Social Work and Integrated Care by Robin Miller

Author:Robin Miller [Miller, Robin]
Language: eng
Format: epub
ISBN: 9781138484160
Barnesnoble:
Publisher: Taylor & Francis
Published: 2019-05-14T00:00:00+00:00

A two-tiered approach to CPA was introduced in Wales in 2003 with a requirement for care coordinators to be identified for people receiving ‘enhanced’ CPA (Welsh Assembly Government 2003). The comprehensive multi-disciplinary care plan was based on a holistic assessment of need and include detailed contingency and crisis plans. The Mental Health (Wales) Measure 2010 legislation introduced a new legal requirement for all people in receipt of secondary mental health services to have a care coordinator and a ‘proportionate and holistic care and treatment plan’ (p1). The associated code of practice (Welsh Assembly Government 2012) contains detailed guidance about the role of the care coordinator and the process for selecting these by the mental health service providers. This should be a combination of the professional having the right experience, skills and training, their relationship with the person and their ability to meet the language and communication needs. Furthermore, there should be consideration of the person’s preference and choice, any conflicts of interest and the professional having sufficient workload capacity. There is an emphasis throughout on the care coordinator working in collaboration with the person to ensure that they are fully informed and that the care plan reflects their perspectives. Care coordinators are also expected to take all practicable steps to consult with carers and/or those with parental responsibility for the person.

The Mental Health (Wales) Measure 2010 places a further duty on Welsh Ministers to review the implementation and impact of the care coordination arrangements. The review published in 2015 reported that 86 per cent of people receiving secondary mental health services had a valid care and treatment plan. A survey in one health board area of 200 people supported by community mental health teams suggested that many of them had positive experiences (Box 5.3). However, the approach was not being consistently implemented to the required standard across Wales. For example, people frequently reported that clinicians were only focusing on medication despite there being an expectation that they would encompass eights aspects of people’s lives (including accommodation, parenting and education). Social workers were seen as being most professionally qualified to take on the holistic role of care coordinator but that it was more common in practice for nurses to take on this responsibility (Welsh Assembly Government 2015). The difficulties of consistency reflect the experience of the CPA in England in which it is implementation rather than agreeing the framework that has been the challenge (Goodwin & Lawton-Smith 2010). Research of care coordination across Wales and England also suggests that there is a difference between how such work ‘is imagined’ and how it such work ‘is done’ (Hannigan et al. 2018). Their interviews reflect a commitment by the coordinators to be relational in their approach but that much of their time is spent completing paperwork (which often changed) and meeting connected targets.

Box 5.3 Survey responses from people regarding care coordination in Wales (Welsh Assembly Government 2016)

Over 91 per cent stated they had a Care and Treatment Plan (CTP) and an equivalent percentage

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