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Improving mental health care planning and coordination

COCAPP knowledge exchange event involved mental health professionals, carers and service users


Mental health professionals, service users and carers from across the UK came to City towards the end of July to talk about the recent results from the COCAPP study, and to discuss how practice in the sector can be improved.

Carried about by academics at City University London, Cardiff University and Swansea University, the study found that mental health service users saw the relationships with their care coordinators as being central to their recovery and felt that care plans were largely irrelevant.

The study, published in BioMed Central Psychiatry, also found that care coordinators saw care plans as a useful record but also as an inflexible administrative burden that restricted time with service users. Risk was also a significant concern for workers, but was rarely discussed with service users.

A further COCAPP study looked at acute care, with the conclusions supporting initial findings from the first COCAPP around issues such as risk, care plans, relationships and perceptions of care.

Following on from this work, the aim of the event was to use the research findings to inform and generate new ideas for developing and improving how mental health care is planned and coordinated. This included disseminating the results of the COCAPP studies as well as providing an opportunity for NHS Trusts/Health Boards to share ideas of good practice between services and localities.

This also includes the opportunity to create ‘impact communities’ within the research sites which will support ongoing discussions and dissemination of work around care planning and coordination in mental health services.

Following an introduction from Professor Alan Simpson, who led the COCAPP project at City, participants attended two workshops based around three different topics, with the aim of trying to identify ideas to take back to organisations to develop further with staff and service users. The three workshops were:

  • Therapeutic relationships – building therapeutic relationships to underpin care planning and coordination
  • Working in partnership – working in partnership with service users and carers to deliver recovery focused care plans
  • Risk and safety – discussing sensitive issues of risk and safety with service users and carers in clinical practice

Following discussions, participants voted on the two best ideas from each workshop, with the results then shared with audience at the end of the day.

In the therapeutic relationships workshop, people discussed how regular ratings on the quality of therapeutic relationships and services would enable transparency and provide an opportunity for feedback. Greater involvement of services users in planning, and also training for professionals about therapeutic relationships was also popular.

In the working in partnership workshops, outcomes highlighted that the process needed to change and the importance of relationships. Participants mentioned that it’s was not just about the process, but also the value of relationships, and also engagement from family and friends. Clarification on the purpose and format of care plans was also widely spoken about.

Lastly, discussions around risk and safety also showed the need for more open dialogue and open accessible language, and also for more integration of risk assessments into care plans.

Speaking about the day, Professor Alan Simpson said:

“It was great to have such a wide range of professionals, carers and service users at the event to not only share the results of our COCAPP studies, but also use the workshops to find out what our fellow professionals and service users think we should prioritise and take back to our respective trusts.

“By using the workshops, we hope to develop a COCAPP action plan which is a chance to develop a local plan to make sustained positive changes in practice and policy relating to care planning and coordination. To make this impact sustainable we need to create ’impact communities’ within NHS Trusts and health boards to keep discussions and development going, and also support service user and carer champions promoting the work via community organisations and support groups.”

The COCAPP project was funded by the National Institute for Health Research Health Services and Delivery Research Programme (HS&DR 1/2004/12).

The views and opinions expressed are those of the authors and do not necessarily reflect those of the HS&DR Programme, NIHR, NHS or the Department of Health.

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