Dr Greening’s survey of the attention paid to physical health parameters of patients in rehabilitation and recovery (Psychiatric Bulletin, June 2005, 29, 210-212) highlighted inadequacies in routine monitoring and a lack of clear guidelines from policymakers over what a full assessment might constitute (National Collaborating Centre for Mental Health, 2003). Standards of competence in physical examination among psychiatric trainees have been widely denigrated and suggestions have been made regarding expected practice (Reference GardenGarden, 2005).

In January 2005 we audited standards of physical healthcare on an acute psychiatric unit and found wide variations in the use of routine blood tests, urinalysis and body mass index (BMI) monitoring. With increasing attention paid to the metabolic effects of schizophrenia and of atypical anti-psychotics (Reference Jin, Meyer and JesteJin et al, 2004) it was felt that clinicians needed to agree a minimum standard for routine testing of all in-patients. Following discussion of this audit at the unit’s academic meeting, views were assembled over which tests should be regarded as routine. An investigations summary sheet was designed, similar to those used on medical units, and included BMI and prolactin. This allows changes over time to be tracked at a glance and has been added to the admission notes to prompt requests for appropriate tests. The aim is to re-audit these standards in 1 year in anticipation that they will have translated into a more rigorous approach to the physical health of psychiatric in-patients.