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Psychosis and schizophrenia in adults [QS80]

Measuring the use of this guidance

Statement: 1

Adults with a first episode of psychosis start treatment in early intervention in psychosis services within 2 weeks of referral.

Quality standard measure: Proportion of adults referred with a first episode of psychosis who receive treatment from early intervention in psychosis services within 2 weeks of referral.
What was measured: The proportion of patients with a first episode of psychosis who start treatment in early intervention in psychosis services within 2 weeks of referral.
Data collection end: June 2015
33%
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.


Statement: 2

Adults with psychosis or schizophrenia are offered cognitive behavioural therapy for psychosis (CBTp).

Quality standard measure: Proportion of adults with schizophrenia who receive CBTp.
What was measured: Proportion of service users who were offered cognitive behavioural therapy.
Data collection end: November 2013
39%
Area covered: England and Wales
Source: Royal College of Psychiatrists. National Audit of Schizophrenia.

Quality standard measure: Proportion of adults with schizophrenia who receive CBTp.
What was measured: Proportion of people with schizophrenia who were offered individual CBT.
Data collection end: November 2010
6.9%
Number that met the criteria: 13 / 187
Area covered: Local
Source: Haddock G. et al (2014) An investigation of the implementation of NICE-recommended CBT interventions for people with schizophrenia. Journal of Mental Health 2014; 23 (4): 162-165

Quality standard measure: Proportion of adults with schizophrenia who receive CBTp.
What was measured: The proportion of patients with a first episode of psychosis or suspected psychosis who were offered and chose to receive Cognitive Behavioural Therapy for psychosis (CBTp).
Data collection end: June 2015
51%
Number that met the criteria: 510 / 1000
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.

Quality standard measure: Proportion of adults with psychosis who receive CBTp.
What was measured: The proportion of patients with a first episode of psychosis or suspected psychosis who were offered Cognitive Behavioural Therapy for psychosis (CBTp).
Data collection end: June 2015
41%
Number that met the criteria: 1000 / 2465
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.

Quality standard measure: Proportion of adults with psychosis who receive CBTp.
What was measured: Proportion of early intervention in psychosis services that provide cognitive behavioural therapy.
Data collection end: August 2014
50%
Area covered: England
Source: Stain H J, Mawn L, Common S, Pilton M, and Thompson A. (2017). Research and practice for ultra-high risk for psychosis: A national survey of early intervention in psychosis services in England. Early Intervention in Psychiatry.


Statement: 3

Family members of adults with psychosis or schizophrenia are offered family intervention.

Quality standard measure: Proportion of adults with schizophrenia whose family members receive family intervention.
What was measured: Proportion of service users offered family interventions.
Data collection end: November 2013
19%
Area covered: England and Wales
Source: Royal College of Psychiatrists. National Audit of Schizophrenia.

Quality standard measure: Proportion of adults with schizophrenia whose family members receive family intervention.
What was measured: Proportion of people with schizophrenia who were recorded as having high or moderate family contact that were offered family intervention therapy.
Data collection end: November 2010
2.5%
Number that met the criteria: 3 / 118
Area covered: Local
Source: Haddock G. et al (2014) An investigation of the implementation of NICE-recommended CBT interventions for people with schizophrenia. Journal of Mental Health 2014; 23 (4): 162-165

Quality standard measure: Proportion of adults with psychosis whose family members receive family intervention.
What was measured: The percentage of psychosis or schizophrenia patients whose families were offered family intervention.
Data collection end: June 2015
31%
Number that met the criteria: 582 / 1901
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.

Quality standard measure: Proportion of adults with psychosis whose family members receive family intervention.
What was measured: The proportion of patients with psychosis or schizophrenia who chose to receive family intervention.
Data collection end: June 2015
38%
Number that met the criteria: 224 / 582
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.

Quality standard measure: Proportion of adults with psychosis whose family members receive family intervention.
What was measured: Proportion of early intervention in psychosis services that provide family intervention.
Data collection end: August 2014
42%
Area covered: England
Source: Stain H J, Mawn L, Common S, Pilton M, and Thompson A. (2017). Research and practice for ultra-high risk for psychosis: A national survey of early intervention in psychosis services in England. Early Intervention in Psychiatry.


Statement: 4

Adults with schizophrenia that has not responded adequately to treatment with at least 2 antipsychotic drugs are offered clozapine.

Quality standard measure: Proportion of adults with schizophrenia that has not responded adequately to treatment with at least 2 antipsychotic drugs (at least 1 of which should be a non‑clozapine second‑generation antipsychotic) who receive clozapine.
What was measured: The proportion of people having a first episode or suspected psychosis who did not have an adequate response to a full trial of two antipsychotic drugs and were prescribed clozapine.
Data collection end: June 2015
36%
Number that met the criteria: 39 / 109
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.


Statement: 5

Adults with psychosis or schizophrenia who wish to find or return to work are offered supported employment programmes.

Quality standard measure: Proportion of adults with psychosis or schizophrenia who wish to find or return to work who receive supported employment programmes.
What was measured: Proportion of service users who wanted a job that reported getting help to find one.
Data collection end: November 2013
48%
Number that met the criteria: 330 / 685
Area covered: England and Wales
Source: Royal College of Psychiatrists. National Audit of Schizophrenia.

Quality standard measure: Evidence of local arrangements to ensure that adults with psychosis or schizophrenia who wish to find or return to work are offered supported employment programmes.
What was measured: The percentage of psychosis or schizophrenia patients recorded as unemployed and seeking work who were offered one or more supported employment or education programmes.
Data collection end: June 2015
63%
Number that met the criteria: 286 / 456
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.


Statement: 6

Adults with psychosis or schizophrenia have specific comprehensive physical health assessments.

Quality standard measure: Proportion of adults having treatment for first episode of psychosis who have a comprehensive physical health assessment 1 year after starting treatment.
What was measured: Proportion of service users for whom all 6 physical health indicators were monitored in the past 12 months (relevant family history, smoking status BMI, blood glucose control, blood lipids and blood pressure).
Data collection end: November 2013
9%
Area covered: England and Wales
Source: Royal College of Psychiatrists. National Audit of Schizophrenia.

Quality standard measure: Proportion of adults with psychosis and schizophrenia who have an annual comprehensive physical health assessment.
What was measured: Proportion of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of blood pressure in the preceding 12 months
Data collection end: March 2015
81.5%
Area covered: England
Source: Health and Social Care Information Centre. Quality Outcomes Framework.

Quality standard measure: Proportion of adults with psychosis and schizophrenia who have an annual comprehensive physical health assessment.
What was measured: Proportion of patients with schizophrenia, bipolar affective disorder and other psychoses who have a record of alcohol consumption in the preceding 12 months.
Data collection end: March 2015
80.3%
Area covered: England
Source: Health and Social Care Information Centre. Quality Outcomes Framework.

Quality standard measure: Proportion of adults having treatment for first episode of psychosis who receive a comprehensive physical health assessment within 12 weeks.
What was measured: The proportion of people with psychosis or schizophrenia who had a physical health screening within 12 weeks and were offered screening for 7 health measures (smoking, alcohol intake, substance misuse, BMI or weight change in 3 months, blood pressure, glucose and cholesterol).
Data collection end: June 2015
22%
Number that met the criteria: 573 / 2635
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.


Statement: 7

Adults with psychosis or schizophrenia are offered combined healthy eating and physical activity programmes, and help to stop smoking.

Quality standard measure: Proportion of adults with psychosis or schizophrenia who smoke who received help to stop smoking within the past 12 months.
What was measured: Proportion of service users identified as requiring an intervention where there is evidence that this was offered (smoking status).
Data collection end: November 2013
59%
Area covered: England and Wales
Source: Royal College of Psychiatrists. National Audit of Schizophrenia.

Quality standard measure: Proportion of adults with psychosis or schizophrenia who smoke who received help to stop smoking within the past 12 months.
What was measured: Proportion of patients with any or any combination of the following conditions: CHD, PAD, stroke or TIA, hypertension, diabetes, COPD, CKD, asthma, schizophrenia, bipolar affective disorder or other psychoses who are recorded as current smokers who have a record of an offer of support and treatment within the preceding 12 months
Data collection end: March 2015
94.1%
Area covered: England
Source: Health and Social Care Information Centre. Quality Outcomes Framework.

Quality standard measure: Proportion of adults with psychosis or schizophrenia who received combined healthy eating and physical activity programmes within the past 12 months.
What was measured: Proportion of service users identified as requiring an intervention where there is evidence that this was offered (BMI>/= 25kg/m2).
Data collection end: November 2013
71%
Area covered: England and Wales
Source: Royal College of Psychiatrists. National Audit of Schizophrenia.

Quality standard measure: The proportion of people with psychosis or schizophrenia who required smoking cessation and were offered a smoking cessation intervention.
What was measured: The proportion of people with psychosis or schizophrenia who required smoking cessation and were offered a smoking cessation intervention.
Data collection end: June 2015
57%
Number that met the criteria: 670 / 1167
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.

Quality standard measure: The proportion of people with psychosis or schizophrenia who required a weight gain/obesity intervention and were offered it.
What was measured: The proportion of people with psychosis or schizophrenia who required a weight gain/obesity intervention and were offered it.
Data collection end: June 2015
52%
Number that met the criteria: 332 / 638
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.

Quality standard measure: Evidence of local arrangements to ensure that adults with psychosis or schizophrenia are offered combined healthy eating and physical activity programmes.
What was measured: Proportion of NHS mental health trusts that offered programmes on healthy eating and physical activity to people with psychosis or schizophrenia.
Data collection end: October 2015
80%
Area covered: England
Source: Swaby L, et al. (2016). Adherence to NICE guidance on lifestyle advice for people with schizophrenia: a survey. BJPsych Bulletin.

Quality standard measure: Evidence of local arrangements to ensure that adults with psychosis or schizophrenia who smoke are offered help to stop smoking.
What was measured: Proportion of NHS mental health trusts that offered help to stop smoking some or all of the time to people with psychosis or schizophrenia.
Data collection end: October 2015
90%
Area covered: England
Source: Swaby L, et al. (2016). Adherence to NICE guidance on lifestyle advice for people with schizophrenia: a survey. BJPsych Bulletin.


Statement: 8

Carers of adults with psychosis or schizophrenia are offered carer‑focused education and support programmes.

Quality standard measure: Evidence of local arrangements to ensure that carers of adults with psychosis or schizophrenia are offered a carer‑focused education and support programme.
What was measured: The percentage of patients aged 17 years or over with an identified carer whose carer were offered a carer-focused education and support programme.
Data collection end: June 2015
50%
Number that met the criteria: 915 / 1828
Area covered: England
Source: Royal College of Psychiatrists. Early Intervention in Psychosis Audit.



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