COVENTRY AND WARWICKSHIRE APPROACH TO SUPPORTING PEOPLE WITH SEVERE MENTAL ILLNESS SHORTLISTED FOR HSJ AWARD

The health system in Coventry and Warwickshire has been shortlisted for a ‘Performance Recovery Award’ in the 2023 Health Service Journal (HSJ) Awards for their work with people with Severe Mental Illness (SMI).

Coventry and Warwickshire Integrated Care System (ICS) was successful in being shortlisted for the award in recognition of their efforts to reduce the difference in life expectancy for people with SMI compared to the rest of the population, also known as the mortality gap, which currently stands at 15-20 years.

The new approach, which delivers annual physical health checks and wraparound support for people with SMI, has been introduced by Coventry and Warwickshire ICS and aims to reduce the mortality gap for people with SMI due to preventable and treatable physical health conditions.

Annual physical health checks are a vital tool in reducing this mortality gap as they allow health professionals to identify potential health issues early, meaning treatment can be started sooner and conditions prevented from becoming more serious. Those with an SMI are entitled to a free annual physical health check but uptake has traditionally been low across the country, leading to a high proportion of undiagnosed health conditions amongst this group.

The ICS has introduced an approach that involves offering personalised support to individuals with SMI, including making them aware they are eligible for a free annual physical health check. There have also been two new services developed, a ‘virtual hub’ and a mobile unit, to make vital information and support as accessible as possible.

Addressing health inequalities for those with SMI has been made a key priority for the NHS and the NHS Long-Term Plan set out a target of 390,000 individuals in England living with SMI to receive a physical health check by 23/24.

Progress nationally has been slow due to the complex nature of the challenges faced by those with SMI. As well as a 15-20 year mortality gap, individuals living with SMI experience gaps in prevention, diagnosis, treatment and outcomes for physical health risk factors and conditions, all of which were exacerbated by the Covid pandemic.

However, despite the undoubted impact that Covid had on those with SMI, even before the pandemic the uptake of annual health checks was worryingly low, with just 25.9% of those on the SMI register having a recorded health check in the previous year by March of 2020.

Engagement with those with SMI in Coventry and Warwickshire revealed a worryingly low awareness of the entitlement to a free annual health checks, with 74% of those spoken to not aware they were eligible.

This engagement with individuals with SMI and their families has been crucial in shaping the ICS’s approach, and in shifting the focus from numbers or targets to seeing people who access the services are seen as people with real lives and real experiences. In addition, there has been significant input to the approach from clinicians and staff who deliver the service, meaning that everyone involved has had the opportunity to shape what it looks like.

This model of designing services with the input of patients, clinicians and staff is known as coproduction. By understanding what matters most to people, the ICS has tailored the services and the way they’re communicated to those who need them - making them easier to access.

Following the introduction of the approach and the awareness drive by the ICS, the percentage of those who had received a physical health check had increased to 67.8% in March of 2023 - an increase of over 450% in two years and above the target of 66% set out in the NHS Long-Term Plan.

Partnership working across the health and care system in Coventry and Warwickshire was vital to the success of the approach, with primary and secondary care, mental health teams, VCSE organisations, the Integrated Care Board, local authorities and NHSE all being involved in its delivery.

This partnership working has been made easier by the creation of Integrated Care Systems in July 2022. ICSs bring together the organisations that deliver health and care services, such as NHS organisations, local authorities and the VCSE sector, to ensure that health and care services are delivered in a joined-up way across a certain geography. By working closely together, these organisations can use their collective resources, knowledge, and experience to deliver better health outcomes for the populations they serve.

Coventry and Warwickshire ICS are now hoping they can go on and win the award, with the winning entries being announced at a ceremony in London on 16^th November.

A ‘record-breaking’ 1456 entries have been received for this year’s Awards, with 223 projects and individuals reaching the final shortlist, making it the biggest awards programme in the award’s 43-year history.

 

Dr Angela Brady, Chief Medical Officer of Coventry and Warwickshire ICB, said:

“I am delighted that the fantastic work done to improve the health and wellbeing of those with Severe Mental Illnesses in Coventry and Warwickshire has been recognised by being shortlisted for a HSJ Award.

“There has been such a commitment from everyone in the ICS to stay true to what we heard matters most and create this success. Seeing the increase in the number of annual health checks carried out, and being shortlisted for this award, is testament to the hard work and dedication of everyone who has worked on this new way of delivering the service. There have been sleepless nights, and even some tears, but seeing the difference we’ve made makes it all worth it.

“We know that those with a Severe Mental Illness have worse health outcomes compared to the rest of the population and initiatives such as this are crucial if we are to succeed in our aim of tackling health inequalities. Annual physical health checks are vital in identifying potential health conditions early and the increase in uptake is really encouraging and will help those who have a Severe Mental Illness live healthier lives.

“A massive thank you to everyone who has contributed to this new way of working and who has helped us achieve the improvements we’ve seen. This is an excellent example of the difference we can make when health and care organisations work together to improve the health and wellbeing of our local population.

“I hope the passion and dedication of all those who have been involved is rewarded by winning the award when the winners are announced in November.”

 

The impact the new approach has had can be seen by some of the testimony that has been provided by people with SMI, including:

“Thank you for everything you have done. I appreciate all your staff and will always thank the NHS”

“You make me feel motivated in getting my life back on track”

“I feel like you care about me and making me a better person”