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Whole person care
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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
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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
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Proportion reporting services helped them achieve good mental health
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Monitoring smoking, weight, BP, glucose, lipids, in the past 12 months
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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
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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%)
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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
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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?