چکیده (انگلیسی):

Background:On average, people with schizophrenia and psychosis die 13–30 years sooner than the general
population (World Psychiatry 10 (1):52–77, 2011). Mental and physical health care is often provided by different
organisations, different practitioners and in different settings which makes collaborative care difficult. Research is
needed to understand and map the impact of new collaborative ways of working at the primary/secondary care
interface (PloS One 7 (5); e36468). The evaluation presented in this paper was designed to explore the potential of
a Community and Physical Health Co-ordinator role (CPHC) (CPHCs were previously Care Co-ordinators within the
Community Mental Health Team, Community in the titleCPHC refers to Community Mental Health) and MultiDisciplinary Team (MDT) meetings across primary and community care, with the aim of improving collaboration of
mental and physical health care for service users with Severe Mental Illness (SMI).
Methods:Data collection took place across five general practices (GPs) and a Community Mental Health Team (CMHT)
in the Northwest of England, as part of a process evaluation. Semi-structured interviews were conducted with a
purposive sample of GP staff (n= 18) and CMHT staff (n=4), a focus group with CMHT staff (n=8) and a survey
completed by 13 CMHT staff, alongside cardiovascular risk data and MDT actions. Framework analysis was used
to manage and interpret data.
Results:The results from the evaluation demonstrate that a CPHC role and MDT meetings are effective mechanisms
for improving the collaboration and co-ordination of physical health care for SMI service users. The findings highlight
the importance of embedding and supporting the CPHC role, with an emphasis on protected time and continuing
professional roles and integrating multiple perspectives through MDT meetings. Considering the importance of
physical health care for SMI service users and the complex environment, these are important findings for practitioners,
researchers and policy makers in the field of primary care and mental health.
Conclusion:There is an increasing focus on integration and collaborative working to ensure the delivery of quality
care across the whole patient pathway, with a growing need for professionals to work together across service and
professional boundaries. The introduction of a two pronged approach to collaboration has shown some important
improvements in the management of physical health care for service users with SMI.