Physical health care policies in mental health trusts within the North East Midlands (UK)

Publication Date06 Jul 2010
AuthorGraeme Tosh,Andrew Clifton,Clive Adams
SubjectHealth & social care
Mental Health Review Journal Volume 15 Issue 2 June 2010 © Pier Professional Ltd 15
Graeme Tosh
Specialist Trainee (ST4), Psychiatry, Nottingham Health Care NHS Trust, UK
Andrew Clifton
Research Fellow, Institute of Mental Health, University of Nottingham, UK
Clive E Adams
Chair of Mental Health Services Research, Institute of Mental Health, University of Nottingham, UK
Physical health care policies in
mental health trusts within the
North East Midlands (UK)
In recent years there has been an increasing focus on improving the physical health of people with serious
mental illness and many policies and guidelines are now tailored to support professionals working in mental
health services to meet these requirements. We found, however, that the physical health care policies
produced by mental health trusts in England varied enormously. Policies were often cumbersome, vague
and lacked clear guidance on what particular action should be taken, when it should be taken, and by
whom. Physical health care policy documents of three mental health care trusts in the north sector of the
East Midlands Strategic Health Authority (UK) were examined in detail. We found significant disparities
between the policies in terms of size, readability, external references and reading cost. None could be
read swiftly and all incorporated vague language into their directives. It would be beneficial for there to be
more consideration given to forming local policies that are readable, succinct, and unambiguous. There is
potential for considerable economy of effort with collaboration in production of these documents.
Key words
Policy, physical health care, mental health.
People with serious me ntal illness have a
reduced lif e expectancy from chronic diseases
compared wi th the gene ral population (Robson
& Gray, 2007). Physica l health mo nitoring in
people with serious me ntal illness is poor both
in primary care (Burns & Coh en, 1998) a nd in
the seconda ry care set ting (Paton et al, 200 4).
Evidence fo r, or again st, the eff ectiveness of
monitoring is limited (Tosh et al , 2010). Th ere
is much relevant polic y guidance but it is easy
to get c onfused as to which po licy to fol low.
Multiple la yers of gui dance and v ariation
between dea neries, trusts and teams may lead
to lack of confidence between team members
as to wh ich policy to follow a nd money co uld
be wasted on duplication, and undermining of
the ability of the policy to d eliver. For example,
Worcestershire Mental Hea lth Partnershi p
NHS Trust has a document fiv e pages lon g
(Worcestershir e Mental He alth Partnersh ip
NHS Trust, undated) whereas Eas t London NH S
Foundation Trust publishe s a documen t on
the same physical heal th care gui dance which
is 63 pa ges (East L ondon NHS F oundation
Trust, 2008 ). This dis parity prompte d us to
systematically investigate local policy in on e
district (N orth East M idlands, UK) as regards
clarity, co nsensus and usability of physical
health poli cy for ment ally ill pe ople.

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