1. Whole person care

2. Growth of specialist services Coexisting conditions Focus of secondary care, benefits of community care providers How are we doing? National Audit Programme

3. National Audit of Schizophrenia (Google: NAS schizophrenia) Better than most in patient feedback, support for employment, access to crisis support, quality of prescribing Similar for access to psychological therapies Worse than most for physical health

4. Proportion reporting services helped them achieve good mental health

5. Monitoring smoking, weight, BP, glucose, lipids, in the past 12 months

6. Monitoring blood glucose

7. Intervention for physical health Physical health indicator Service users requiring an intervention n (% of those monitored) Service users offered an intervention n (% of those requiring it) Smoking status2,923 (59%)1,724 (59%) BMI>/= 25kg/m 2 2,171 (74%)1,531 (71%) Blood glucose control 1,309 (41%)468 (36%) Lipid levels556 (17%)165 (30%) Blood pressure648 (19%)160 (25%)

8. Impact Physical health of people with mental health problems – premature mortality (19 years for men with psychosis, 18 for people with personality disorder) Mental health of people with physical health problems - reduced quality of life, poorer recovery, increased mortality

9. Whole person care? How to improve things? GPs and secondary care Role of a Trust that provides community services? Role of service users and carers?