伦敦各地患有严重精神疾病 (SMI) 的成年人的过早死亡率差异很大，其中陶尔哈姆莱茨（高度贫困且种族多样化的地区）得分最高。 找出改善身体状况的最佳实践和共同设计建议的示例对塔尔哈姆莱茨的 SMI 患者进行健康检查和后续护理。数据通过在线问卷（使用 SMI 身体健康最佳实践清单）、一对一访谈 (n = 7) 和焦点小组 (n = 3) 收集包括全科医疗、二级心理健康服务、社区服务和公共卫生项目的专员和领导、经验丰富的专家以及陶尔哈姆莱茨的社区、志愿和社会企业组织。使用演绎和归纳主题分析对数据进行分析。代表 15 个全科诊所（共 32 个）、二级心理健康服务机构、专员和公共卫生主管的 22 名参与者完成了在线调查问卷。二十一名参与者参加了访谈和焦点小组。最佳实践的例子包括按照一般做法定期清理和验证 SMI 登记册、了解已接受和/或接受身体健康检查的患者数量、拥有通往社区和专科护理服务的明确途径、使用各种沟通方法并拥有为 SMI 患者量身定制戒烟服务的关键绩效指标 (KPI)。建议包括采用基于证据的风险分层框架，并利用经过专门培训的更广泛的初级保健人员来跟进结果、提供干预措施并支持引导路径和采取后续护理。需要制定激励计划来提供额外的身体健康检查内容，例如口腔健康、癌症筛查、Covid-19 疫苗接种和性健康检查。将 KPI 纳入其他社区服务规范中并参考 SMI 人员是有必要的。需要通过经验和员工培训与专家进一步接触。本举措确定了最佳实践示例并共同设计了建议，以改善贫困和多种族 SMI 患者的身体健康检查和后续护理。该举措得到了三位专家的支持具有经验的人以及两个社区组织，他们参与了数据管理和解释、建议的制定和/或传播活动，包括撰写本手稿。© 2024 作者。约翰·威利 (John Wiley) 出版的《健康期望》

There is wide variation in premature mortality rates in adults with severe mental illness (SMI) across London, with Tower Hamlets (a highly deprived and ethnically diverse area) scoring the highest.To identify examples of best practice and co-design recommendations for improving physical health checks and follow-up care amongst people with SMI in Tower Hamlets.Data were collected through online questionnaires (using SMI physical health best practice checklists), one-on-one interviews (n = 7) and focus groups (n = 3) with general practices, secondary mental health services, commissioners and leads of community services and public health programmes, experts by experience and community, voluntary and social enterprise organisations in Tower Hamlets. Data were analysed using deductive and inductive thematic analysis.Twenty-two participants representing 15 general practices (out of 32), secondary mental health services, commissioners and public health leads completed the online questionnaires. Twenty-one participants took part in interviews and focus groups. Examples of best practice included cleaning and validating the SMI register regularly by general practices, knowing the number of patients who had been offered and/or received physical health checks, having clear pathways to community and specialist care services, using various communication methods and having a key performance indicator (KPI) for tailored smoking cessation services for people with SMI. Recommendations included adopting evidence-informed frameworks for risk stratification and utilising the wider primary care workforce with specific training to follow up on results, offer interventions and support navigating pathways and taking up follow-up care. Incentivising schemes were needed to deliver additional physical health check components such as oral health, cancer screening, Covid-19 vaccination and sexual health checks. Including KPIs in other community services' specifications with reference to SMI people was warranted. Further engagement with experts by experience and staff training were needed.The present initiative identified best practice examples and co-designed recommendations for improving physical health checks and follow-up care in deprived and ethnically diverse people with SMI.This initiative was supported by three experts with experience, and two community organisations, who were involved in data curation and interpretation, development of recommendations and/or dissemination activities including writing this manuscript.© 2024 The Author(s). Health Expectations published by John Wiley & Sons Ltd.