People with Schizophrenia have excess mortality due to physical illness. Guidelines recommend monitoring of physical health at least once a year with both primary and secondary Care having a role to play.

The aim was to improve the monitoring of the physical health of patients with severe mental illness on antipsychotic medications.

The objectives were to look at the standards derived from NICE and Maudsley guidelines which included parameters like weight, blood pressure, ECG and blood tests and compare the current clinical practice and improve the annual monitoring of these in both primary and secondary care.

Data was collected retrospectively from case notes and pathology laboratory results from August 2009 to August 2010. Inclusion criteria were patients between 18 and 65 years in the community who were on antipsychotics. Sample size obtained was 82.

Weight, Blood Pressure and ECG were recorded in less than 10% of cases and blood parameters were recorded in less than 20% of cases in secondary care. Around 60% of patients had their blood parameters monitored in primary care. There was no communication of these results between primary and secondary care. In 60% of cases an annual physical health check was not recommended by Psychiatrists to General Practitioners.

Monitoring of Physical health needs to be more robust. We have devised a proforma to record results of the monitoring. We have developed a post for a Nurse Practitioner to facilitate liaison and more effective communication between the two services.