Outreach programme increases uptake of physical health in people with mental illness

A series of outreach programmes has been successful in increasing the number of  people with severe mental illness (SMI) receiving regular physical health checks, a report has found.

The report, from the Centre for Mental Health, investigated the impact of outreach funding provided by NHS England to increase uptake of annual physical health (PHSMI) checks, Covid-19 vaccines and flu vaccines (where eligible) among people living with SMI.

The average age of death of people with SMI is, on average, 15 to 20 years lower than that of the general population, largely because physical illnesses that could be prevented or treated. To address this inequality, NHS England made a commitment that by 2023/4, 390,000 people living with severe mental illness would receive an annual physical health check, including measuring blood pressure and cholesterol levels. This equates to approximately three-quarters of people on primary care SMI registers receiving an annual physical health check.

In 2023 Equally Well UK, an organisation that supports collaborative action to improve physical health among people with a mental illness, investigated how the outreach funding had been used, with the aim of identifying best practice. It found that the funding had been key in enabling local NHS systems and their partners to reach people on primary care SMI registers who need additional support and adjustments to access PHSMI checks.

Targeted campaign saw 500% increase in uptake

The ways in which the funding had been used to reach people with SMI included:

• Coproducing information about the benefits of PHSMI checks with people with lived experience
• Commissioning local Voluntary, Community and Social Enterprise (VCSE) organisations to provide outreach, particularly using peer support workers to reach people and offer them personalised support in attending appointments
• Investing in point-of-care testing equipment
• Recruiting additional clinical staff to provide outreach and deliver the checks, including in patients’ homes
• Establishing clinics in community venues

The report said that the funding “has been particularly effective when embedded as part of a broader commitment and investment from Integrated Care Systems (ICSs) to address the physical health needs of people living with severe mental illness.”

In one example, Hillingdon in North West London, the numbers receiving the checks rose from 320 in Q3 2020/21 to 1,943 in Q4 2022/23 – an increase of 507%. This was largely down to a targeted campaign.

If a GP surgery in Hillingdon does not receive a reply to an invitation for a PHSMI check, they can refer the patient to the Hillingdon Mind service, which then writes to the patient explaining what the check involves. This is followed by a phone call to explain the process of the PHSMI check and answer any questions. Staff offer to book the appointment on the person’s behalf, liaise with primary care staff and attend the appointment with them. “The service has found that more people favoured afternoon appointments and that longer appointments were helpful in avoiding the need for people to return for a follow-up for different aspects of the PHSMI check,” the report says.

Sean Duggan, chief executive of the NHS Confederation’s mental health network, welcomed the findings of the report. He said that it was “completely unacceptable” that people with SMI die at much younger ages than the general population, adding: “Health leaders will welcome the report’s finding that specific outreach funding has increased uptake of these physical health checks and Covid vaccine uptake for people with severe mental illnesses.

“The voluntary, community and social enterprise sector are often best placed to support underserved groups to access support, and GP practices may not always be the most appropriate environment to have physical health checks. It is therefore vital that mental health providers communicate and work more closely with primary care and voluntary, community and social enterprise organisations to reduce these health inequalities and focus on prevention.”