In 2016, the Five Year Forward View for Mental Health (MHFYFV) set out NHS England and NHS Improvement’s (NHSE and NHSI) approach to reducing the stark levels of premature mortality for people living with severe mental illness (SMI) who die 15-20 years earlier than the rest of the population, largely due to preventable or treatable physical health problems.
In the MHFYFV NHSE and NHSI was committed to leading work to ensure that “by 2020-21, 280,000 people living with SMI have their physical health needs met by increasing early detection and expanding access to evidence-based physical care assessment and intervention each year”. This equates to a target of 60% of people on the General Practice SMI register receiving a full and comprehensive physical health check across primary and secondary care. This ambition was reiterated in NHS Long Term Plan (NHS LTP) and associated Mental Health Implementation Plan, with the commitment to increase the number of people receiving physical health checks to an additional 110,000 people per year (in addition to the current 280,000 MHFYFV ambition), bringing the total to 390,000 checks delivered each year.
A central, NHS Digital General Practice Extraction Service (GPES) data collection is required to track progress towards these objectives in 2020-21 and in future years. To ensure monitoring drives the right clinical behaviour, it is crucial that NHSE and NHSI is able to monitor delivery of the full comprehensive health check and to collect benchmarking information on the uptake of the corresponding relevant follow-up interventions and access to national cancer screening programmes. In addition, in order to understand the impact of the health checks and provide rapid and ongoing policy evaluation, it is important to understand physical health outcomes. Patient-level information is required to monitor these outcomes, for example to understand whether the delivery of a particular follow-up intervention affects individual health check indicator values over time.
Currently clinical commissioning group (CCG) delivery is monitored via a quarterly NHS Digital Strategic Data Collection Service (SDCS) collection, collecting, and reporting aggregate CCG-level data on the numbers (for instance counts) of physical health checks and follow-up interventions delivered. The data will continue to be collected from CCGs until there is confidence in the quality and coverage of the data collected via GPES. Once NHS Digital analysis of the data has confirmed that the quality and coverage is of a sufficient standard, the “Establishment of information systems for NHS services: serious mental illness data collection Direction 2018” will be revoked by NHS England.
This record level GPES data extraction will replace the current data collection submitted via SDCS. The record level data will enable data linkage with wider national datasets.