiatrist and specialist mental health nurse to tackle one of the greatest ‘parity’ inequalities in British healthcare. “The Bradford Care trust has now skilfully adapted the template for use in its secondary mental health care inpatient and community services. In addition, what is very impressive, is the close collaboration between mental health and GP leaders across Bradford.”
In 2009 an audit was carried out in Bradford looking at the base line physical health measures used in primary care and found the measures did not reflect patient’s needs. In 2012 the SystemOne electronic Mental Health Physical Review Template was developed and introduced into primary care. It has now been published and gradually rolled out across all 80 GP surgeries. During the annual physical health check it helps support doctors and practice nurses structure how to detect the possible additional problems these patients may experience.
In 2014 following recommendations in The Antipsychotic Shared Care and Physical Health Guidance, which highlights the specific responsibilities of both primary and secondary care staff, BDCT published the RIO version of the template onto the secondary care IT system. Read the full story here: https://www.england.nhs.uk/2015/04/08/smi-bradford/