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Metabolic and cardiovascular risk factors must be monitored in these patients, say a collection of advocacy groups including the National Obesity Forum.

Weight gain is a multi-pronged problem in schizophrenia. As well as issues over cardiovascular health, there are concerns that some patients discontinue antipsychotic drugs when they put on weight.

Although the management of severe psychiatric care should continue to be the preserve of specialist services, GPs should be getting more involved with day-to-day management of these patients, say the charities.

The GMS quality framework mental health domain has 23 points for giving patients with schizophrenia health promotion advice depending on their health status. But in the manifesto developed by the advocacy groups, GPs are urged to embrace this role 'enthusiastically'. It called on GPs to set up screening systems to help manage metabolic and cardiovascular risks.

This could lead to referring a patient back to secondary care for a review of their antipsychotic medication.

Dr Dave Tomson, a Tyneside GP with an interest in mental health, called for more flexible support from mental health services.