Making the Case for Integrating Physical and Mental Health Care

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New study highlights gap between physical health and life expectancy among specialist mental health patients in the Black Country and West Birmingham

A ground-breaking analysis developed by in-house NHS experts in the West Midlands could help health services across England to co-ordinate their efforts to tackle one of the biggest hidden health inequalities facing our society.

The Strategy Unit, inspired by earlier research published by the Nuffield Trust, has created a report which investigates in detail the interaction between mental and physical health – highlighting the gap between the physical health and life expectancy of those in contact with specialist mental health services and the rest of the population, and looking at levels of variation in health care utilisation.

‘Making the Case for Integrating Physical and Mental Health Care’  has been designed to inform greater partnership working within local health economies to drive better health outcomes for patients and improved levels  of efficiency. The Black Country STP were the pilot area for this work, and having received their STP level report last year have made a number of strides forward towards improving integrated care using the data it provided.

NHS England has since commissioned the Strategy Unit to produce a bespoke report for all 44 STP areas.

The data packs will give STP leads bespoke data and analysis, for their own STP footprint, setting out the scope to improve patient care by better integrating mental and physical health services, in line with the ambition set out in the Five Year Forward View for NHS . It will also model potential financial savings, from reduced pressure on acute care and elsewhere.

Director of the Strategy Unit Peter Spilsbury said: “This report is important. Using newly linked national data and novel analysis, it can unpack for each STP area one of the biggest yet least spoken about health gaps facing our society - the gap between the physical health and life expectancy of those in contact with mental health services and the rest of the population.”

Andy Williams, Chartered FCIPD, MIHM, Accountable Officer, SWB CCG, Lead Officer, Black Country STP said:  “The Black Country STP has been an early adopter of this important study by the Strategy Unit. We saw its potential to inspire a transformation of our response to the physical health needs of mental health service users so we commissioned an earlier version to inform the development of our plan.

Some of the differentials in both health outcomes and health service utilisation are eye opening but we have been able to use these findings (and the summary of the evidence base provided) to begin building a broad coalition of local partners to identify and implement practical changes. I commend it enthusiastically to colleagues as a catalyst for much needed change.”

According to the study, men with mental health disorders in England are estimated to live 18 years less than those without. For women this gap is around 15 years and the figures for both can vary substantially between STP localities.

The research, which uses linked national datasets, also reveals that there is a difference of eight years between the lowest and highest mental health life expectancies across STP areas in England.

Demographic differences alone cannot explain the range, which suggests that factors related to service provision are significant. Common causes of death for specialist mental health service users do not mirror the rest of the population.

GP Dr David Hegarty, Chair of the CCG and Chair of the Black Country STP Clinical Reference Group, said: “The headlines from this remarkable report are overwhelming. The sad fact is that we have a shocking position that cannot be allowed to remain unaddressed. This report is vitally important and a powerful call to action. For us it has defined a new high priority work stream and it seemed fitting that today, we bring together clinical leaders from across the Black Country and West Birmingham to focus on this.” 

Steven Marshall , STP Lead for Mental Health & learning Disabilities said: “This report shines a light on the need to bring together the provision of physical and mental health services. It will also enable us as an STP to deliver this transformation as an integral component of our models for local, place-based care. 

The full Black Country report is available here, along with the output of a stakeholder workshop and a reflection on the different type of patients/service users that STP plans will need to address.