Physical Health Checks for People with Severe Mental Illness (PHSMI)

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 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 equated to a target of 60% of people on the General Practice SMI register receiving a full physical health check across primary and secondary care.

This ambition was reiterated in the 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. 

In 2023/24, 361,000 people on the General Practice SMI register had received a full physical health check (equated to 68% of those on the SMI register).

In 2024/25 Operational Planning Guidance, NHS England sought to “reduce inequalities by working towards 75% of people living with severe mental illness receiving a full annual physical health check, with at least 60% receiving one by March 2025.” This target was met, with 66.5% of people on SMI registers receiving an annual physical health check by March 2025.

While there is no official target for SMI physical health checks in the 2025/26 NHS Oversight Framework, there is a system performance metric for ICBs – ‘Is the system’s proportion of annual physical health checks for those with severe mental illness completed in the last year below 60%?’ As a transitional year this is contextual and is not used for segmentation. There is also an indicator on PHSMI in the National Oversight Framework for 2026/27.

A central, NHS England 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 SMI health check, collection of benchmarking information on the delivery of recommended comprehensive health checks, and 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. 

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 Health and Social Care Act 2012 (the 2012 Act).

None

• Be informed
  
• Get access to it
  
• Rectify or change it
  
• Erase or remove it
  
• Restrict or stop processing it
  
• Move, copy or transfer it
  
• Object to it being processed or used
  
• Know if a decision was made by a computer rather than a person
  

Consent is not the basis for processing.

NHS England’s lawful bases for processing (collection and analysis) of personal data are:

• UK GDPR Article 6(1)(c) - legal obligation (Physical Health Checks for people with Severe Mental Illness Directions 2020)
• UK GDPR Article 6(1)(e) - public task, supplemented by:
  • Section 8(c) of the Data Protection Act 2018 - the exercise of a function conferred on a person by an enactment or rule of law.

NHS England’s lawful bases for processing (collection and analysis) special categories of personal data are:

• UK GDPR Article 9(2)(g) - reasons of substantial public interests, supplemented by:
  • Schedule 1, Part 2, Paragraph 6 of the Data Protection Act 2018 - 'statutory etc and government purposes';
• UK GDPR Article 9(2)(h) - management of health or social care systems and services, supplemented by:
  • Schedule 1, Part 1, Paragraph 2(2)(f) of the Data Protection Act 2018 - 'health or social care purposes'; and
• UK GDPR Article 9(2)(j) - archiving purposes in the public interest, scientific or historical research purposes or statistical purposes, supplemented by:
  • Schedule 1, Part 1, Paragraph 4 of the Data Protection Act 2018 - 'Research etc'."