The history of the care programme approach in England: where did it go wrong?

Simpson, A., Miller, C. and Bowers, L. (2003) The history of the care programme approach in England: where did it go wrong? Journal of Mental Health, 12 (5). pp. 489-504. ISSN 0963-8237

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Background: The Care Programme Approach (CPA) was introduced in England in 1991 as a form of case management to improve community care for people with severe mental illness. It helped services maintain contact with users but failed to provide comprehensive, co-ordinated care and is associated with increased bed use Aim: To describe and evaluate the introduction, implementation and development of the CPA and identify reasons for its relative failure. Method: A critical review of key events, audits, reports, research and policies that shaped the CPA. Results: Reasons for the relative failure of the CPA included the socio-political and financial context, clinicians' resistance to political and managerial interference, and the bureaucratic, complex and time-consuming nature of the policy. This reduced face-to-face contact whilst contributing to an emergent 'blame culture' and defensive psychiatric practice. The CPA also presumed levels of community resources and interprofessional teamwork that were frequently absent Conclusions: The CPA was a flawed policy introduced insensitively into an inhospitable environment. It was destined to fail and after more than a decade remains ineffectively implemented. Changes introduced recently may have contradictory influences on the ability of services to provide effective case management but remain to be evaluated.

Item Type: Journal article
Uncontrolled Keywords: Care Programme Approach (CPA); Case Management; Community Care; Multi-disciplinary Teams; Teamwork
Subjects: B000 Health Professions
DOI (a stable link to the resource): 10.1080/09638230310001603555
Faculties: Faculty of Health and Social Sciences > School of Nursing and Midwifery
Depositing User: editor snam
Date Deposited: 23 Nov 2006
Last Modified: 20 Feb 2014 11:29

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