Mental Health Matters: NHS failing to carry out basic checks on vulnerable

New data published last week - on the number of people with a learning disability who are receiving physical health checks - shows a woeful picture.

During 2019-20, a maximum of 57 per cent recieved a health check, which shows minimal improvement from 55 per cent in 2017-18 (a figure which Mencap found “shocking”).

Meanwhile, the proportion of people with severe mental illness receiving a check was only around 30 per cent last year, against a 60 per cent target.

Health checks are vital for both groups of people and should be a relatively simple task. But the NHS is still miles away from its long-term ambition to have 75 per cent of both groups receiving a health check each year.

Covid-19 will further scupper any potential progress in 2020-21, while a new health check standard for people with autism is likely to be kicked into the long grass.

Edel Harris, chief executive for charity Mencap, told HSJ the checks “provide an important opportunity to assess the well-being of a patient, detect health problems early and develop a health action plan.”

She added: “By carrying out a learning disability health check, a GP can also flag a person’s individual needs on NHS systems so that appropriate adjustments can be made, for example if they need to go to hospital.  

“Even more worrying, then, is that this data does not yet capture the full impact that the coronavirus has had on the uptake of these checks; we can only imagine that the numbers are even more dismal and we are extremely concerned that lockdown has stopped many people from attending their doctors altogether.”

The charity also called on NHS England to “urgent[ly]” provide GPs with guidance on how to support people with a learning difficulty during the pandemic, which should include how they can conduct annual health checks. 

HSJ understands current guidance for GPs only states health checks should be carried out where possible. 

Health checks are incentivised through the GP enhanced services scheme but are not mandatory. Could it be the poor uptake is primarily down to this mechanism?

GPs are likely to be required to actively seek out those with learning difficulties or SMI, rather than this population engaging of their own accord. This legwork takes resources and time, which are not plentiful in general practice.

An opportunity to improve the uptake of health checks lies in the development of primary care networks, and the new funding channels for health inequalities, which are in development.

Mental Health Matters is written by HSJ’s mental health correspondent Rebecca Thomas. Tell her what you think, or suggest issues she could cover, by emailing her in confidence at rebecca.thomas@wilmingtonhealthcare.com or by sending a direct message on Twitter.