Electronic Letters to:

Articles:
David Kingdon and Shabbir Amanullah
Care programme approach: relapsing or recovering?: REVISITING... MAKING CARE PROGRAMMING WORK
Adv Psychiatr Treat 2005; 11: 325-329 [Abstract] [Full text] [PDF]
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[Read eLetter] Patient Care- The eventual goal of clinical practice
Yasir Abbasi   (16 September 2005)

Patient Care- The eventual goal of clinical practice 16 September 2005
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Yasir Abbasi,
SHO in Psychiatry, Nottinghamshire Healthcare NHS Trust
Based at CAHMS, Thorneywood Adolescent Unit.

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Re: Patient Care- The eventual goal of clinical practice

dryiabbasi{at}yahoo.com Yasir Abbasi

While no one can deny the importance of CPA implementation in clinical practice, it is also crucial that it is used appropriately to improve follow up of patients in the community. Many of us oscillate between two extremes of CPA. ‘Standard’ CPA comprises highlighting the basic requirements of patients, providing them with a few phone numbers, and sending them home with a copy of the CPA document. This can leave us feeling satisfied within ourselves thinking that we are ‘legally safe’. At the other extreme is ‘Enhanced’ CPA which involves a book's worth of paper-work and a burdensome extensive follow up which sometimes creates misunderstandings between different components of the multidisciplinary team.

There seems to be no middle ground for patients who would not benefit from either standard or enhanced CPA. I believe it would be beneficial to have a step-ladder pattern of CPA implementation involving not just two but many levels of care provision. This should start from the lowest rung going upwards or back downwards if and as required by assessing the needs of the patient on a regular basis.

I believe that excessive government intrusion, bureaucratisation, and a profusion of red tape has shifted a patient orientated approach towards a 'being safe and legally covered' phenomenon.