Severe Mental Illness, Physical Health Checks
The term severe mental illness (SMI) refers to all individuals who have received a diagnosis of psychosis, schizophrenia or bipolar affective disorder. This definition should not be seen to imply that other diagnoses are not ‘serious’ or ‘severe’, or that they do not carry any associated physical health risk, but is used to align this guidance with NICE guidance for physical health checks and the scope of the Quality and Outcome Framework (QOF) SMI register.
People living with SMI face one of the greatest health equality gaps in England. Their life expectancy is 15–20 years shorter than that for the general population, and this disparity is largely due to preventable physical illnesses. Work to address this inequality is part of Core20PLUS5, NHS England’s flagship approach for tackling health inequalities.
People living with SMI have:
- 6 times increased risk of respiratory disease
- 5 times increased risk of liver disease
- 1 times increased risk of cardiovascular disease
- 3 times increased risk of cancer
- 3 times more likely to lose their natural teeth
It is important that the SMI physical health checks (PHCs) start at the point of initial diagnosis.
The 6 elements of the ‘core’ annual SMI PHC are:
- Alcohol consumption status – how much alcohol someone drinks each week
- Blood glucose or HbA1c test (as clinically appropriate) – a measure risk for diabetes
- Blood pressure – the measure of the strength with which your blood pushes on the sides of your arteries as it’s pumped around the body
- Body mass index (BMI) – a measure of your height and weight
- Lipid profile – a measure of cholesterol
- Smoking status – if a person smokes or not
Improving Access to SMI PHC – Outreach Service and promotional materials:
Norfolk and Waveney ICB have commissioned Together for Mental Wellbeing to provide outreach support to people living with Severe Mental Illness (SMI) to access their
- 1) annual physical health check
- 2) COVID vaccination
- 3) and/or flu vaccination.
Together can provide the following:
- Support and encouragement for people to book the appointment
- Booking the appointment (where practice allows)
- Funding and booking taxi transportation to and from the appointment
- Providing people with information on health checks, COVID vaccination and flu vaccination via letter or telephone e.g. NHS published resources or co-produced materials from organisations such as Equally Well UK
- Offering advocacy via video call
If you would like to take up this offer of outreach support please contact together.smiproject@nhs.net in the first instance.
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