Mental health awareness week: our innovative project improves physical health of patients
Our pilot project focussing on improving the physical health of people with a severe mental illness is reporting such positive results that the model is being rolled out across Manchester.
We’ve been working with Manchester Mental Health and Social Care Trust (MMHSCT) and Manchester Academic Health Science Centre (MAHSC) to improve the physical health care of mental health service users.
The project has tackled the health inequalities that mean having a severe mental health problem increases the risk of physical ill health. People with mental health problems such as schizophrenia or bipolar disorder die on average 16–25 years sooner than the general population. They have higher rates of respiratory, cardiovascular and infectious disease and obesity, abnormal lipid levels and diabetes. Increased smoking is responsible for much of the excess mortality of people with severe mental health problems.
The pilot project worked with the Trust’s North West Community Mental Health Team (NWCMHT) and five GP practices in the North Manchester Clinical Commissioning Group (CCG), focusing on integrating physical and mental health care to create a clear pathway that can support prevention, early diagnosis, treatment and management of physical health problems. This joint project involved the introduction of a Physical Health Link Worker (PHLW) to facilitate the sharing of physical and mental health information at multi-disciplinary team meetings between GPs and the Trust’s NWCMHT.
There have already been positive outcomes for patients. Initial findings show that 101 service users have been discussed during 24 multi-disciplinary team meetings, from which 163 physical health related management actions have been performed. These involved different elements of physical health care, with 26% involving service users having cardiometabolic disease reviews by their GP surgery, 23% relating to service users having physical health assessments, 10% having community lifestyle service referrals and 10% medication changes and reviews. The project has also helped more service users to have their cholesterol levels, smoking status, body mass index (BMI) and blood pressure measured and recorded at their GP practice.
Ten out of eleven (91%) care co-ordinators who took part believe that the approach has had a positive impact on service user care. As one care co-ordinator says, “I have liaised with the PHLW, who in turn has liaised with staff at the GP practice which has allowed me to better co-ordinate care…Specifically, I have been able to monitor my patient’s appointments with the practice nurse and support her to attend, because GP staff highlighted her historical poor attendance. This allowed the practice nurse to carry out several tests and my patient’s diabetic medication has now been changed.” As a result of the project, training on physical health is now mandatory for care co-ordinators and other relevant CMHT staff.
The project also revealed that medication management for mental health service users is an area that requires further improvement. To address this issue, GM CLAHRC is working to produce a medication helper guide that will aid medication communication between health care professionals and help to empower the service user by having access to clear and accurate information regarding their medication.
The new ways of working will be rolled out across the city over the next few months and has the potential to form the basis for the development of a national model when the full evaluation is published in the summer.