In order to tackle the nationally poorer physical health outcomes for people with severe mental illness we conducted a Trust-wide improvement programme to improve the assessment and interventions offered for patients at risk of cardio-metabolic diseases.
We innovatively deployed, tested and subsequently rolled out point of care cholesterol and glucose testing machines and procedures in Community Hubs (Alere LDX). We have also incorporated standard operating procedures for physical health monitoring and interventions within our secondary care services (including at CPA review, depot and Clozapine clinics), made clinical information improvements to identify patients on caseloads due cardio-metabolic assessment (CMA), and improved access to online pathology results from primary care testing.
For the baseline period of 8 months prior to our improvement programme the % of required CMAs completed rose modestly from 10-28% in CMHTs and to 41% in Early intervention Services (EIS), using traditional managerial performance approaches. Following the quality improvement programme commencing on the 18th July 2017 performance rose to 71% in the CMHTs (CQUIN target 65%) and 72% in EIS (Target 90%) by mid November 2017 with good staff engagement.