What is the purpose and structure of the Care Programme Approach?

The Care Programme Approach (CPA) is a framework developed by the National Health Service (NHS) in the United Kingdom to provide coordinated and comprehensive care for individuals with mental health needs. It was designed to ensure that those with complex and persistent mental health conditions receive appropriate and effective care that meets their specific needs. This system has been in place since the early 1990s and has evolved over the years to better meet the changing needs of individuals with mental health issues. In this essay, we will explore the purpose and structure of the Care Programme Approach and its impact on mental health care in the UK.

Care Programme Approach (CPA) is a United Kingdom system of delivering community services to those with mental illness. It was introduced to England in 1991 and by 1996 become a key component of the mental health system in England. 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, 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, 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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