Annual Physical Health Checks for Severe Mental Illness: A Care Staff Guide

Many people with a severe mental illness have physical health problems that go unnoticed for a long time. They may not mention symptoms, may find appointments stressful, or may have had physical complaints put down to their mental health. The NHS offers a free annual physical health check for adults with a severe mental illness, and care and support staff are often the people best placed to make sure it actually happens.

This guide explains who the check is for, what it includes, and how care staff can help someone attend and get the most from it. It draws on the NHS guidance on the annual health check for people with severe mental health conditions, last reviewed in January 2025.

What is the annual health check for severe mental illness?

The NHS describes a free check, offered once a year, for adults aged 18 or over who have schizophrenia, bipolar disorder or psychosis. It is run through the person's GP surgery, which should send an invitation letter. If no letter arrives, the person, or someone supporting them, can ask the surgery to arrange it.

This is a separate check from the NHS Health Check, which is offered to people aged 40 to 74 every five years to check the risk of heart disease, stroke, kidney disease, diabetes and dementia. Staff should not assume that one replaces the other. If you support someone with schizophrenia, bipolar disorder or psychosis, our guides to psychosis and schizophrenia and bipolar disorder explain the conditions themselves; this guide is about the physical health side.

What the check includes

The NHS says the appointment takes about 45 minutes. It covers a mix of conversation, measurements and tests:

• A discussion about mental health symptoms and how they affect daily life.
• Weight, heart rate and blood pressure.
• A urine sample and a blood test.
• A review of vaccinations.
• A review of medicines, including side effects.
• Support with other health conditions, such as asthma or diabetes.
• Agreement to share information with the person's mental health team, with their consent.
• Lifestyle advice on diet, exercise, alcohol and smoking.
• A possible follow-up appointment.

Why the check matters

The purpose is to find physical health problems early and to check whether medicines are working without causing unwanted effects. Medicines used in mental health care can have side effects, which is one reason a medicine review is built into the check. Some medicines also need their own regular monitoring; for example, our guide to clozapine monitoring explains the blood tests involved. The annual check does not replace that monitoring, but it gives the GP and the mental health team a chance to look at the whole picture.

For care staff, there is a second reason. People who find it hard to describe symptoms, or who are used to having their concerns put down to their diagnosis, can miss out on physical care. A routine check that does not depend on the person raising a problem helps close that gap.

Who can arrange the check?

According to the NHS, a family member or friend can contact the GP surgery to ask for an appointment for the check. If the person is in regular contact with a mental health team, the team can carry out the check, and a care coordinator can tell them how to book it. Staff in supported living, residential or day services can often help with the practical steps, but the person's own wishes should lead. Anyone supporting them should check the person agrees before booking, sharing information or attending on their behalf.

Reasonable adjustments

The NHS says people can ask for reasonable adjustments so the appointment works for them. Examples it gives include:

• A longer appointment.
• A companion, such as a carer, friend or peer support worker.
• A quiet or off-peak time.
• Transport or a home visit.
• A sign-language service.
• Extra reassurance for people anxious about needles.

Adjustments are usually recorded in a health profile or action plan, so the person should not have to ask again at every appointment. Staff can help by telling the surgery in advance rather than waiting for a problem on the day.

How care staff can help

The NHS page describes what the check involves; the following steps are general good practice rather than NHS requirements, and should be adapted to the person and your organisation's policies.

Before the appointment

• Find out whether the person has had an invitation this year, and if not, support them to ask the surgery.
• Talk through what will happen, including the blood test and urine sample, so there are fewer surprises.
• Gather an up-to-date list of medicines and any recent changes, and note any side effects you have seen.
• Agree who will go with them, how they will get there, and what adjustments to request.

On the day

• Allow plenty of time and avoid rushing the person.
• Let the person speak for themselves wherever possible, and add what you have observed only with their agreement.
• Make sure any follow-up appointment is clear before you leave.

Afterwards

• With the person's consent, record the outcome and any actions in their care plan.
• Support follow-up appointments, tests or lifestyle changes the person has chosen.
• Share relevant information with the mental health team only in line with what the person has agreed.

Training and CPD

Supporting someone with their physical health draws on knowledge of mental health conditions, medicines and communication. Keep a record of what you learn in your CPD log and discuss real examples in supervision. You can browse professional development options on our CPD pages.

Key points to remember

• The annual check is free for adults aged 18 or over with schizophrenia, bipolar disorder or psychosis.
• It takes about 45 minutes and covers measurements, blood and urine tests, a medicine review and lifestyle advice.
• The GP surgery should send an invitation; family, friends or the care team can help arrange it.
• Reasonable adjustments can be requested and are usually recorded in a health profile.
• It is separate from the NHS Health Check and does not replace specialist medicine monitoring.

Frequently asked questions

Is the check compulsory?

The NHS describes it as a free offer. The person decides whether to attend, so staff should explain the benefits and support them, not pressure them.

What if the person has not received an invitation?

The NHS says they can request a check if no letter arrives. Contact the GP surgery, with the person's agreement, and ask for it to be booked.

Does the check include the whole person's mental health care?

No. It includes a conversation about mental health symptoms and medicines, but it is mainly a physical health check. It sits alongside, not in place of, reviews with the mental health team.

This guide is for general information and is not a substitute for clinical advice or your organisation's policies.