NHS England RightCare physical health and severe mental illness scenario

26 July, 2023

This resource focuses on 22-year-old fictional patient called Tom with mental health issues whose physical health deteriorates without the right support from an optimal pathway

NHS England have released a new RightCare scenario in July 2023 that is designed to help highlight the variation between optimal and suboptimal pathways for care of people with severe mental illness (SMI) and a physical health issue. The resource focuses around a 22-year-old fictional patient called Tom and the deterioration of his physical health over years of care in the suboptimal scenario, and how that could have been prevented though an optimal pathway.

The document highlights how people with severe mental illness are at a greater risk of poor physical health and how in England they are almost 5 times as likely to die prematurely than those who do not have severe mental illness. Factors contributing to worse health outcomes include high rates of smoking, poor nutrition and limited physical exercise, that contribute to cardiometabolic risks from a younger age; negative effect on physical health of medication such as antipsychotics; and lack of confidence across the workforce to deliver physical health checks to people with severe mental illness.

As well as the pathways the document provides useful questions to support discussions within local systems about how to improve physical healthcare for people with SMIs. Tips and resources to completing a physical health check are also provided.

For more information, please visit the NHS England website.