Patients with a severe mental illness (SMI) experience significant physical health inequality compared to the general population, resulting in a 15–20 year reduction in life expectancy. Estimates suggest that 60% of the excess mortality in patients with SMI is avoidable, demonstrating the necessity for healthcare professionals to take action. The aim of our project was to determine whether introducing a ‘Physical Health Clinic’ on an inpatient psychiatric ward led to improved management of physical health for these patients.

Using the criteria and standards as set by the Academy of Medical Royal Colleges to assess the physical health in SMI patients, retrospective analysis of 17 inpatients on a psychiatric working-age male ward was conducted. A ‘Physical Health Pro-Forma’ was designed and integrated within a weekly ‘Physical Health Clinic’, and re-audit data was compared against baseline data to assess the impact of the clinic.

Introduction of a ‘Physical Health Clinic’ demonstrated a marked improvement to all physical health parameters, in particular cardiovascular risk, infectious disease risk and oral health monitoring. Baseline compliance identified that only 12% of inpatients had a subsequent physical health assessment following admission, compared to 100% of patients after clinic introduction. Increased focus on physical health led to several new diagnosis of illness and conditions, including diabetes, spinal fractures and serious infectious diseases.

Initial compliance with physical health standards was poor. Introduction of a weekly clinic significantly improved physical health compliance, demonstrating an improvement in physical health management. Following discussion with Trust Medical Directors, the clinic is being implemented Trust-wide to all inpatient psychiatric wards, thereby enabling greater data collection and research into the physical health of these patients with overall aims to improve health management to psychiatric patients.