whole person care. growth of specialist services coexisting conditions focus of secondary care,...

Whole person care

Whole person care• Growth of specialist services• Coexisting conditions• Focus of secondary care, benefits of

community care providers• How are we doing?• National Audit Programme

National Audit of Schizophrenia(Google: NAS schizophrenia)

• Better than most in patient feedback, support for employment, access to crisis support, quality of prescribing

• Similar for access to psychological therapies

• Worse than most for physical health

Proportion reporting services helped them achieve good mental health

Monitoring smoking, weight, BP, glucose, lipids, in the past 12 months

Monitoring blood glucose

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

64 12 13 66 67 26 49 35 74 70 11 46 02 42 44 09 04 39 05 51 17 16 28 29 06 72 63 60 33 56 19 41 68TN

S 38 43 30 15 52 73 36 31 34 54 47 50 24 21 08 20 65 61 25 37 53 59 01 27 10 03 69 48 45 07 71

Source: Audit of practice tool

Status/ results recorded No record

Intervention for physical health

Physical health indicator

Service users requiring an intervention n (% of those

monitored)

Service users offered an

intervention n (% of those requiring it)

Smoking status 2,923 (59%) 1,724 (59%)

BMI>/= 25kg/m2 2,171 (74%) 1,531 (71%)

Blood glucose

control

1,309 (41%) 468 (36%)

Lipid levels 556 (17%) 165 (30%)

Blood pressure 648 (19%) 160 (25%)

Impact• Physical health of people with mental health

problems – premature mortality (19 years for men with psychosis, 18 for people with personality disorder)

• Mental health of people with physical health problems - reduced quality of life, poorer recovery, increased mortality

Whole person care?

• How to improve things?

• GPs and secondary care

• Role of a Trust that provides community services?

• Role of service users and carers?