In recent years there has been an increasing focus on improving the physical health of people with serious mental illness and many policies and guidelines are now tailored to support professionals working in mental health services to meet these requirements. We found, however, that the physical health care policies produced by mental health trusts in England varied enormously. Policies were often cumbersome, vague and lacked clear guidance on what particular action should be taken, when it should be taken, and by whom. Physical health care policy documents of three mental health care trusts in the north sector of the East Midlands Strategic Health Authority (UK) were examined in detail. We found significant disparities between the policies in terms of size, readability, external references and reading cost. None could be read swiftly and all incorporated vague language into their directives. It would be beneficial for there to be more consideration given to forming local policies that are readable, succinct, and unambiguous. There is potential for considerable economy of effort with collaboration in production of these documents.