Article from HSJ
Last week, Public Health England published new data revealing a dramatic gap in life expectancy between those with severe mental illness and those without.
According to the data for 2015 to 2017, a person with SMI is 4.5 times more likely to die before the age of 75 compared to those without.
In response, Wendy Burn, chair of charity Equally Well UK, warned: “With emerging data showing that people with a severe mental illness are also more likely to die from covid-19, this cannot wait.
“We must ensure that people with [SMI] get prioritised access to vaccines and other protections. We need to see more people with mental illness getting annual health checks, help to stop smoking when they want it, and opportunities to eat well and be physically active. And we need to ensure people have enough money to live on and safe and secure housing.”
Although the mortality data is appalling, it is not surprising. The disparities in health outcomes between those with mental health illness and the general population are well known.
Yet, a brief look at NHS England data published in November reveals the NHS is still failing on the basics — carrying out physical health checks for those with SMI.
The data showed the percentage of those with SMI receiving a health check in quarter two of 2020-21 was the lowest since 2018-19.
Figures also showed the South West was the poorest performer, with just 16 per cent of those with SMI getting a health check during Q2 of this year.
North East and Yorkshire has been the best performing region since the data was first published in 2018-19. However, even here, only 30 per cent of the SMI population had health checks in Q2 of this year.
If the NHS does not improve this performance, it could risk mortality gaps widening further.
Rather than leave it to individual GP practices and the quality outcomes framework, this should be a priority for integrated care system boards and primary care network leaders.
However, a lack of public health funding in this year’s spending review means actions towards improving conditions for those with mental health needs will be limited.
The same health inequalities that exist for those with mental health illness exist for those with learning difficulties.
A report from PHE last month revealed adults with LD were six times more likely to die from covid-19 in comparison to the general population. As pointed out by academic Chris Hatton last month, PHE’s report found younger people with LD were disproportionately impacted as well.
Those with “severe and profound learning difficulty”, along with those with SMI and other long-term conditions, are sixth on the vaccine priority list, meaning they will be vaccinated after those aged 65 and over. Charity Mencap has been among those calling for those with LD to be moved up the list.
HSJ understands those with LD and SMI will mostly be vaccinated at primary care sites and, as they will mostly be covered by priority cohorts four and six, will likely be vaccinated by the end of January and March respectively.
However, according to NHSE documents seen by HSJ, there remain a number of issues relating to rolling out the vaccine for those with LD, autism and mental health needs.
This includes how to organise the specialist workforce that might be needed at sites to assist those, for example, who cannot attend a mass vaccination centre or do not have the capacity to consent.
The documents also revealed NHS leaders in London felt they should “influence, where possible” the JCVI to include those with LD on priority lists.
It is also not yet clear how vaccine roll out will work for those within private mental health units.
If you have a tip or would like to share feedback direct message on Twitter or email me on rebecca.thomas@wilmingtonhealthcare.com.
Prior to the outbreak of coronavirus, the NHS Long-term Plan made renewed commitments to improve and expand access to care for children and adults needing mental health support. The pandemic has raised questions around access to services – with a drop off in referrals reported. We have also seen some commitments brought forward. The HSJ Mental Health Virtual Forum will provide the opportunity to assess the impact of coronavirus on national and local mental health work and where the NHS is in implementing national commitments. It will also provide a platform to discuss and prepare for upcoming strategic challenges. Register for a free NHS place here.
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