Between 2014 and 2016, NHS England worked with staff and patients in four mental health trusts to improve the cardiovascular (CVD) health outcomes and reduce premature mortality in people with serious mental illness. CVD is the biggest cause of premature death in this patient group. This toolkit is designed to help other mental health trusts implement the Lester tool, using a combination of detailed case studies, short examples and supporting documents provided by each pilot site. By sharing the pilot sites’ own material (such as physical health policies, example job descriptions and lists of equipment), we hope that other trusts will be able to use these as the basis for their own materials – without needing to start from scratch.

The materials included in this toolkit are all practical, local resources and some may still be work in progress. Readers are encouraged to consider, adopt or adapt the content as locally appropriate, and to acknowledge and reference the relevant trust accordingly. These sites own the intellectual property rights for their materials and are provided on an ‘as is’ basis.

The Royal College of Psychiatrists were commissioned to carry out an independent evaluation, which looked at how the Lester tool had been implemented in each of the four trusts. This identified a number of ‘causal mechanisms’ which based on the pilot sites’ experience are the key to bringing about change:

1. Motivating and engaging staff
2. Roles and responsibilities
3. Skills and confidence
4. Equipment
5. Recording information
6. Communicating with service users
7. Interfaces with other services

This toolkit deals with each causal mechanism in turn, providing guidance, supporting documents and case studies to illustrate how trusts can address each factor when implementing the Lester tool.