1. Physical health care challenges in primary care Mark Ashworth, May 12

2. Physical health care of SMI patients - challenges in primary care Mark Ashworth, May 12

3. Measures of mortality Relative risk Mortality rates Years of life lost

4. Health inequalities The most disadvantaged will, on average, die 7 years earlier than people living in the richest areas 1 1. Marmot M, Fair society healthy lives, 2010

5. Physical health mortality measures Years of life lost: Smoking: 7.6 yrs in men; 6.7 yrs in women DM: 1.3 yrs in men; 2.0 yrs in women BMI 40-45: 10 yrs

6. SMI mortality measures Years of life lost: any SMI: 12.9 yrs in men; 11.8 yrs in women 1 1. Chang C-K, et al. PLoS One 2011, 6, e19590

7. SMI mortality gap: causes CVD risk factors: smoking, obesity, poor diet, physical inactivity illicit drug use suicide anti-psychotic medication reduced access to healthcare

8. QOF indicators for physical health in SMI alcohol BMI BP cholesterol:HDL glucose cervical smear on lithium: creatinine, TSH, lithium levels.

10. Collaborating? your physical health targets our physical health targets

11. Conclusion 12 year life expectancy reduction in SMI physical health in SMI firmly on the agenda need for evidence based interventions sharing the physical health care