A new approach is needed to improve the physical health of patients with mental health problems, otherwise ‘parity of esteem’ between both will never be achieved the Royal College of General Practitioners (RCGP) and the Royal College of Psychiatrists (RCPsych) have said.
In a joint statement, the Colleges set out how they will work together to improve the physical health of patients with mental health problems, including calling for rebalancing of NHS resources to support better care in the community for people with mental ill health.
Evidence points to people with mental ill health being more likely to experience physical health problems, such as diabetes, coronary heart disease and respiratory disease. In addition, people with serious mental health illness die on average 15-20 years earlier than the rest of the population, with more than 33,000 dying prematurely every year.
The RCGP and RCPsych believe patients should benefit from:
• More time to discuss, plan and manage their long-term care in consultation with GPs, psychiatrists and other health professionals in the community
• Services that are better coordinated with one another, and around their lives, with health professionals from different disciplines given the time and resources to develop more effective ways of working together
• Better continuity of care, with patients able to see members of the same team if they wish
• More care delivered closer to home outside hospitals, and expanded outreach services to those who need it.
To help integrate mental and physical health services, the Colleges have made several joint pledges including:
• Raising awareness of the importance of improving the physical health of patients with mental health problems
• Continuing to embed the Lester UK Adaptation: Positive Cardiometabolic Health Resource into clinical practice
• Committing to working together with the College for Mental Health Pharmacy and the Royal Pharmaceutical Society to review shared care of the prescribing of psychotropic medicines and any professional training needs in this area
• Sharing examples of good practice and focusing on particular areas of care such as smoking cessation support, emphasising the importance of regular physical health screening of patients with serious mental illness
• Committing to working with the voluntary sector, service users and carers, where appropriate.
Maureen Baker, chair of the RCGP, said: “The chasm between mental and physical health is shocking.
“It is a travesty that in the 21st century, people with mental health issues are still more likely to die up to 20 years earlier than others of the same age and background, and that they are more susceptible to serious physical illness.
“Early intervention and prevention is the key when dealing with mental health issues and helping patients manage their condition, and GPs play an integral role in looking after patients in their local communities and making sure that they have access to the best care and joined-up services.
“As generalists, we can ensure that they are looked after holistically and that their physical health needs, as well as their mental health, are given attention and monitored.”
Baker also called for a reassessment of the way NHS funding is allocated including giving community services the resources to deliver more proactive, planned care to patients with serious mental illness.
“… Resources for general practice and community mental health services are under severe strain. Over 90% of all NHS patient contacts take place in general practice for just 8.39% of the total UK NHS budget – an increase in funding to 11% is the only way that we will be able to preserve, protect and strengthen the NHS and deliver the best care possible for all patients.”
Professor Sue Bailey (pictured) – in her final week as president of the RCPsych – added that the signing of the joint pledge is timely as NHS England has introduced a new CQUIN [Commissioning for Quality and Innovation] for improving the physical healthcare of mentally ill patients in mental health settings.
“Our focus is physical health care of all people with mental health problems in our communities, and some of our work will be undertaken with other professionals, such as pharmacists and pathologists, as well as with people with lived experience. It is time to rebalance funding towards the holistic care of all patients, and we will continue to make this case, although I hope one day we will no longer need to do so.”