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Summary  Hamilton's paper describes a thorough and pragmatic approach to the introduction of physical health checks in people registered with mental health services. This is a moral and political priority, but translating this into day-to-day practice in already stretched community mental health teams requires leadership and vision. Pivotal in Hamilton's success was the establishment of good channels of communication between the mental and physical healthcare teams. Hearing about good practice and positive experiences in other teams should help in the widespread introduction of reliable systems to improve physical health in mental health service users.

Falling between the cracks. Invited commentary on … Service innovation: the first year of lifestyle clinics for psychiatric outpatients