Physical Health Checks for people with Severe Mental Illness (PHSMI) Directions Specification

This is a revision of this Requirements Specification to reflect the change in the collection frequency, the upcoming retirement of the Strategic Data Collection Service (SDCS) collection in March 2024 and the legal and organisational changes which came into effect on 1 July 2022 and 1 February 2023.

This document sets out the requirements for the Physical Health Checks for people with Severe Mental Illness (PHSMI) Directions and should be read alongside the Physical Health Checks for people with Severe Mental Illness Directions 2020 issued by NHS England.

On 1 February 2023, the statutory functions of NHS Digital transferred to NHS England under the Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023 (Transfer Regulations). Under these Transfer Regulations, the provisions of all Directions from either the Secretary of State for Health and Social Care or NHS England to NHS Digital are to be treated as if contained in Directions from the Secretary of State for Health and Social Care to NHS England. Read the Transfer Regulations. 

Consequently, the legal basis for this Specification is still the Direction identified above, with its status now treated as if contained in a Direction from the Secretary of State for Health and Social Care to NHS England under section 254 of the Health and Social Care Act 2012 (the 2012 Act).

In 2016, the Five Year Forward View for Mental Health (MHFYFV) set out NHS England’s 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 NHS England 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. As of 31 March 2021, 121,030 people on the General Practice SMI register had received a full and comprehensive physical health check in the preceding 12 months.

This ambition was reiterated in NHS Long Term Plan 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. The NHS Long Term Plan and associated Mental Health Implementation Plan. 

As of 31 March 2023, 313,022 people on the General Practice SMI register had received a full and comprehensive physical health check in the preceding 12 months.

A central, NHS England General Practice Extraction Service (GPES) data collection is required to track progress towards these objectives. The collection is crucial as it enables monitoring of the delivery of the full comprehensive SMI health check, collection of benchmarking information on the uptake of the corresponding, relevant follow-up interventions and access to national cancer screening programmes. This is vital as it ensures monitoring drives the right clinical behaviour. In addition, 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 national, regional, Integrated Care Board (ICB) and sub-ICB delivery is monitored via an NHS England SDCS collection and GPES collection. The SDCS data collection will be retired on 31 March 2024. At this point the “Establishment of information systems for NHS services: serious mental illness data collection Direction 2018” will be revoked. 

The record level data will enable data linkage with wider national datasets.

The data collection links to ICB’s statutory functions, responsibilities and commitments to, alongside other bodies, improve and integrate services providing physical healthcare and reduce health inequalities and premature mortality across people with SMI, in line with the relevant legislation including the Public Sector Equality Duty, the Equality Act 2010 and the 2012 Act.