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The use of operationalised criteria for inclusion on a Care Programme Approach register

Mental Health for Older Adult Services, South London and Maudsley Hospital, Denmark Hill, London SE5 8AZ, tel: 080 79192193, fax: 020 79192961

Heidi Hales, Senior House Officer

Mental Health for Older Adult Services, South London and Maudsley Hospital

Bart Sheehan, Lecturer

Section of Old Age Psychiatry, Department of Psychiatry, The Warneford Hospital, Oxford

Suzanne Reeves, Honorary Specialist Registrar

Mental Health for Older Adult Services, South London and Maudsley Hospital

Martin Lawlor, CPA Administrator

South London and Maudsley Hospital

Correspondence: e-mail: yum54{at}dial.pipex.com

AIMS AND METHOD

To determine the rates at which clinical teams within one NHS trust placed older people on a Care Programme Approach (CPA) register and to examine the degree to which clinicians' use of the register conformed to trust policy. Two retrospective case notes surveys were carried out 6 months apart within a completed audit cycle.

RESULTS

Consultant teams varied considerably in their application of the CPA policy. Feedback to clinicians after the first survey had a variety of effects on subsequent use of the CPA register.

CLINICAL IMPLICATIONS

Health service policies exist to reduce variation in clinical practice and to ensure minimum standards. Clinical audit may be a useful tool in identifying irrational variation within the framework of clinical governance.

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