In the UK and other high-income countries, life expectancy in people with schizophrenia is 20% lower than in the general population.

To examine the quality of assessment and treatment of physical health problems in people with schizophrenia.

Retrospective audit of records of people with schizophrenia or schizoaffective disorder aged ⩾18. We collected data on nine key aspects of physical health for 5091 patients and combined these with a cross-sectional patient survey.

Body mass index was recorded in 2599 (51.1%) patients during the previous 12 months and 1102 (21.6%) had evidence of assessment of all nine key measures. Among those with high blood sugar, there was recorded evidence of 53.5% receiving an appropriate intervention. Among those with dyslipidaemia, this was 19.9%. Despite this, most patients reported that they were satisfied with the physical healthcare they received.

Assessment and treatment of common physical health problems in people with schizophrenia falls well below acceptable standards. Cooperation and communication between primary and secondary care services needs to improve if premature mortality in this group is to be reduced.

Literature comparing the quality of care on psychiatric intensive care units and acute wards is sparse, but a review has found differences in key areas e.g. violence, drugs and alcohol.

This study compares the response to questionnaires completed by patients, carers and qualified nursing staff from PICUs and acute wards as part of the Accreditation for Inpatient Mental Health Services (AIMS) process.

There were few differences between the standards of care on PICUs and acute wards according to patients, carers and qualified nurses. Patients reported a more negative experience of care on PICUs than trained nurses, and in particular rated low standards on accessing records and counselling. Carers reported inadequate involvement in risk assessment an assessment of their needs. Nurses generally gave positive views of standards of care.

The challenging environment of the PICU does not appear to be compromising quality of care. There is however still room for improvement for both acute wards and PICUs in key areas, including full involvement of patients and carers and imparting information.