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

Annex A - Data specification

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Indicator - cohort

Indicator 1

Indicator reference

PHSMICX001

Indicator text

The patients with a diagnosis of schizophrenia, bipolar affective disorder and other psychoses up to and including the reporting period excluding patients recorded as ‘in remission’.

Cohort information

This cohort contains patients with a diagnosis of schizophrenia, bipolar affective disorder and other psychoses up to and including the reporting period end date and excluding patients in remission.

Purpose

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 Five Year Forward View 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. 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.

Indicator and data extract - PHSMI001

Extract ID - PHSMI001

Description - Data extract for physical health checks for people with severe mental illness.

Applied to population - PHSMICX001

Below is a description of the proposed groupings of data items to be extracted for each of the patient in the cohort. These will be defined following consultation and be subject to clinical review.

Patient's date of birth

Patient's NHS number

Postcode of patient's CURRENT address only

The national practice code for the practice

Patient's sex

The latest ethnicity of the patient

The most recent date and ethnicity code of the patient.

The date and code of the most recent psychosis, schizophrenia or bipolar affective disease diagnosis up to and including the reporting period end date.

The date, code and value of the most recent BMI recorded within the 12 months up to and including the reporting period end date.

The date, code and value of the most recent height recording with an associated value within the 12 months up to and including the reporting period end date.

The date, code and value of the most recent weight recording with an associated value within the 12 months up to and including the reporting period end date.

The date, code and value of the most recent waist circumference recorded with an associated value within the 12 months up to and including the reporting period end date.

ALL dates and codes for weight management interventions (either referrals to weight management services, or referrals for exercise therapy, or dietary or weight management advice, or exercise advice) that have been recorded within the 12 months up to and including the reporting period end date.

ALL dates and codes indicating the patient’s choice not to accept weight management interventions within the 12 months up to and including the reporting period end date.

The date, code and value of the most recent BMI recorded within the 12 months up to and including the date of the latest weight management intervention.

The date, code and value of the most recent height recording with an associated value within the 12 months up to and including the date of the latest weight management intervention.

The date, code and value of the most recent weight recording with an associated value within the 12 months up to and including the date of the latest weight management intervention.

The date, code and value of the most recent blood pressure recording with an associated systolic and diastolic value within the 12 months up to and including the reporting period end date.

ALL dates, codes and prescription values for antihypertensive medications prescribed within the 12 months up to and including the reporting period end date.

ALL dates and codes indicating the patient’s choice not to receive antihypertensive medication within the 12 months up to and including the reporting period end date.

The date, code and value of the most recent pulse rate recorded with an associated value within the 12 months up to and including the reporting period end date.

The date, code and value of the most recent blood pressure reading with an associated systolic and diastolic value within the 12 months up to and including the latest weight management intervention.

The date, code and value of the most recent blood pressure reading with an associated systolic and diastolic value within the 12 months up to and including the latest antihypertensive medication prescribed.

The date, code and value of the most recent QRISK score recorded with an associated value within the 12 months up to and including the reporting period end date.

Date, code and value of the most recent total cholesterol or HDL cholesterol or LDL cholesterol or total cholesterol: HDL cholesterol or non-HDL-C cholesterol with an associated value recorded within the 12 months up to and including the reporting period end date.

ALL dates, codes and prescription values for statin medications prescribed within the 12 months up to and including the reporting period end date.

ALL dates and codes indicating the patient has chosen not to receive a statin prescription within the 12 months up to and including the reporting period end date.

Date, code and value of the most recent HbA1c reading or blood glucose test or HbA1c (DCCT) level code recorded with an associated value within the 12 months up to and including the reporting period end date.

All dates and codes of offer to diabetes prevention programme recorded within the 12 months up to and including the reporting period end date.

All dates and codes of attendance to diabetes prevention programme recorded within the 12 months up to and including the reporting period end date.

All dates and codes of completion of diabetes prevention programme recorded within the 12 months up to and including the reporting period end date.

The date, code and value of the most recent of the following:

HbA1c reading
Blood glucose test
HbA1c (DCCT) level code

recorded with an associated value within the 12 months up to and including the most recent diabetes prevention programme code.

The date, code and value of the most recent of the following:

HbA1c reading
Blood glucose test
HbA1c (DCCT) level code

recorded with an associated value within the 12 months up to and including the latest weight management intervention.

All dates and codes of offer or referral to diabetes structured education programme within the 12 months up to and including the reporting period end date.

All dates and codes of attendance or completion of diabetes structured education programme within the 12 months up to and including the reporting period end date.

All dates and codes indicating patient is unsuitable for diabetes structured education programme within the 12 months up to and including the reporting period end date.

All dates, codes and prescription values associated with the diabetes prescriptions recorded within the 12 months up to and including the reporting period end date.
Date, code and value of the most recent of the following:

HbA1c reading
Blood glucose test
HbA1c (DCCT) level code

recorded with an associated value within the 12 months up to and including the most recent diabetes structured education programme code.

Date, code and value of the most recent of the following:

HbA1c reading
Blood glucose test
HbA1c (DCCT) level code

recorded with an associated value within the 12 months up to and including the most recent date of diabetes medication prescribed.

Date, code and value of the most recent alcohol consumption or AUDIT or AUDIT C or FAST or alcohol usage recorded within the 12 months up to and including the reporting period end date.

All dates and codes of brief intervention for excessive alcohol consumption recorded within the 12 months up to and including the reporting period end date.

All dates and codes of extended intervention for excessive alcohol consumption recorded within the 12 months up to and including the reporting period end date.

All dates and codes of advice, information and any brief intervention given on alcohol usage recorded within the 12 months up to and including the reporting period end date.

All dates and codes of referral to specialist alcohol treatment service recorded within the 12 months up to and including the reporting period end date.

All dates and codes of referrals regarding alcohol usage recorded within the 12 months up to and including the reporting period end date.

All dates and codes indicating the patient has chosen not to accept an alcohol intervention service within the 12 months up to and including the reporting period end date.

Date, code and value of the most recent of the following:

Alcohol consumption code
AUDIT code
AUDITC code
FAST code
Alcohol usage code

recorded within the 12 months up to and including the most recent alcohol intervention.

The date and code of the most recent smoking habit recorded within the 12 months up to and including the reporting period end date.

All dates and codes of smoking pharmacotherapy recorded within the 12 months up to and including the reporting period end date.

All dates, codes and prescription values of smoking pharmacotherapy drugs recorded within the 12 months up to and including the reporting period end date.

All dates and codes of smoking cessation service or advisor referral and support recorded within the 12 months up to and including the reporting period end date.

All dates and codes of advice, signposting or information on smoking recorded within the 12 months up to and including the reporting period end date.

Date and code of the most recent smoking habit recorded within the 12 months up to and including the most recent date of smoking intervention.

The date and code of the most recent nutrition and diet assessment recorded within the 12 months up to and including the reporting period end date.

The date and code of the most recent exercise level assessment recorded within the 12 months up to and including the reporting period end date.

The date and code of the most recent Illicit substance abuse recorded within the 12 months up to and including the reporting period end date.

All dates and codes indicating interventions to illicit substance abuse within the 12 months up to and including the reporting period end date.

The date and code of the most recent Illicit substance abuse recorded within the 12 months up to and including the most recent code indicating an intervention to illicit substance abuse.

The date and code of the most recent medication review recorded within the 12 months up to and including the reporting period end date.

The date and code indicating the most recent check or reconciliation of medication has been completed within the 12 months up to and including the reporting period end date.

The most recent date and code indicating the patient has chosen not to have their body mass index (BMI) measured up to and including the reporting period end date.

The most recent date and code indicating the patient has chosen not to have their waist circumference measured up to and including the reporting period end date.

The most recent date and code indicating the patient has chosen not to have their blood pressure measured up to and including the reporting period end date.

The most recent date and code indicating the patient is unsuitable or has chosen not to have a cardiovascular disease (CVD) risk assessment up to and including the reporting period end date.

The most recent date and code indicating the patient has chosen not to have a cholesterol test up to and including the reporting period end date.

The most recent date and code indicating the patient has chosen not to have a blood glucose test up to and including the reporting period end date.

The most recent date and code indicating the patient has chosen not to have an alcohol screening or assessment up to and including the reporting period end date.

The most recent date and code indicating patient has chosen not to provide smoking status up to and including the reporting period end date.

The most recent date and code indicating patient has chosen not to complete a General Practice Physical Activity Questionnaire up to and including the reporting period end date.

The most recent date and code indicating patient has chosen not to have an exercise assessment up to and including the reporting period end date.

The most recent date and code indicating patient has chosen not to have an illicit substance abuse assessment up to and including the reporting period end date.

The most recent date and code indicating patient has chosen not to have a medication review up to and including the reporting period end date.

The date and code of the most recent cervical screening in the 60 months up to and including the reporting period end date.

The earliest date and code indicating complete removal of the cervix up to and including the reporting period.

The most recent date and code indicating patient has chosen not to receive a cervical smear up to and including the reporting period end date.

The most recent date and code indicating that the cervical screening care is unsuitable for the patient.

The date and code of the most recent breast cancer screening in the 36 months up to and including the reporting period end date.

The most recent date and code indicating patient has chosen not to have breast cancer screening up to and including the reporting period end date.

The date and code of the most recent bowel cancer screening in the 24 months up to and including the reporting period end date.

The most recent date and code indicating patient has chosen not to have bowel cancer screening up to and including the reporting period end date.

Last edited: 9 December 2020 2:58 pm