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The Royal College of Psychiatrists Improving the lives of people with mental illness


National Audit of Schizophrenia

Background and standards

Physical healthcare in severe mental illness

Why focus on schizophrenia?

Schizophrenia is a national priority and was the topic for the first ever guideline published by the National Institute of Clinical Excellence (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.


Standards and outcome indicators

The standards are drawn from National Institute of Clinical Excellence (NICE) guidelines, and will enable you to evaluate:

  • Practice in the prescribing of antipsychotic drugs
  • The quality of physical health monitoring and interventions offered to people with schizophrenia
  • Patients’ experience of treatment and its outcome
  • Carers satisfaction with the support and information they have received




Why take part?

As part of the National Clinical Audit and Patient Outcomes Programme (NCAPOP) it is expected that all eligible Mental Health Trusts in England and Wales will take part in  NAS. Sixty (94%) eligible mental health Trusts and Health Boards participated in the first round of audit.

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
  • Compare their performance with results from the first round of audit
  • 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.



Where next...


papers and links in liaison psychiatry
NAS,  21 Prescot Street, London, E1 8BB    Tel: 020 3701 2688   Email:


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