Practices told to catch up on health checks in patients with serious mental illness

NHS England has said that GPs should work with mental health services to catch up on physical health checks for patients with severe mental illness, delivering them face-to-face where possible.

Practices should also ensure they bring any vulnerable patients in for face-to-face consultations if they have safeguarding concerns that make remote care inappropriate, NHS England added.

The latest update to the GP standard operating procedures said: ‘Practice staff should work proactively with secondary mental health care services to identify which individuals on the severe mental illness (SMI) register are due a physical health check. 

‘Where face-to-face checks are not possible, practices should complete elements remotely, where practicable.’

NHS England added that ‘reasonable adjustments’ should be made to accommodate the needs of patients with severe mental illness when delivering the health checks.

The document also said GPs should have a ‘low threshold’ for bringing a patient in for a face-to-face consultation if there are safeguarding concerns.

It said: ‘Clinicians should consider when remote, video and face-to-face consultations are appropriate, particularly for vulnerable patients. 

‘All clinicians need to remain vigilant and professionally curious and should retain a low threshold for bringing in a patient for a face-to-face consultation if there are safeguarding concerns.’

Practices should ensure their safeguarding policy is updated to accurately reflect issues around remote consultations and managing digital imagery, NHS England added.

Dr Tim Cooper, a GP partner in Hampshire and clinical lead for mental health at North Hampshire CCG, said it was important for GPs to continue SMI check-ups but that physical monitoring should involve secondary colleagues who historically ‘defer’ this back to practices.

He said: ‘We have to recognise the SMI patients are as important as those we are prioritising for other proactive services such as vaccination.

‘Where I think we should and could work better with our secondary health colleagues is on the physical monitoring of the SMI check  – such as bloods, ECG, BMI, BP etc.

‘This is often a challenge throughout the year where it is often deferred back to practices.’

He added: ‘Locally, our clinical leads have been working proactively with our mental health trust to manage this, but more should be done to integrate these services.

‘It doesn’t make sense for patients to have to attend multiple appointments, which in a world of Covid-19 does increase everyone’s potential risk, particularly if there are elements of the health check that could be done with our providers and referred back to us.’

Last month, primary care networks were urged to hire mental health specialists amid a ‘rising tide of poor mental health as a result of the pandemic’.

NHS England has revealed that mental health referrals have seen a sharp decline of an estimated 30-40% during the pandemic – while GPs have warned of an ‘imminent’ surge in mental health issues in the aftermath of Covid-19.

As previously published in our sister title Pulse.