Part of Physical Health Checks for people with Severe Mental Illness (PHSMI) Directions Specification
Annex A - Data specification
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
Patient's ethnicity
The most recent code indicating the patient’s ethnicity up to and including reporting period end date.
The code and date of the most recent psychosis, schizophrenia or bipolar affective disease diagnosis recorded up to and including reporting period end date.
The value, code and date of the latest BMI recording within the 12 months up to and including the reporting period end date.
The value, code and date of the latest height recording with an associated value within the 12 months up to and including the reporting period end date.
The value, code and date of the latest 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 referral to 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.
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 (either referrals to weight management services, or referrals for exercise therapy, or dietary or weight management advice, or exercise advice).
(The latest weight management intervention must have taken place in 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 date of the latest weight management intervention (either referrals to weight management services, or referrals for exercise therapy, or dietary or weight management advice, or exercise advice). (The latest weight management intervention must have taken place in the 12 months up to and including the reporting period end date).
The date, code and value of the most recent weight recording within the 12 months up to and including the date of the latest weight management intervention (either referrals to weight management services, or referrals for exercise therapy, or dietary or weight management advice, or exercise advice). (The latest weight management intervention must have taken place in the 12 months up to and including the reporting period end date).
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.
The date, code and value of the latest pulse rate recorded with an associated value within the 12 months up to and including the reporting period end date.
All dates, codes and prescription values of antihypertensive medications prescribed in the 12 months up to and including the reporting period end date.
ALL dates and codes indicating the patient’s choice not to receive an antihypertension medication within the 12 months up to and including the reporting period end date.
The code, date and value of the latest blood pressure reading with an associated systolic and diastolic value in the 12 months up to and including the date of the latest weight management intervention.
(The latest weight management intervention must have taken place in 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 antihypertensive medication prescribed.
(The latest antihypertensive medication must have been prescribed in the 12 months up to and including the reporting period end date).
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.
The date, code and value of the latest total cholesterol or HDL cholesterol or LDL cholesterol or total cholesterol: HDL cholesterol or non-HDL-C cholesterol or triglyceride test result with an associated value recorded within the 12 months up to and including the reporting period end date.
All dates, codes and prescription values of statins prescribed in 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.
The date, code and value of the most recent HbA1c reading or blood glucose test or HbA1c Diabetes Control and Complications Trial (DCCT) level 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 HbA1c reading or blood glucose test or HbA1c Diabetes Control and Complications Trial (DCCT) level code recorded with an associated value within the 12 months up to and including the most recent date of offer, attendance or completion of diabetes prevention programme.
(The most recent date of offer, attendance and completion of diabetes prevention programme must have been taken place in the 12 months up to and including the reporting period end date).
The date, code and value of the most recent HbA1c reading or blood glucose test or HbA1c Diabetes Control and Complications Trial (DCCT) level code recorded with an associated value within the 12 months up to and including the latest weight management intervention (either referrals to weight management services, or referrals for exercise therapy, or dietary or weight management advice, or exercise advice).
(The latest weight management intervention must be in the 12 months up to and including the reporting period end date).
All dates and codes of offers or referrals 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.
The date, code and value of the most recent HbA1c reading or blood glucose test or HbA1c Diabetes Control and Complications Trial (DCCT) level code recorded with an associated value within the 12 months up to and including the most recent date of offer, attendance to diabetes structured education programme.
(The most recent date of the arrays of offer, attendance, completion of NHS structured education programme must have taken place in the 12 months up to and including the reporting period end date).
The date, code and value of the most recent HbA1c reading or blood glucose test or HbA1c Diabetes Control and Complications Trial (DCCT) level code recorded with an associated value within the 12 months up to and including the most recent date of diabetes medication prescribed.
(The prescription should be in the 12 months up to and including the reporting period end date).
Date, code and value of the most recent alcohol consumption or AUDIT code or AUDIT C code or FAST code 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 patient has chosen not to accept an alcohol intervention service or alcohol health education within the 12 months up to and including the reporting period end date.
Date, code and value of the most recent alcohol consumption code or AUDIT code or AUDITC code or FAST code or Alcohol usage recorded within the 12 months up to and including the most recent date of alcohol interventions (including brief intervention for excessive alcohol consumption, extended intervention for excessive alcohol consumption, advice, information and any brief intervention given on alcohol usage, referral to specialist alcohol treatment service, referrals regarding alcohol usage) recorded.
(The most recent date alcohol interventions recorded must have taken place in the 12 months up to and including the reporting period end date).
The code and date of the latest smoking status 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 smoking pharmacotherapy prescribed or recorded or smoking cessation service or advisor referral and support or advice, signposting or information on smoking recorded.
(The most recent date of smoking pharmacotherapy prescribed or recorded or smoking cessation service or advisor referral and support or advice, signposting or information on smoking recorded must have taken place in the 12 months up to and including the reporting period end date).
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 most recent intervention to illicit substance abuse must have taken place in the 12 months up to and including the reporting period end date).
The date and code of the most recent medication review in 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 in 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 latest code and date showing the patient has chosen not to have blood pressure recorded 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 latest code and date showing the patient has chosen not to have a blood glucose test up to and including the reporting period end date.
The latest code and date showing the patient has chosen not to have an alcohol screening or assessment up to and including the reporting period end date.
The latest code and date showing the patient has chosen not to provide their smoking status up to and including the reporting period end date.
The latest code and date showing the patient has chosen not to complete their General Practice Physical Activity Questionnaire up to and including the reporting period end date.
The latest code and date showing the patient has chosen not to receive an exercise assessment up to and including the reporting period end date.
The date and most recent code indicating patient has chosen not to have an illicit substance abuse assessment up to and including the reporting period end date.
The latest code and date showing the patient has chosen not to receive 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 code and date of the latest breast cancer screening in the 36 months up to and including the reporting period end date.
The date and most recent code indicating patient has chosen not to have a breast cancer screening up to and including the reporting period end date
The code and date of the latest bowel cancer screening code in the 24 months up to and including the reporting period end date.
The date and most recent code indicating patient has chosen not to have a bowel cancer screening up to and including the reporting period end date.
Last edited: 11 October 2023 12:24 pm