East London NHS Foundation Trust

Increased metabolic and cardiovascular risk for individuals who suffer from severe mental illness

Research has argued that living with a severe mental illness is associated with an increase in an individual’s cardiovascular risk and a decrease in life expectancy. Service users who suffer from a severe mental illness often live a sedentary lifestyle, experience increased levels of social isolation and are less likely to access services, more specifically primary care services.

In addition to these social factors, individuals who suffer from a severe mental illness are often prescribed medication which can have undesirable side effects. These side effects can include increased appetite, weight gain, decreased energy levels and increased levels of sedation. More specifically atypical antipsychotic medications have been associated with the development of metabolic syndrome and type 2 diabetes. Therefore in addition to lifestyle choices, the treatment service users are prescribed may be further contributing to an increased cardiovascular risk and mortality rate.

East London NHS Foundation Trust (ELFT) has acknowledged these concerning issues and has prioritised physical health as one of its four quality improvement priority areas. At ELFT we have adopted a trust wide approach to reducing the cardiovascular risk of service users who are prescribed psychotropic medication. This strategy focuses on two main streams of work: the assessment and monitoring of service users physical health and health promotion. Assessment and monitoring has primarily involved the introduction of physical health monitoring pods to all community services and teams have focused on finding ways to increase the number of service users having their physical health assessed/monitored.

The Quality Improvement work on health promotion has involved changes being made to the meals served in a low secure forensic unit. This quality improvement project began following concerns raised by service users about the quality of the food being served on the wards and a desire to prepare and cook their own healthier options. Many of the meals each week are now self-catered and following the success of this project, the self-catering work is being spread to the forensic medium secure unit. Watch the video below to find out more information about this project.

ELFT Quality Improvement Self-Catering Project

Furthermore teams across three different services in ELFT are running quality improvement projects focusing on physical activity. They are testing different ways in which they can encourage service users and staff members to be more physically active on a daily basis.

In addition to the work that ELFT is doing for service users who suffer from a severe mental illness, we have a diabetes specialist team who work across both mental health and community health services. This team has been actively involved in improving the care that service users with diabetes receive when admitted to a mental health ward and are currently running a quality improvement project focusing on housebound diabetes patients. This project aims to increase the number of referrals they receive from district nurses and to improve the care pathways for service users who have HbA1c levels greater than 75mmol/mol.

If you would like to learn more about the physical health quality improvement work at East London NHS Foundation Trust please visit our QI Microsite at: QI ELFT NHS or get in contact with the Quality Improvement team at qi@elft.nhs.uk.