1. Re-audit Don’t just screen - intervene Paul Greenwood Project Manager

2. Audit November 2012 audit response = 543 May 2013 re-audit response = 524 Male – 67% Female – 33% Total numbers within screening periods 4 weeks – 14 3 months – 47 12 months – 146 24 months - 295

3. Analysis - issues Survey Monkey used and not paper copy. Confusion over intervention refusal/referral rates. Handful of incomplete audits compared to Nov audit.

4. Analysis Data clearer 63%- 80% received complete screening package at each time period. 20-35% still not recorded screen when eligible. One site shows 100% improvement at 4 weeks/3 months. Lag in data for those not yet due screen. Family history had 7% N/A ? 25% referral for exercise/dietician up 1% 57% smokers (223 no responses) High refusal rates smoking 80%+

5. Case example 31 yr old female. 4 weeks – No recorded screening. 3 months - No recorded screening. 12 months – Full cardio metabolic screen recorded. 24 months- Full cardio metabolic screen recorded No family history. Smoker Referred for Hyperlipidemia Referred for exercise/smoking cessation (refused both)

6. BMI %

7. Referral – exercise/dietician/smoking

8. Smoking status recorded

9. Full screening package Nov Audit

10. Full screening package Re- audit

11. Target 50%(69%) of all service users who are eligible for screening to have received full cardio metabolic screening package within 4 weeks- 3 month periods. 20%(63-80%) of all service users who are eligible for screening to have received full cardio metabolic screening package within 3 -12 and within the 24 month period

12. Screening recorded within 3 months from date of prescribing antipsychotic medication

13. Screening recorded within 12-24 months from date of prescribing anti psychotic medication

14. Further analysis Gender Deprivation/postcode data Ethnicity Refusal rates – Pro-active practitioner low refusal rates. Workforce attitude to physical health. Targeted approach to core group not screened

15. PDSA’s Primary care – improving communications/ SMI and non SMI registered. Public health – Engaged with health trainers/health improvement programme IT – utilised outlook calender as flagging system/screening checklists Workforce- developed champions/skills training Improved equipment

16. Contacts Paul.greenwood@srft.nhs.uk