1. Physical Health Strategy Birmingham and Solihull Mental health trust.

2. A personal experience Staff reports and personal experiences with service users Alarm at the standard of physical health care, knowledge and processes. A disconnect of the mind body physiological interplay in mental health.

3. National drivers Choosing health Disability rights commission report 2005 in mental health Incidence for early mortality 9-12 years less than people without SMI

4. National drivers cont’ Incidence of physical health co morbidities Choosing health: Supporting the physical health needs of people with SMI NSF’s Common core principles to support self care. Darzi review

5. Why Physical health in mental health? Hypercortisoleamia Physical health direct impact on mental health Mental health causative relationship with physical health( Blumenthal, Rozanski et al- 2005 Journal of the college of Cardiology )

6. Pathophysiological mechanisms

7. Evolvement of the physical health strategy in BSMHT Physical health committee Multidisciplinary committee All directorates represented. Service user representation

8. Engagement with service users Surveys asking what they would like Clinical engagement day shared across service users and clinical staff User voice participation

9. Pragmatism Accessing community and local authority activities GP’s do not necessarily give SU’s the physical health service they deserve and need Service users in BSMHT have a poor record of appointment attendance for specialist appointments.

10. Strategy Core generic physical health assessment as routine to all new episodes of care Pathways documented for all anomalies found Establishing key clinical specialist posts to drive training and education

11. Strategy cont’ Free market style driver for physical health activities Locality based advisory groups and activities Clear pathways from mental health services to local authority physical health activities Clear pathways into PCT organised physical health activities and programmes Closed loop documentation re physical health or specialist appointments, to facilitate appointments taking place

12. Strategy links Competence and capability –physical health services and activities policy Mapping of current activities and resources Collection of information and summary into a data base.

14. Physical health areas covered by the strategy Core physical health basic assessment to include BMI Sexual health and menstrual cycles Contraception Blood borne virus screening in vulnerable groups TB awareness and sign posting Drug and alcohol use/abuse and attitudes

15. Implementation Strategy will inform team practice It will drive policy development A clinical specialist to lead training and embed clinical practice in teams Format of the single care record and core documentation Training needs identified- 2 tear training