Care Programme Approach

Care Programme Approach (CPA) in the United Kingdom is a system of delivering community mental health services to individuals diagnosed with a mental illness. It was introduced in England in 1991[1] and by 1996 become a key component of the mental health system in England.[2] The approach requires that health and social services assess need, provided a written care plan, allocate a care coordinator, and then regularly review the plan with key stakeholders,[3] in keeping with the National Health Service and Community Care Act 1990.

History and impact

In 1999 the approach was simplified to standard and enhanced levels, the term key worker was changed to care coordinator, and there was an emphasis on risk management, employment and leisure, and the needs of the carer.[4]

There is some criticism that the approach has changed the role of staff away from implementing clinical interventions into administrative tasks,[5][6] that the policy is carried out inconsistently,[7][8][9] and has not been well aligned to clinical models of case management.[10] Formal review on the impact and effectiveness of this initiative has been difficult because of the variation of clinical interventions given under a CPA model.[11]

See also


  1. Department of Health (1990). "Care Programme Approach" Circular HC(90)23/LASSL(90)11. London: Department of Health
  2. Department of Health (1995). Building bridges. A guide to arrangements for interagency working for the care and protection of seriously mentally ill people. London: HMSO.
  3. "CPA association". Retrieved 2009-06-29.
  4. Department of Health (1999). "Effective care co-ordination in mental health services: modernising the care programme approach". London: Department of Health. Retrieved 2009-06-29.
  5. Simpson A (December 2005). "Community psychiatric nurses and the care coordinator role: squeezed to provide 'limited nursing'". J Adv Nurs. 52 (6): 689–99. doi:10.1111/j.1365-2648.2005.03636.x. PMID 16313382.
  6. Easton and Oyebode (1996). "Administrative demands of care programme approach." BMJ; 312: 1540.
  7. Bindman J, Beck A, Glover G, et al. (October 1999). "Evaluating mental health policy in England. Care Programme Approach and supervision registers". Br J Psychiatry. 175 (4): 327–30. doi:10.1192/bjp.175.4.327. PMID 10789298.
  8. Schneider J, Carpenter J, Brandon T (November 1999). "Operation and organisation of services for people with severe mental illness in the UK. A survey of the Care Programme Approach". Br J Psychiatry. 175 (5): 422–5. doi:10.1192/bjp.175.5.422. PMID 10789272.
  9. Venables D, Hughes J, Stewart K, Challis D (2005). "Variations in care management arrangements for people with mental health problems in England". Care Manag J. 6 (3): 131–8. doi:10.1891/cmaj.6.3.131. PMID 16642687.
  10. Simpson A, Miller C, Bowers L (August 2003). "Case management models and the care programme approach: how to make the CPA effective and credible". J Psychiatr Ment Health Nurs. 10 (4): 472–83. doi:10.1046/j.1365-2850.2003.00640.x. PMID 12887640.
  11. Burns T (May 1997). "Case management, care management and care programming". Br J Psychiatry. 170 (5): 393–5. doi:10.1192/bjp.170.5.393. PMID 9307684.

External links

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