Q Exchange
Equality Benchmarking of Serious Mental Illness Physical Health Checks
- Proposal
- 2023
What is the challenge your project is going to address and how does it connect to the theme of 'How can improvement be used to reduce delays accessing health and care services'?
All Mental Health Trusts are required through their NHS contracts to complete an annual physical health check on patients with a serious mental illness (SMI). Individuals with SMI face shorter life expectancy, by an average of 15-20 years. It is estimated that for people with SMI, two out of three deaths are from physical illnesses and could be prevented through timely and appropriate onward referral to specialist services, e.g. diabetes or cardiovascular. It is currently unknown whether there are specific barriers faced by individuals based on ethnicity, sex ,age or diagnosis to receiving their annual health check. In order to understand whether and where there are barriers to access to physical health checks for people particular groups it is necessary to understand which populations, if any, are underrepresented in receipt of their annual physical health checks and their onward referral to specialist services.
What does your project aim to achieve?
This project aims to identify inequalities in the completion of physical health checks by London Mental Health Trusts by bench marking attendance and completion of checks for people with serious mental illness by ethnicity, sex, age, diagnosis and areas of deprivation, and subsequently reporting recommendations for next steps to improve access to physical health checks for any under-served groups.
Outcomes include:
- Quantifying the number of physical health checks attended and completed by ethnicity, age, sex, areas of deprivation and diagnosis.
- Analysing the data to identify areas for improvement.
- Creating a technical specification and guidance for Mental Health Trusts to replicate the benchmarking exercise.
- Conducting focus groups or interviews with service users from any underrepresented populations to inform recommendations to improve equality of access.
- Publish a learning report and host a webinar to share findings and recommendations.
How will the project be delivered?
The Health Innovation Network will work in partnership with Experts By Experience and the Clinical Service Lead for South London and Maudsley NHS Foundation Trust. With the added value of existing commitment from the London Physical Health Leads Network (a collaboration of physical health leads from nine London Mental Health Trusts) to replicate the model and address the recommendations.
The Clinical Lead will work with HIN data analysts to define the data collection and to create the technical specification for replication by the Physical Health Leads in the remaining eight London Trusts.
Focus groups or interviews with service users from underrepresented populations will be held to understand the inequalities barriers.
HIN will produce a report with findings and recommendations and host a project findings webinar.
All risks will be managed through HIN and London Physical Health Leads governance process.
How is your project going to share learning?
The Health Innovation Network will:
- Produce a comprehensive report on findings and recommendations which can be shared with Q Community members.
- Host a webinar on findings and recommendations which can be shared with Q Community members.
- Seek opportunities to further expand and act on recommendations to improve access to physical health checks for people with serious mental illness from any underrepresented groups.
- Share learning at Q Community events.
- Share learning 1:1 as requested with other Q Community members looking to implement something similar.
- Produce a plain English report informed by Experts By Experiences to accompany the full report which will be shared with London Mental Health Trust Service Users and made available to Q Community members, and both reports will be hosted on The Health Innovation Network website.
How you can contribute
- We would welcome any intelligence on similar projects elsewhere and feedback on this proposal for development. We are aware that the underrepresented populations we anticipate identifying will require a culturally sensitive, targeted and creative approach to inclusion, and as such we are particularly interested in Q Community members sharing their experiences of inclusion of seldom heard from groups.
Plan timeline
| 10 Jul 2023 | Initial project team meeting |
|---|---|
| 7 Aug 2023 | Data collection (SLaM then other Trusts) August to October |
| 1 Nov 2023 | Analyse data for further action |
| 19 Nov 2023 | Hold focus groups with service users to share findings |
| 30 Jan 2024 | Publication of report and webinar |
Comments
Eoin Gogarty 22 Mar 2023
This is a great project as I'd think that people who aren't getting their annual checks are probably the people who need them the most.
There's clear potential for collaboration as our project aims to improve overall cardiac care for patients with SMI, and health checks act as a great preventative measure. Do feel free to reach out at any stage, our idea is Improving Cardiac Care for Patients with Severe Mental Illness.
Jillian Owens 24 Mar 2023
Fantastic thank you. Finding out who is missing from physical health checks is only the beginning, its projects like yours which mean the next step - getting a specialist referral once an risk is identified - that makes all the difference to outcomes. I'll definitely check out your bid and hopefully we will both be successful so can connect as the projects develop. Thanks Eoin.
Ambra Caruso 9 Mar 2023
This project idea is fantastic, it can lead to sustained benefits for vulnerable patients, and has the potential to be scalable. Good luck Aileen and Jill!
Jillian Owens 20 Mar 2023
Thanks Ambra! Appreciate the positive feedback and hope to be able to share outcomes/learning in due course.
Fran Butler 8 Mar 2023
This sounds like a really important project and will I am sure have lessons for all mental health services and as Anna says, for primary care if you are able to cover this. Just to note, ethnicity is notoriously poorly collected/populated on trust systems so that might impact your ability to obtain comprehensive and meaningful results for race. Have you looked into this as to whether data quality is a problem for this item and if it is, whether you will be able to address shortfall in completeness in time to ensure the data quality won't affect your ability to report on this aspect?
Aileen Jackson 9 Mar 2023
Hi Fran , really good point , we know that the Maudsley have had a focus on collecting data on ethnicity so we are optimistic that the data will be relatively good, if we find the other London Trusts have variable recording , this is a finding in itself that we will ask them to address
Aileen
Ursula Clarke 7 Mar 2023
These results would be very enlightening on a national level and could change practice on how to achieve what`s best for those with SMI
Jillian Owens 7 Mar 2023
Thanks Ursula, if successful hope to be able to share the learning far and wide to improve practice as you say
Anna Burhouse 2 Mar 2023
Love this idea. Still find it amazing in this day and age that people with SMI are facing such health inequalities. It would be good to see what the data finds and the action plan that comes from this. Would it worth linking primary care in too? Great work done in Yorkshire about identifying physical health checks in System One?
Jillian Owens 7 Mar 2023
Absolutely re primary care
Jillian Owens 7 Mar 2023
Thanks Anna great heads up on work taking place elsewhere and absolutely the disparities are still frightening. If successful hopefully this is a step toward improving care and outcomes
Ayobola Chike-Michael 2 Mar 2023
This is a great piece of work that can potentially help reduce health inequalities in people living with SMI. I am excited about the deliverables. Enabling the collection of necessary data London wide will help build a visual map that highlights underrepresentation and low uptake of annual physical health check and further explore why. These are necessary for identifying and taking the necessary steps to reduce health inequalities
Jillian Owens 7 Mar 2023
Thanks Ayo, thats exactly it. Appreciate the supportive comments and really hope to be able to take this forward
Catherine Dale 2 Mar 2023
This sounds great, I just wondered if you were including experts by experience in your project team - I know you often do that in your work. It would be great to have the user perspective to start the understanding about why people do and do not attend and complete these checks.
Jillian Owens 7 Mar 2023
Thanks Catherine and quite right that lived experience would be crucial, especially once the data tells us 'who' and 'where' and we need to find out the all important 'why' and what we can do to improve
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