A digital place for people who access services, carers, staff and partner agencies, to share ideas around care co-ordination & care planning in mental health

Update @ 2nd June 2015

My Wellbeing and Recovery Plan will be launched on 8th June 2015; click here for more information.

Donna Kemp

It is now agreed, with thanks to your feedback, voting and discussions at the Service User Network, that the new name for the CPA Care Plan will be My Wellbeing & Recovery Plan. To be clear, this only relates to the care plan, CPA as an approach, framework, process to support people, remains the same.

This change, alongside others relating to the care plan (see below) will come about over the coming months; I will update nearer the time.


Update @ 25th Feb 2014

Many thanks to those of you who let me know your views about the proposed changes to the CPA Care Plan (yes, the name is being voted upon currently but for now I will refer to it as the CPA Care Plan). There are a number of comments on this post, plus emails and a few of you let me know your views in passing.

The full proposed changes can be found here; the main points you made and the changes to come are:

1. You said that the wording for ‘occupying my time’ was not quite right.

The new wording will be ‘Making the most of my time’; this replaces two of the previous domains in the CPA Care Plan

2.  You said that it’s mighty annoying to have to tick lots of boxes just to be able to save the document for later; and, that there is no way to go back to the form to make changes after discussion with the individual.

The ‘review questions will no longer be mandatory.  They do however have clinical relevance and will form part of the full CPA review and as such will need completing. Additionally, the questions will reduce to a yes response rather than a yes/no response where possible; and the focus around offering the care plan will shift to giving the care plan and when this happens (in response to service users telling us that they don’t have a care plan). The aim of this change is to allow clinicians/practitioners to work flexibly. This change will be reviewed after 6 months.

3. The CPA Audit told us that the timeframes for completing actions agreed in the care plan were not always completed.

The 4 sections in the care plan were 1. Goal  2. Action agreed 3. Who is involved 4. The time frames. These are to be restructured to 2 sections:

1. Goals

2. Who is doing what and when/how often?

The aim of this is to provide clinicians/practitioners with a tool that they can use creatively, encouraging staff to record in a way that is more person-centred and less service driven/rigid.

4. The ‘useful contacts’ in the crisis plan section is not always appropriate to people

Ideally this will be made editable so that it can be deleted out or amended; this will have contacts for York and North Yorks added too, once agreed what they need to be.

Next steps will be to formally request the changes; updates will be posted

Donna Kemp

CPA Development Manager

Original Post:

The CPA Care Plan (*name currently under review) has 2 aspects to it.

1. The electronic form (that we see on PARIS – the electronic patient record)

2. The printed Care Plan (that we print from PARIS)

In preparation for Integrated Care Pathways (ICP’s),  in readiness for PARIS becoming available in York and North Yorks and because it has been in use for 3 years, there are some proposed changes to the  electronic form that I would like to consult with staff upon over the next 4 weeks. There may also be changes that you would like to see, that are evident from working with the care plan over time – please share these suggestions on here or via donna.kemp@nhs.net

The proposed changes include the following (click on pic to enlarge it):-

Care plan section 1

CPA Care Plan proposed changes to section 1 – changes to better support flexible, service user focused reviews

care plan section 2

CPA Care Plan proposed changes to section 2 – to reduce questions where possible; to use plain language

CPA Care Plan proposed changes to section 3

CPA Care Plan proposed changes to section 3 – change to section header; reduction in number of boxes to fill – providing more flexibility for care coordinator in completing the care plan with the individual

care plan section 4

CPA Care Plan proposed changes to section 4 – changes to the section headings in response to Service User Network feedback and better use of plain English

CPA Care Plan proposed changes to section 5

CPA Care Plan proposed changes to section 5 – Feedback needed as to what useful contacts should be listed for York and North Yorks, please consider that this is used across all services working with CPA

You can see the changes within the full document here CPA Care Plan content review 2014

Can staff and services please consider the proposed changes and post feedback as comments below or email donna.kemp@nhs.net by 20th February 2014

Many thanks

Donna Kemp


Comments on: "An update on proposed changes to the ‘CPA Care Plan’" (7)

  1. Email received ………….

    Hi Donna

    The useful contacts/crisis plan part of CPA has never been helpful for our SU’s here in prison. Maybe this part could be left blank so we can write in info about Prison services (Samaritans phone, the prison ‘Listeners scheme’).


    Tim Chippendale
    Mental Health Nurse


  2. Siobhan Martin said:


    ‘Is any of the plan Self Dirceted Support of Personal Budgets (FACS Eligible)? – Could this be reworded, for example ‘Is any of this plan delivered via Self Directed Support/ a Personal Budget?’ We wonder if (FACS eligible) is required in the wording or whether this complicates the question as to receive SDS/PB the person will be FACS eligible. It would be useful also to capture whether the SDS care package was reviewed at the same time as the ‘CPA’ Review? (in line with the Recovery Agenda and Integration – promoting best practice).

    It may also be helpful to have a question relating to the consideration of Self Directed support eg ‘Has Self Directed Support/ Personal Budget been considered as part of this plan?’

    Hope this is helpful,

    Siobhan Martin and Jenny Titcombe


    • Hi Siobhan and Jenny,

      Thank you for your helpful comments; they reflect how far self directed support (SDS) and personal budgets have come over the last 3 years! Rewording the question is definitely an option; is SDS featured within the integrated care pathway? If so, we need to make sure there is no duplication.




  3. Email comments received from Allied Health Professional Lead:-

    I am wondering if the change to ‘occupying my time’ rather than work/training/education & meaningful activity is a backwards step in terms of recovery. I can understand that simplifying is important, but occupying my time could be construed as needing to be distracted rather than engaging in or aspiring to something more meaningful. This covers a broad area so I appreciate the difficulty in capturing all the possibilities, as OT’s we often talk in terms of work/productivity, leisure and self-care, which I appreciate won’t mean as much to other people.

    So could it simplified to something more positive like ‘making the most of my time’, ‘best use of my time’, ‘how I want to use my time’, or even aspirational like ‘healthy use of my time’. I’m sure there are lots of other variations on this theme!

    One other thing, can we make it so that you can save the care plan in draft before you have to tick the box about the service users agreement with the plan, so that you can show it to them and ensure that it correctly captures the agreements that have been made.


  4. Iain Turnbull said:

    Hi Donna,

    One idea is to highlight a word or abbreviations which when highlighted, this then explains what the word or abbreviations mean. ie : PARIS. Trans.

    Sorry I don’t how to do that, maybe your IT department can help. Hope this makes sense.



    • Hi Iain,

      Thanks for the comments – a timely reminder to ‘jargon bust’ my posts!

      PARIS is the electronic patient record

      kind regards,



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Dr Sally Pezaro

This is the research blog of Dr Sally Pezaro. Sally is 'The Academic Midwife' working to secure excellence in maternity services. Specialist interests include maternity services, workforce and midwifery research.



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