Table 3 List of the second round NAS standards

S1

Service users report that their experience of care over the past 12 months has been positive.

S2

Service users report positive outcomes from the care they have received over the past 12 months.

S3

Carers report satisfaction with the support and information they have been provided with to assist them in their role as a carer over the past 12 months.

S4

The following physical health indicators have been monitored within the past 12 months:

i. body mass index, or waist circumference;

ii. blood pressure;

iii. Use of tobacco;

iv. use of alcohol;

v. substance misuse;

vi. blood levels of glucose and lipids (total cholesterol and HDL cholesterol);

vii. History of cardiovascular disease, diabetes, hypertension or dyslipidaemia in members of the service user’s family.

S5

When monitoring within the past 12 months has indicated a need for intervention, the following have been offered to the service user or the treating clinician has made a referral for the service user to receive:

i. advice about diet and exercise, aimed at helping the person to maintain a healthy weight;

ii. treatment for hypertension;

iii. Treatment for diabetes;

iv. treatment for dyslipidaemia;

v. help with smoking cessation;

vi. help with reducing alcohol consumption;

vii. Help with reducing substance misuse.

S6

The service user has been provided with evidence-based, written information (or an appropriate alternative), in an accessible format, about the antipsychotic drug that they are currently prescribed.

S7

The service user was involved in deciding which antipsychotic was to be prescribed, after discussion of the benefits and potential side-effects.

S8

The service user is currently only prescribed a single antipsychotic drug (unless they are in a short period^a of overlap while changing medication or because clozapine is co-prescribed with a second antipsychotic) and a rationale for this has been documented.

S9

The current total daily dose of antipsychotic drug does not exceed the upper limit of the dose range recommended by the BNF. If it does, the rationale for this has been documented.

S10

If there was no or inadequate response to the first antipsychotic drug prescribed after a minimum of 4wks at optimum dose^b:

i. medication adherence was investigated and documented;

ii. the potential impact of alcohol or substance misuse on response was investigated and documented.

S11

If there was no or inadequate response to the first antipsychotic drug within 8 weeks, part of which was at optimum dose^b the first antipsychotic drug was stopped and a second antipsychotic drug given.

S12

If there was no or inadequate response to two antipsychotic drugs, one of which should be a second-generation antipsychotic at optimum dose^b, clozapine was offered.

S13

If there was no or inadequate response to treatment despite an adequate trial of clozapine^c, a second antipsychotic was given in addition to clozapine for a trial period of at least 8 weeks at optimum dose^b.

S14

a. CBT has been offered to all service users.

b. Family intervention has been offered to all service users who are in close contact with their families.

S15

Each service user has a current care plan

S16

Each service user knows how to contact services if in crisis