Why focus on schizophrenia

Schizophrenia is a national priority and was the topic for the first ever guideline published by NICE.  It is often a long-term, sometimes life-long, condition that affects about 250,000 people in England and Wales.  As well as causing distressing symptoms such as hearing voices, it can cause lasting impairment and a degree of social exclusion.  Also, people with schizophrenia are more at risk than others of physical ill health and have lower life expectancy.  Antipsychotic medication is effective at treating symptoms and preventing relapse.  However these drugs are associated with a number of side-effects that can cause or contribute to distress and physical ill health.  People who experience these side-effects may discontinue medication and thus be at increased risk of relapse.

Good prescribing for schizophrenia requires achieving a balance between the beneficial and adverse effects of medication, full involvement of the patient in decision-making, close monitoring of physical health and active advice and support regarding health promotion.  There is evidence of both sub-optimal practice and wide variation across clinical teams in important aspects of the management of schizophrenia; including treatment-resistant schizophrenia.

Why take part

As part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) it is expected that all Mental Health Trusts in England and Wales will take part in at least Module 1 of NAS. Registration closed on 31st March 2011.

By taking part in this audit:

Individual clinicians and teams will:

• Better understand the outcomes and experience of their patients and their carers
• Compare their performance with best practice and national benchmarks
• Identify areas in which they are performing well and areas for improvement
• Receive support to improve practice and the quality of care

Managers can:

• Report participation in NAS as part of their Quality Account (in England)
• Benchmark practice and performance with standards and other organisations
• Identify areas in which they are performing well and areas for improvement.

The audit 

NAS is an initiative of the Royal College of Psychiatrist's Centre for Quality Improvement (CCQI). It is part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP), funded and managed by the Health Quality Improvement Partnership (HQIP). It is a Trust level audit consisting of an audit of practice plus service user experience and carer satisfaction surveys for more detail please visit the page; Audit methodology.

CASInO-S^© (previously known as NAS module 2)

This is a pilot for a proposed new system, the Clinical Audit, Standards, Indicators and Outcomes (CASInO^©) system, this part of the pilot is known as CASInO^© Schizophrenia Module (S). It will be an individual psychiatrist or team level audit based around the standards and indicators from NAS. More information will be available in Spring 2012.