Good news: the small change at the GPs which can make a big difference for people with mental illness

It can be difficult to get excited about acronyms, but last week the British Medical Journal published an article about QOF which got us very excited indeed.

QOF stands for Quality and Outcomes Framework. It’s a way of giving GPs financial incentives to do certain things that will improve the treatment and care they give their patients. A good example is giving people advice about stopping smoking – GPs will get extra money if they can show they have been doing this regularly.

The framework also includes some physical health measures for people affected by mental illness. This is really important as we know that many people living with mental illness, particularly those taking antipsychotic medication, can experience weight gain and other changes which can increase their risk of certain physical health conditions. But there have also historically been some problems with the mental health part of QOF.

Back in 2014/15, three key physical health checks were removed from QOF. These measurements were body mass index (BMI), cholesterol and blood glucose, and their removal meant that there was no additional incentive for GPs to do these checks. Given the increased risk of heart disease among people with mental illness, and the fact that physical health monitoring levels are low anyway, we felt this was a real step backwards. There was also an issue with age criteria for these three checks, which only started once a person was 40, although we know the physical impact of medication can start much earlier than this.

Strengthening these checks in the Quality and Outcomes Framework has therefore been a key campaigning issue for Rethink Mental Illness. Which brings us back to the article I mentioned at the beginning of this blog. It looks like NICE (the National Institute for Health and Care Excellence) is recommending that the three checks that had been removed are reintroduced AND that they are extended to anyone aged 18 years and over. These are exactly the things we explicitly called for earlier this year in a response we wrote in partnership with other members of the Mental Health Policy Group. Hurrah! These changes are not set in stone yet as they still have to be negotiated with GPs but it is really encouraging to see them on the table and we will be keeping the pressure up!

To learn more about why it's so important GPs make the proper physical checks for people with mental health conditions, watch Clare talk about her brother Mark, who had a diagnosis of schizophrenia.

Rethink Mental Illness campaigns for a better life for people with mental illness, whether that’s improved NHS treatment, or the right support to live in the community. Click here to support our work by becoming a member today.

Video: Claire’s story