August 2005

The following definitions relating to CPA are extracted from the latest version of the NHS Data Dictionary. For more information, please visit the NHS Information Authority Website.

Care Programme Approach Episode:
A period of care provided as part of the Care Programme Approach for an adult (including elderly) PATIENT. The CARE PROGRAMME APPROACH EPISODE forms part of a MENTAL HEALTH CARE SPELL.

The first CARE PROGRAMME APPROACH EPISODE starts when the MENTAL HEALTH CARE SPELL initial assessment of the PATIENT determines that a plan of care or treatment is required which will be delivered under the Care Programme Approach.

The CARE PROGRAMME APPROACH EPISODE ends when one of the following occurs:

• a review determines that no further care need be provided
• a different level of Care Programme Approach is required
• a PATIENT transfers to another HEALTH CARE PROVIDER with main responsibility for provision of mental health care also being transferred
• death of the PATIENT

A Care Programme Approach must involve all of the following key elements:



There are two levels of Care Programme Approach; standard and enhanced.

MH030 – CARE PROGRAMME APPROACH EPISODE:

A CARE PROGRAMME APPROACH EPISODE involves care and assessment carried out by one or more MENTAL HEALTH CARE TEAM MEMBERS, one of whom must be the named care coordinator, the CPA CARE COORDINATOR ALLOCATION.

A CARE PROGRAMME APPROACH EPISODE starts with a CARE PROGRAMME APPROACH REVIEW, which assesses the PATIENT's health and social care needs, and further CARE PROGRAMME APPROACH REVIEWS take place throughout the CARE PROGRAMME APPROACH EPISODE. PATIENT DIAGNOSES and HONOS SCORES FOR PERSONS may be recorded during these reviews.

Within a CARE PROGRAMME APPROACH EPISODE a PATIENT may have SUPERVISION REGISTER EPISODES, which are periods of time when the PATIENT is on a Supervision Register which indicates the risk against which the PATIENT is being supervised. A PATIENT may also have SUPERVISED DISCHARGE EPISODES, when they receive supervised aftercare while still within a CARE PROGRAMME APPROACH EPISODE.

The named care coordinator for the CARE PROGRAMME APPROACH EPISODE may be involved in FACE TO FACE CONTACTS CPA CARE COORDINATOR, FACE TO FACE CONTACTS COMMUNITY CARES and PROFESSIONAL STAFF GROUP CONTACTS. Contacts with the PATIENT by a MENTAL HEALTH CARE TEAM MEMBER who is a social worker are recorded as FACE TO FACE CONTACTS SOCIAL WORKER.

Care Programme Approach Review: A clinical review of the health and social needs of a PATIENT who is the subject of a CARE PROGRAMME APPROACH EPISODE. The review may take the form of a single meeting of interested parties, usually including the allocated care coordinator and the PATIENT or it may comprise a series of meetings and discussions over a number of days. The CARE PROGRAMME APPROACH REVIEW ends when a definite outcome is established and recorded. The date when this is recorded will be taken as the CPA REVIEW DATE. The outcome will determine whether the CARE PROGRAMME APPROACH EPISODE continues or is ended.

The review will also include the assessment and recording of the HoNOS score and the assessment or re-assessment of the need for a SUPERVISION REGISTER EPISODE.

Care Plan: A plan of the treatment or health care to be provided to a PATIENT within a CARE SPELL.

A CARE SPELL may include more than one CARE PLAN. Often the effectiveness of a CARE PLAN is reviewed periodically and as a result of the review a new CARE PLAN may be developed.

Care Programme Approach Care Co-ordinator: For purposes of the Mental Health Minimum Data Set (MHMDS) collection, OCCUPATION (CPA CARE COORDINATOR) is the NHS OCCUPATION or NON-NHS OCCUPATION of the MENTAL HEALTH CARE TEAM MEMBER allocated as the named CPA care coordinator at the end of the REPORTING PERIOD.

This is derived from the START DATE and END DATE of CPA CARE COORDINATOR ALLOCATION with the MENTAL HEALTH CARE TEAM TYPE classifying whether the CPA care coordinator is an NHS or Non-NHS employee.

Care Programme Approach Level of Need: Please note that although both CPA ENHANCED DAYS and CPA STANDARD DAYS are classed as optional data item notes at least one of them should be present within the MHMDS collection record as Care Programme Approach is mandatory. A PATIENT subject to a MENTAL HEALTH CARE SPELL therefore should always have recorded CPA days with only the CPA LEVEL varying during the period of the MENTAL HEALTH CARE SPELL.