The Care Programme Approach (CPA) was introduced in England in 1991. It established a joint health and social care approach to the care of people with mental health problems who are referred to specialist mental health services. It required health authorities in collaboration with social services departments to put in place appropriate arrangements for the care and treatment of mentally ill people in the community.
The CPA aims to facilitate closer and integrated working, enabling a co-ordinated approach to care delivery and the recovery process.
The four main elements of the CPA process are:
- Systematic arrangements for assessing the health and social needs of people accepted into specialist mental health services;
The formation of a care plan, which identifies the health and social care required from a variety of providers;
The appointment of a care co-ordinator to keep in close touch with the service user and to monitor and co-ordinate care and;
Regular review and, where necessary, agreed changes to the care plan.
In October 1999 the Department of Health (DH) published Effective Care Co-ordination in Mental Health Services – Modernising the Care Programme Approach and broadened the application of the CPA to all adults of working age who are under the care of secondary mental health services (health and social care), regardless of setting. It stated that CPA is care management for those of working age in contact with specialist mental health and social care services.
Refocusing the Care Programme Approach: Policy and Positive Practice Guidance (DH, March 2008) was the outcome of a national review which had the intention of ensuring the national policy is more consistently and clearly applied, and that unnecessary bureaucracy is removed.
A particular feature of the revised policy is that the two previous levels of care, ‘Standard’ and ‘Enhanced’, are removed. The CPA is now used to describe the term used in secondary mental health care to assess, plan, review and co-ordinate the range of treatment, care and support needs for people in contact with secondary mental health services who have complex characteristics. Implicit in every element of the approach is the involvement of the service user and, where appropriate, their carer.
However, the rights that people have to an assessment of their needs, the development of a care plan and a review of that care by a professional involved will continue to be good practice for all.