Personalised health support for people living with severe mental illness

People living with severe mental illness have a reduced life expectancy of 15-20 years, particularly due to cardiovascular disease linked to modifiable risk factors. 

The Primrose programme trains healthcare professionals to offer tailored sessions to patients to help them set specific, personalised and achievable health goals that are tailored to their individual needs and circumstances. 

The Primrose model began with a randomised controlled trial (2010), where Primrose was estimated to save the NHS £895 per patient per year in healthcare costs compared to usual care. Since then, it has expanded to include intervention development, implementation, and evaluation, supported by NIHR ARC North Thames. 

The Primrose model has been included in national guidance recommended by NHS England, as well as local strategy. 

At the patient level, individuals who were supported through Primrose are less likely to be admitted to inpatient care, and report improved mental health, motivation, and physical health. Healthcare staff also noted patients’ improved engagement, quality of life, and reduced isolation.  

At the staff level, healthcare professionals have gained confidence and skills to work in a patient-centred and holistic way with patients living with severe mental illness. This can also inform their broader clinical practice beyond the Primrose programme. 

Access resources for how to implement the Primrose programme

• Key intervention components: Strong therapeutic relationships built between patients and clinicians through via regular appointments that are long enough to address social issues as well as mental and physical health concerns.  

• Key implementation components: the project team providing adaptable training resources to support the intervention’s delivery; healthcare leaders (ie, those in decision making positions in GP practices, Trusts, ICBs) taking ownership of the intervention; frontline staff championing the intervention. 

The Primrose Study has several phases with multiple funding phases and collaborators, including NIHR ARC East Midlands and NIHR ARC Yorkshire and Humber.  

The NIHR ARC North Thames was involved in the evaluation and implementation phase of the programme, led by our deputy director and Multimorbidity Theme lead, Professor David Osborn.  

Between early 2022 and mid-2024, UCLP-PRIMROSE was rolled out across 24 GP practices in Yorkshire and London, in collaboration with secondary care and VCSE partners. This was supported by NIHR ARC North Thames’ partner Health Innovation Network UCLPartners. 

The original NIHR programme was led by Prof David Osborn and researchers at University College London in partnership with Camden and Islington NHS Foundation Trust and Rethink Mental Illness/McPin.