BMJ 1996;312:1540 (15 June)

Letters

Administrative demands of care programme approach

EDITOR,--Max Marshall makes the point that the care programme approach has never been fully evaluated, and that its American counterpart, case management, has not proved to be a particularly successful approach.1 In Britain, some studies have claimed that the approach is successful--for example, in tailoring care to individual needs--whereas others have shown that care programme approach fails to improve outcome and has no effect on rates of suicide or reoffending.2 3

We investigated the implementation of this approach within a mental health trust, studying administrative demands and the opinions of practitioners regarding the potential benefits and problems. Our results suggest that the care programme approach increases workload disproportionately to its perceived benefits. The most commonly cited problems included increased demands of time and workload due to extra administrative tasks and, perhaps more worryingly, the consequent detraction from time available to spend with patients.

The same issues were highlighted in the observational . . . [Full text of this article]


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Relevant Article

Case management: a dubious practice
Max Marshall
BMJ 1996 312: 523-524. [Extract] [Full Text]

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