Two-thirds of people with schizophrenia receive ‘inadequate’ physical care

First national audit of schizophrenia care also reveals concerns over psychiatrists’ prescribing and need for ‘collaborative’ work between medics and social workers.

Over two-thirds of people with schizophrenia are receiving inadequate support for their physical health despite being at increased risk of premature death from heart problems, research has revealed.

The first ever national audit of schizophrenia care in England and Wales revealed that just 29% of people with schizophrenia received a full physical health check for risk factors such as cardio metabolic disease. Less than half (43%) received a weight check.

Paul Jenkins, chief executive of Rethink mental illness, said the shortfall in care needed to be addressed “urgently”.

“It doesn’t take much time or money for health professionals to carry out a proper physical health check, and it really is a disgrace that so many people with schizophrenia are not getting the basic physical health support that the NICE guidelines recommend,” Jenkins said.

The audit, which was led by the Royal College of Psychiatrists, compared NHS data on the care offered to over 5,000 people with schizophrenia against NICE guidance. Researchers also surveyed service users and carers on their views of the treatment offered.

Concerns over psychiatrists’ prescribing were also revealed, with 16% of people being prescribed more than one antipsychotic drug at a time despite there being “no clear evidence of benefit” expect from in a minority of cases. In some trusts 30% of patients were being prescribed multiple antipsychotics.

A third of people whose response to medication had been “disappointing” had not been offered a psychological therapy, the audit found.

A disparity in the views of service users and professionals on shared care was also exposed. While 62% of clinicians thought they had involved service users in medication choices, only 41% of service users agreed – with around 22% saying that their views were not taken into account.

The study also warned that audits of schizophrenia care in mental health teams are too often “uni-professional” because not all professional groups are supported to make the necessary time available. It said trusts need to involve medical, nursing, pharmacy and social work professionals in “collaborative audit”.

Professor Mike Crawford, lead of the National Audit of Schizophrenia Project Team, said: “Financial pressures on mental health services are making it harder to deliver high quality care. The results of this audit show that some services are coping better with these pressures than others.”

“There needs to be better coordination of care between GPs and mental health services if standards of care are to be improved,” Crawford added. 

is Community Care’s community editor

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