title: Integrating care for people with mental illness: the Care Programme Approach in England and its implications for long-term conditions management.
abstract: BACKGROUND
  This policy paper considers what the long-term conditions policies in England and other countries could learn from the experience of the Care Programme Approach (CPA). The CPA was introduced in England in April 1991 as the statutory framework for people requiring support in the community for more severe and enduring mental health problems. The CPA approach is an example of a long-standing 'care co-ordination' model that seeks to develop individualised care plans and then attempt to integrate care for patients from a range of providers.
  The CPA experience is highly relevant to both the English and international debates on the future of long-term conditions management where the agenda has focused on developing co-ordinated care planning and delivery between health and social care; to prioritise upstream interventions that promote health and wellbeing; and to provide for a more personalised service.
  
  
  CONCLUSIONS
  This review of the CPA experience suggests that there is the potential for better care integration for those patients with multiple or complex needs where a strategy of personalised care planning and pro-active care co-ordination is provided. However, such models will not reach their full potential unless a number of preconditions are met including: clear eligibility criteria; standardised measures of service quality; a mix of governance and incentives to hold providers accountable for such quality; and genuine patient involvement in their own care plans.
  
  
  CONCLUSIONS
  Investment and professional support to the role of the care co-ordinator is particularly crucial. Care co-ordinators require the requisite skills and competencies to act as a care professional to the patient as well as to have the power to exert authority among other care professionals to ensure multidisciplinary care plans are implemented successfully. Attention to inter-professional practice, culture, leadership and organisational development can also help crowd-in behaviours that promote integrated care.
authors.affiliation: The King's Fund, 11-13 Cavendish Square, London, W1G 0AN, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Goodwin
authors.affiliation: The Mental Health Foundation, Sea Containers House, 20 Upper Ground, London, SE1 9QB, UK.
authors.forename: Simon
authors.initials: S
authors.lastname: Lawton-Smith
keywords: care co-ordination; care management; care planning; care programme approach; integrated care; long-term conditions; mental health; personalised care; policy