The poor assessment and treatment of physical health problems in people with schizophrenia found by Crawford et al ^{Reference Crawford, Jayakumar, Lemmey, Zalewska, Patel and Cooper1} is sadly not surprising.

The methodological problems that became evident in the pilot phase mirrors the problems faced in practice – many trusts do not have up-to-date physical health monitoring and these must be requested from primary care. Clinicians in mental health services interested in getting this information and who want to actively take part in physical health assessment and treatment have to, like Crawford et al, write to the general practitioner (GP) requesting this information and hope for a timely response.

Out of hours, there is no simple way of checking current medication, physical health conditions and allergies: information that is readily available on primary care databases. Many clinicians in mental health spend considerable time contacting GP practices to request investigations and results. Conversely, GPs are often frustrated at not finding out about changes in management plans and psychotropic medication quickly enough. This system of care is not conducive to the urgent need to improve physical healthcare for this group of patients.

A shared IT platform for primary care and mental health services, with up-to-date information on physical health such as blood pressure, smoking, weight, body mass index, blood tests, electrocardiograms, physical health conditions and their management, current medication and allergies, would surely result in improved efficiency and patient safety, and go some way to reconnect, if not integrate, physical and mental health treatment. If this is beyond our capabilities, then certainly electronic access to some version of primary care records is surely not?

I note the authors’ affiliation with the Centre for Quality Improvement at the Royal College of Psychiatrists and I would hope that such a project is high on the agenda. An improved system would come as a huge relief to many clinicians, especially trainees, who work with these issues every day and might even encourage them to become more involved in the physical health management of their patients.

Unfortunately, primary care services are not incentivised to monitor physical health assertively in those with schizophrenia and many in this patient group do not regularly attend their primary care service. Patients who attend secondary care services are increasingly being offered monitoring of physical health conditions as well as treatment in this setting. A shared IT system would certainly help improve the efficiency of such initiatives and allow for a more integrated approach, to the benefit of all parties.