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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〔Department of Health (1990). "Care Programme Approach" Circular HC(90)23/LASSL(90)11. London: Department of Health〕 and by 1996 become a key component of the mental health system in England.〔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.〕 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,〔(【引用サイトリンク】title=CPA association )〕 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.
There is some criticism that the approach has changed the role of staff away from implementing clinical interventions into administrative tasks,〔Easton and Oyebode (1996). "Administrative demands of care programme approach." ''BMJ''; 312: 1540.〕 that the policy is carried out inconsistently, and has not been well aligned to clinical models of case management. 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.
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