Integrating care for people with mental illness: the Care Programme Approach in England and its implications for long-term conditions management
Nick Goodwin,Simon Lawton-Smith +1 more
TLDR
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.Abstract:
Introduction : 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. Policy description : 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. Conclusion : 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. Implications : 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.read more
Citations
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O cuidado das condições crônicas na atenção primária à saúde: o imperativo da consolidação da estratégia da saúde da família
TL;DR: The model of care for acute events has failed to respond to health situations dominated by chronic conditions, which has led different countries and several institutions to seek models of Care for chronic conditions.
All Together Now: A Conceptual Exploration of Integrated Care.
TL;DR: In this article, the authors explore the many definitions, concepts, logics and methods found in health system and service integration, and summarize the main elements or building blocks of integrated care and suggest a way to address its various complexities and unknowns in a real world sense.
Journal ArticleDOI
Integrated care to address the physical health needs of people with severe mental illness: a mapping review of the recent evidence on barriers, facilitators and evaluations
TL;DR: There is a need for improved communication among professionals and better information technology to support them, greater clarity about who is responsible and accountable for physical health care, and greater awareness of the effects of stigmatisation on the wider culture and environment in which services are delivered.
Journal ArticleDOI
Comparison of effectiveness and cost-effectiveness of an intensive community supported discharge service versus treatment as usual for adolescents with psychiatric emergencies: a randomised controlled trial.
Dennis Ougrin,Dennis Ougrin,Richard Corrigall,Jason Poole,Jason Poole,Toby Zundel,Mandy Sarhane,Victoria Slater,Daniel Stahl,Paula Reavey,Sarah Byford,Margaret Heslin,John Ivens,Maarten Crommelin,Zahra Abdulla,D. Hayes,Kerry Middleton,Benita Nnadi,Eric Taylor +18 more
TL;DR: SDS provided by an intensive community treatment team reduced bed usage at 6 months' follow-up but had no effect on functional status and symptoms of mental health disorders compared with usual care.
References
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Book
Caring for People with Chronic Conditions: A Health System Perspective
Ellen Nolte,Martin McKee +1 more
Journal ArticleDOI
Caring for people with chronic conditions: a health system perspective
TL;DR: This book focuses on a range of health system and policy issues related to caring for people with chronic conditions and aims to contribute to the evolution of a more evidence-based approach to policy formulation in the health sector.
Mental health, resilience and inequalities
TL;DR: The latest review of the evidence on what determines mental well-being, covering resilience, social determinants of mental health and the benefits of positive mental health, can be found in this paper.