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Physical healthcare

Around three-quarter of the people we met in rehabilitation and continuing care wards said they had a health check. We were able to record dates of the health check for most. All but three of the dates were within the past year.

We were pleased to see that a large proportion of the individuals who receive care and treatment for a severe and enduring mental illness are receiving physical health checks at least annually. However, a significant number of these occurred in the context of medical treatment provided for identified need, rather than routine scheduled health checks. Given the additional risks and health inequalities experienced by this group of individuals, we think more attention needs to be paid to this aspect of care.

All of the wards we visited received medical input from a hospital doctor, GP or both.  When asked whether there was a policy on physical health checks, around a half of staff answered positively, but, disappointingly, almost half did not have a policy. Where there is a policy on health checks, around a half specified annual checks. Some were more frequent and some did not state the frequency with which they occurred.

In some wards, where staff said there is no policy for routine health checks, it was clear that despite the absence of policy there is still good medical input. In several wards there were also plans to introduce a policy.

"This person was receiving hospital treatment for an eye injury, but there were no regular physical health checks on the ward, there was no GP input and junior doctors provided a responsive service but did not attend the ward regularly."

(MWC visitor to Gartnavel Royal)

"The GP attends every day and responds to nurses requests to see individuals. Nurses run a 'health care clinic' every Monday morning and perform bloods, BP and ECGs, but there are no overall regular GP health checks."

(MWC visitor to Bellsdyke)

The Scottish Government's 'Delivering for Mental Health' (2006) requires, where possible and appropriate, that every person with severe and enduring mental illness has a physical health assessment at least once every fifteen months.

Local hospital policies should be in place to ensure regular physical health checks are done for these individuals, whether or not they have an identified illness requiring medical attention. This is especially important in view of their increased risk of physical health problems and potential side effects of medication.

"I was recently diagnosed with diabetes after a routine health check."

"This man's bloods are checked regularly for Lithium levels. He claims not to have had a full physical examination for 15 years."

(MWC visitor)