smokingMental health staff are to begin giving lifestyle MOTs to service users, as well as assessing their psychological wellbeing, in a bid to reduce the numbers of avoidable deaths.

Mental health trusts will receive financial rewards for carrying out the checks, which will include smoking status, diet, weight, blood pressure, glucose and fats or lipids, and ensuring identified illnesses are treated.

The move is said to be the world’s largest ever physical health in serious mental illness improvement initiative and is considered key by the NHS to helping patients avoid early death due to conditions such as cardiovascular disease, lung disease and liver disease.

Of the 300,000 people with serious mental Illness (SMI) conditions in England, such as bipolar, psychosis and schizophrenia, many die of the same conditions as the general population, but up to 15 years earlier.

People with SMI often do not access healthcare in the same way as the general population so introducing these checks and getting treatment started while they are admitted to hospital is deemed crucial.


Mental health service providers will receive a financial incentive for meeting specific targets on undertaking physical health checks and delivering interventions. The incentive is being paid through the national CQUIN (commissioning for quality and innovation) scheme, set from April 1. The professionals carrying out the checks will include mental health nurses, psychiatrists, healthcare assistants and psychologists.

The CQUIN will require them to provide interventions where a patient has poor physical health, and this could include referring the patient to another consultant or providing education and services such as weight management, stop smoking, diabetes or other relevant lifestyle programmes.

Patients taking antipsychotic medications, who often make up the majority of mental health inpatients, are an important part of the drive. They are at the highest risk of gaining weight due to the side effects of such medications and will be specifically targeted.

Closing the gap

Dr Geraldine Strathdee, NHS England’s national clinical director for mental health, said: “We are committed to making sure that mental health is treated the same way as physical health and NHS England is working hard to close the gap between the two with great support from partners and the field.

“The national financial incentive we have introduced this year for trusts is the world’s largest ever initiative in improving physical health in people with severe mental ill health conditions and will be a clinical quality game changer. It’s England’s first significant landmark in this area.

“We are starting by targeting in-patients who we know are most at risk, and where there are major opportunities to increase knowledge about healthy lifestyles and support smoking cessation. They are also in the best position to receive both assessments and treatment for those common conditions that are killing our patients 14 to 20 years early.”

Welcome move

Mark Winstanley, CEO of charity Rethink Mental Illness, welcomed the development. “This is great news for our supporters, who have been fighting for decades to get proper physical health care for themselves and their loved ones,” he said.

“Our recent report, Lethal Discrimination, highlighted how 30,000 people with mental health problems are dying needlessly every year in England, due to preventable physical illness. It’s one of the biggest hidden health scandals of our time, so to see it prioritised in this way is a significant step forward.

“While there are some pockets of good practice in the system, most people with mental illness are being badly let down when it comes to their physical health. 

“This new financial incentive is a positive move forward, but it will not work in isolation. The Government’s recent Living Well for Longer strategy outlined a whole range of actions that local leaders and health professionals need to take if we’re going to tackle this inequality effectively. We need the whole system to work together to make the physical health of people with severe mental illness a top priority.”