Physical Health Strategy

1
Physical Health Strategy

• Birmingham and Solihull Mental health trust.

2
A personal experience

• Staff reports and personal experiences with
  service users
• Alarm at the standard of physical health care,
  knowledge and processes.
• A disconnect of the mind body physiological
  interplay in mental health.

3
National drivers

• Choosing health
• Disability rights commission report 2005 in
  mental health
• Incidence for early mortality 9-12 years less
  than people without SMI

4
National drivers cont

• Incidence of physical health co morbidities
• Choosing health Supporting the physical health
  needs of people with SMI
• NSFs
• Common core principles to support self care.
• Darzi review

5
Why Physical health in mental health?

• Hypercortisoleamia
• Physical health direct impact on mental health
• Mental health causative relationship with
  physical health( Blumenthal, Rozanski et al-2005
  Journal of the college of Cardiology)

6
Pathophysiological mechanisms
7
Evolvement of the physical health strategy in
BSMHT

• Physical health committee
• Multidisciplinary committee
• All directorates represented.
• Service user representation

8
Engagement with service users

• Surveys asking what they would like
• Clinical engagement day shared across service
  users and clinical staff
• User voice participation

9
Pragmatism

• Accessing community and local authority
  activities
• GPs do not necessarily give SUs the physical
  health service they deserve and need
• Service users in BSMHT have a poor record of
  appointment attendance for specialist
  appointments.

10
Strategy

• Core generic physical health assessment as
  routine to all new episodes of care
• Pathways documented for all anomalies found
• Establishing key clinical specialist posts to
  drive training and education

11
Strategy cont

• Free market style driver for physical health
  activities
• Locality based advisory groups and activities
• Clear pathways from mental health services to
  local authority physical health activities
• Clear pathways into PCT organised physical health
  activities and programmes
• Closed loop documentation re physical health or
  specialist appointments, to facilitate
  appointments taking place

12
Strategy links

• Competence and capability physical health
  services and activities policy
• Mapping of current activities and resources
• Collection of information and summary into a data
  base.

13
(No Transcript)
14
Physical health areas covered by the strategy

• Core physical health basic assessment to include
  BMI
• Sexual health and menstrual cycles
• Contraception
• Blood borne virus screening in vulnerable groups
• TB awareness and sign posting
• Drug and alcohol use/abuse and attitudes

15
Implementation

• Strategy will inform team practice
• It will drive policy development
• A clinical specialist to lead training and embed
  clinical practice in teams
• Format of the single care record and core
  documentation
• Training needs identified- 2 tear training