We helped integrated care systems increase numbers of annual physicals health checks for patients with severe mental illness by finding and implementing suitable technology to enable healthcare staff to complete them in a single patient visit.

Background

As part of the national policy outlined in the five-year view to increasing annual physical health checks (APHC) for patients with severe mental illness (SMI), 11 integrated care systems (ICSs) across the Midlands needed to increase the uptake.

APHC helps prevent the development of more serious illnesses by identifying and treating health issues early.

The checks include monitoring body mass index, blood lipids, blood glucose, blood pressure, smoking and alcohol use, and take place across a variety of care settings, including in the community, at a care home or in the patient’s home.

The goal is to increase the number of these checks by 10,800 through the use of digital technology by the end of June 2022, to cover the national targets of 60% of patients on the Midlands SMI register.

Action

NHS Midlands and Lancashire (NHS ML) proposed to scope, define and deliver the technology needed to deliver these checks during a single patient visit.

We are working with each ICS to discuss challenges, share best practices and ensure our solutions fit into their existing pathways for patients with SMI. We are also:

• acting as a central point of contact in the Midlands to raise awareness and provide project management support
• holding the event of a technology-enabled solution with Academic Health Science Network where suppliers can present their devices for ICS representatives to express interest
• operating a single procurement exercise to acquire technology on behalf of all ICSs
• ensuring a streamlined rollout by producing all regulatory assessments, training, and clinician safety assurance materials
• sharing data performance so each ICS can monitor their progress
• integrating the physical and mental health pathways to allow the roll out of technology
• ensuring the continual review of data coming from each ICS and flagging opportunities to complete full health checks.

Impact

This project is successfully contributing to increasing the uptake of annual physical health checks for patients with SMI.

• Across England, the Midlands has seen the largest increase in full health checks in 2021/22 (32.5%).
• The number of complete checks in the Midlands far exceeded the national averages for each quarter (increases of 2,622 [Q2] and 4,915 [Q3]). We estimate the total number of complete checks to be 34,124 by the end of 21/22, surpassing our goal.

A key factor in the success of this project is the portability of the technology, meaning healthcare staff can carry it to any location. This has allowed for more opportunities for patients to be offered a physical health check.

This project provides a model for sharing best practices and engagement across systems by using a joined-up approach to better serve patients. Full data on the impact of this project will be available in July 2022.

“NHS ML’s direction and   leadership brought clinicians and managers together to focus on the task, and their coordination and delivery of ICS level guidance to assist procurement and other governance standards has been invaluable in assisting ICS areas nationally.”

Eloise Barnes | Senior Delivery Manager, Digital Health Team, NHSX

“Together we have made the policy and clinical case for change, supported the team to mobilise, and embedded into regional functions and relationships to support delivery of this policy area. This integrated way of working has supported systems to understand the integrated nature of how this solution needs to operate whilst giving a cohesive NHS England message. Our collective approach has maximised our impact and way of relating back to systems – an approach we would seek to continue.”

Darren Vella, Mental Health Clinical Network Senior QI Manager, NHSEI