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The government has gone ahead with plans to limit the care programme approach (CPA) to people with severe mental health needs.

The Department of Health launched guidance last week which stipulates that only people with severe needs will be treated under the CPA, the system designed to co-ordinate and manage care for people requiring specialist mental health services. It will no longer apply to people with less severe needs, currently on the "standard" level of CPA.

CPA refocused

Refocusing the Care Programme Approach follows a consultation and review into the future of the CPA, and is designed to end variation around the country in who qualifies for the system.

From October 2008 the term CPA will only apply to complex and high-risk cases, defined as those who need multi-agency support and intense intervention. It will no longer be used for people with straightforward secondary care needs and contact with only one agency. It will mean a reduction in formal paperwork for those with lower-level needs, although a statement of care agreed with the service user should still be recorded.

Charities sceptical

However, mental health charities were sceptical that the new policy would achieve its goal. Andy Bell, director of public affairs at the Sainsbury's Centre for Mental Health, said that the organisation's concerns during the consultation process were not addressed in the final document. He said: "It is not clear who should qualify for the new CPA and what provision there will be for those that don't.'

And Jane Harris, head of campaigns at Rethink, said: "Our worry is that without such a formal care programme in place, people with less complex conditions might miss out on the services they need as the guidance will be down to local mental health trusts to interpret. While this group of people should still get a care programme of sorts, if this is only in the form of a letter from a clinician or GP it might not amount to very much."

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