1. Dr Marcus Bicknell GP CALVERTON HILL MEDIUM SECURE HOSPITAL

2. PHYSICAL HEALTHCARE CHALLENGES IN SECURE SETTINGS

3. Unexpected death Morbidity and mortality Long term conditions Self-harm Health Promotion Commissioning

4. Unexpected death Epilepsy Morbid obesity Polytherapy Expect the unexpected (embolism, sepsis) Challenge abnormalities Coroners, CQC, MHC

11. MORBIDITY AND MORTALITY Treating physical health problems in psychiatric hospital is as important as the treatment of mental illness. Recovering the 20 lost years

12. LONG TERM CONDITIONS Diabetes Asthma Epilepsy Hypertension and heart disease Computers – QOF - Recall Cancers

13. SELF-HARM Gender Personality disorder Rotherham, Rochdale, Oxford, Broxtowe Severity GP issues Outcomes Costs Women’s health implications (smears – menstruation)

14. HEALTH PROMOTION SMOKEFREE PIC QOF – FLUVAC – PNEUMOVAC – CYTOLOGY – DIET – EXERCISE PHYSICAL HEALTH REVIEWS MONITORING PHYSICAL WELL-BEING – ECGs – AMMONIA – CLOZAPINE LIAISON WITH PSYCHIATRISTS

15. COMMISSIONING Research at Calverton Hill £45,000 Specialised vs CCG vs NHSE Self-harm GP registration 111 / OOH / A and E