Promoting the safe management of people with Severe Mental Illness by training practice nurses in primary care

ContactDr Fiona Nolan, Camden and Islington NHS Foundation Trust
Address4th Floor, East Wing, St Pancras Hospital, 4 St. Pancras Way, London, NW1 0PE

a presentation about the project This project, led by Dr Fiona Nolan, Camden and Islington NHS Foundation Trust, developed training for practice nurses and carried out research on the physical health needs of patients with Severe Mental Illness.

Research undertaken by Dr Sheila Hardy, Education Fellow, UCLPartners and Visiting Fellow for Primary Care, University of Northampton, found that contrary to popular belief, patients with serious mental illness will attend health checks, and proper training in this area for practice nurses increases the level of screening and lifestyle advice given.


  • Increase the ability of GP practices to deliver the QOF annual physical health check for people with SMI.
  • Enhance the capacity of primary care to manage the safe discharge of Cluster 11 patients.
  • Support the transfer of activity from secondary to primary care.


The training package developed by Dr Sheila Hardy included a power point presentation, practice nurse manual, trainers’ manual and a best practice guide for physical health checks.

Physical health checks for people with Severe Mental Illness: a primary care guide provides the necessary guidance and tools needed for setting up a nurse-led clinic and carrying out a health check for people with serious mental illness. The  guide is also available at

The first stage involved Sheila Hardy delivering training to 45 Mental Health nurses on the safer management of patients with serious mental illness. Following this 1350 GP practice nurses were emailed to advertise training opportunities. The Mental health nurses who attended the sessions held by Sheila Hardy then went on to train practice nurses in the second stage. These nurses were provided with a trainer’s manual. Using this Cascade model over 600 practice nurses have been trained to better identify and look after the physical health needs of patients with serious mental illness. The practice nurses received a nurse’s manual.

The module itself involves training on the following areas:

  1. Depression and anxiety (including suicide risk and medication).
  2. Severe mental illness (including medication and administering depot medication).
  3. Assessment of physical health care in accordance with the Quality and Outcomes Framework (QOF) standards for people with severe mental illness.
  4. Recovery focussed local supports and care plans.
  5. Liaising with the local mental health teams.


Brief training in mental health delivered by mental health professionals to practice nurses has a positive impact on their self-reported confidence and knowledge.

This form of training is cost effective and builds on the existing expertise of the trainers who are exposed to one session on use of the training materials.

Dr Sheila Hardy has been appointed as Education Fellow at UCLPartners to further develop this model nationally.

Download a presentation about the project or view it in the window below