Reducing the inequality gap in physical health outcomes for people with severe mental illness by improving access to physical health checks

People living with severe mental illness (SMI) in England die on average 15 to 20 years earlier compared to the general population. For people with SMI, 2 in 3 deaths are from physical illnesses that are preventable. SMI patients have a higher prevalence of obesity, asthma, diabetes, COPD, CHD, stroke, and HF, which alongside their mental illness, increases the complexity of their care.

Physical Health Checks (PHC) and their subsequent interventions are designed to reduce the risks of developing long term conditions (LTC) — or develop worsening symptoms in existing LTCs — such as cardiovascular disease, respiratory disease and other physical health problems associated with an increased BMI, sedentary lifestyle, and behavioural risk factors. Research has shown that people with SMI who have their annual physical health checks have fewer A&E attendances and unplanned hospital admissions yet. only around half of people who are eligible for an annual physical health check through their Mental Health Trust or their GP actually receive them in full.

The annual physical health checks consist of:

• Height and weight
• Blood glucose
• Blood Pressure
• Blood lipids
• Smoking status
• Alcohol use

The HIN South London is working in partnership with South London Partnership, Oxleas NHS Foundation Trust, South London and Maudsley NHS Foundation Trust, South East London Mind and Mind in Bexley to increase the number of physical health checks for people living with severe mental illness across South East London. The project approach includes using mental health nurse teams to support GP practices to complete physical health checks in their SMI registered populations and updating and validating patient records, and voluntary sector-led interventions to raise awareness and support the increase of physical health checks.

This project – funded by South East London ICS – will also deepen understanding as to what the barriers and enablers are to completing physical health checks for people living with SMI and explore the effectiveness of interventions such as working with the voluntary sector in addition to exploring where digital opportunities exist that address the operational challenges of completing physical health checks in primary care.

The project is due to complete in Spring 2025. Findings and recommendations will be shared on completion of the project.