YearDescription of guidelines
2002NICE guidelines on schizophrenia are released (CG1) that state that clinicians should ‘regularly monitor the physical health’ of patients,
stating that ‘particular attention should be paid to the risk of metabolic and cardiovascular disease’.14
2006The Department of Health release best practice guidance for supporting the physical health needs of people with severe mental illness.15
The guidance states that patients should receive annual physical health check reviews, including blood tests and urinalysis, basic health
checks (including blood pressure, pulse and body mass index), and lifestyle review (including diet, physical activity and smoking).
2009NICE guidelines on schizophrenia are updated (CG82) to recommend that patients should receive annual physical health check reviews,
with a ‘focus on cardiovascular disease risk assessment’.16
2014Current NICE guidelines on psychosis and schizophrenia in adults (CG178) recommend more frequent regular physical health monitoring
for patients receiving antipsychotic medication. The guidelines state the following physical health markers should be measured:12
  1. weight: baseline, then weekly for the first 6 weeks, at 12 weeks, at 1 year and then annually;

  2. waist circumference: baseline, and then annually;

  3. pulse and blood pressure: baseline, then at 12 weeks, at 1 year and then annually;

  4. fasting blood glucose, HbA1c and blood lipid levels: baseline, then at 12 weeks, at 1 year and then annually;

  5. overall physical health (nutritional status/diet/physical activity): baseline and at regular intervals.


There are similar NICE guidelines that recommend regular physical health monitoring for young people which psychosis and schizophrenia
(CG155),17 and for patients with bipolar disorder (CG185).18