Junior health minister John Bowis last week launched what he
hoped will be seen as the ‘bible’ of care for people with severe
The new document, Building Bridges, gives information on joint
working arrangements, building on existing procedures, particularly
the Care Programme Approach, which health authorities must review
by the end of this month.
‘We have responded to a number of areas where we’ve been asked
by the field for clarification and guidance,’ Bowis said.
He warned that local government reorganisation and the
restructuring of health authorities should not be used as an excuse
for holding up joint agreements.
‘There should be a smooth transition: there’s someone in charge
today; there’ll be someone in charge tomorrow.’
June McKerrow, director of the Mental Health Foundation,
welcomed the guidance’s definitions of severe mental illness: ‘They
are broad: they include, rather than exclude.’
But she said much of the document’s content had been said
before, which meant the key issue was ensuring compliance.
‘It would be good to see local contracts that give the whole
Jennifer Bernard, mental health spokesperson for the Association
of Directors of Social Services, also welcomed the attempt to
clarify responsibilities and define mental illness.
‘I think what has caused consternation has been the difficulty
of establishing who precisely has the lead.’
She said concerns remain over resources and the future of the
Mental Illness Specific Grant.
MIND made a strong attack on government policy. Director Judi
Clements said it should ‘stop producing guidance on guidance and
start putting in national minimum standards of care’.
Policy is being undermined by lack of resources and by decisions
of other government departments, she said, such as cutbacks to
social housing programmes.
MIND also launched its ‘blueprint’ for community care at its
annual conference earlier this week.The guidance addresses
co-ordinating the Care Programme Approach’s key worker with the
care manager. It recommends a joint procedure agreed between health
and social services and GP fundholders to select an individual to
co-ordinate the assessment, and choose a key worker
Such agreements should also determine a procedure for screening
referrals, allocating resources to a care plan, and monitoring its
implementation.Operating the care programme approachl 24-hour
* supported housing
* better access to employment and education
* alternative therapies
* advocacy and information
* key worker
* partnershipsMIND’s blueprintBernard: Concerns