Two Names, One Thing — and a Framework That Has Since Moved On.
Care Plan Approach vs Care Programme Approach (CPA): What Replaced It
If you have searched for the "care plan approach", you may actually be looking for the Care Programme Approach (CPA) — the national approach that, for around thirty years, coordinated specialist and community mental health care in England. It is worth being precise, because CPA has changed. For community mental health services, CPA has been superseded by the Community Mental Health Framework for Adults and Older Adults, first published by NHS England in 2019. The transition was carried through the NHS Standard Contract, which from 2021/22 removed the requirement to use CPA, and was confirmed in NHS England's Care Programme Approach position statement (published in 2021, updated to version 2.0 in March 2022). A common point of confusion is the date: the NHS Long Term Plan's figure of almost £1 billion a year by 2023/24 is a funding target for the new community mental health model — it is not the year CPA was "replaced". CPA also has not disappeared everywhere: it continues to be used in some settings, including secure services and prisons. This guide explains what CPA was, what replaced it and when, where it still applies, and what the new model looks like in practice.
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Two Names, One Thing
Why "care plan approach" and "Care Programme Approach" so often refer to the same thing — and why it matters to be precise. CPA is a specific mental health framework, not a general phrase about planning care, and knowing which one you mean changes the answer.
What the Care Programme Approach Was
CPA was the national policy framework, introduced by Department of Health guidance in 1990, for coordinating specialist mental health care — built around care coordination, a written care plan, a named care coordinator, and regular review. It was refreshed in 2008 to a single, streamlined approach.
What Replaced It
For community mental health, CPA has been superseded by the Community Mental Health Framework for Adults and Older Adults, first published by NHS England in 2019 — part of a wider shift set out in the NHS Long Term Plan towards integrated, place-based community mental health care.
The Transition Timeline
The change ran over several years, not a single date: the Framework in 2019, the removal of the CPA requirement in the NHS Standard Contract from 2021/22, and NHS England's position statement in 2021 (updated March 2022). The "2023/24" figure people cite is a funding target, not a replacement date.
Where CPA Still Applies
The change is not a blanket removal. CPA continues to be used in some settings — including secure services and prisons — and elements of it persist in certain specialist services. Knowing where CPA still applies matters if you work across more than one type of service.
What the New Model Looks Like
The Community Mental Health Framework moves from generic care coordination to intervention-based care, a named key worker within a clearer multidisciplinary team, and high-quality, co-produced, personalised care and support planning — while keeping the sound principles CPA was built on.
The problem
Common Questions About CPA
Is the "care plan approach" the same as the Care Programme Approach?
Usually, yes — "care plan approach" is a common way of referring to the Care Programme Approach (CPA). CPA is not a general phrase about how to approach care planning; it is a specific, named mental health framework. If you have found this page looking for how CPA works or what happened to it, you are in the right place. If you genuinely mean the general process of planning care, that is a broader topic — but most people searching this phrase are looking for CPA.
Same thing, most of the time.Has CPA been abolished — and when was it replaced?
CPA has not been abolished by a single Act on a single date, because it was never created by one — it was a policy framework introduced by Department of Health guidance in 1990. For community mental health services it has been superseded, but the change ran across several years: the Community Mental Health Framework was published in 2019, the NHS Standard Contract removed the CPA requirement from 2021/22, and NHS England confirmed the position in 2021 (updated March 2022). It is not accurate to say CPA was "replaced in 2023" — the 2023/24 date that circulates is a funding target in the NHS Long Term Plan, not the year of replacement.
Superseded across 2019–2022, not "replaced in 2023".Does this mean someone currently on CPA loses their care?
No. NHS England was explicit that moving away from CPA does not mean taking away any positive aspects of the care someone on CPA currently receives. The Community Mental Health Framework was designed to retain the sound principles CPA was built on — good care coordination and high-quality care planning — while improving on the parts that were not working. The aim is a better-integrated model, not a withdrawal of support.
The good parts are kept, not removed.Is CPA gone everywhere now?
No. The move away from CPA applies to community mental health services, but CPA continues to be used in some settings — including secure services and prisons — and elements persist in certain specialist services. If your work spans more than one type of service, it is worth checking which framework applies where, rather than assuming CPA has ended across the board.
Community services moved on; some settings still use CPA.What replaces the care coordinator under the new model?
The Community Mental Health Framework shifts from a generic care-coordinator role to a named key worker operating within a clearer multidisciplinary team, alongside high-quality, co-produced and personalised care and support planning. The intent is a move from coordinating services in the abstract to delivering meaningful, individualised interventions — with the person, their goals and their carers at the centre.
A named key worker and personalised planning.Comparison
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How it works
From CPA to the New Community Mental Health Model
CPA Introduced (1990)
The Care Programme Approach was introduced by Department of Health guidance in 1990, with implementation from the early 1990s, to coordinate the care of people using specialist mental health services — through assessment, a care plan, a named care coordinator, and review.
DH guidance, 1990
Refreshed (2008)
CPA was refreshed in 2008, moving from a two-tier "standard and enhanced" system to a single, streamlined approach focused on people with the most complex needs. This was the last major update before the framework itself was superseded.
Refocusing the CPA, 2008
Community Mental Health Framework Published (2019)
NHS England published the Community Mental Health Framework for Adults and Older Adults in 2019, setting out a new, integrated, place-based model for community mental health care as part of the NHS Long Term Plan.
NHS England, 2019
CPA Requirement Removed From the Standard Contract (2021/22)
The NHS Standard Contract for 2021/22 removed the specific requirement to use CPA, with its technical guidance stating that, with the publication of the Community Mental Health Framework, CPA had been superseded.
NHS Standard Contract, 2021/22
Position Statement Confirms the Change (2021, updated 2022)
NHS England published a Care Programme Approach position statement in 2021, updated to version 2.0 in March 2022, confirming the move to the new model, setting out its principles, and making clear where CPA continues to apply.
NHS England position statement
What the New Model Changes
What makes CareVoice the right choice for your documentation needs.
Intervention, Not Just Coordination
Meaningful interventionA shift from generic care coordination to meaningful, intervention-based care — the emphasis moves from administering a process to delivering the specific support a person actually needs.
A Named Key Worker
Clear responsibilityA named key worker for people using the service, within a clearer multidisciplinary team — so responsibility is explicit and the person knows who is coordinating their care.
Co-Produced, Personalised Planning
Built with the personHigh-quality, co-produced, holistic and personalised care and support planning — built with the person rather than for them, keeping the sound care-planning principles CPA was founded on.
Carers Recognised
Carers includedExplicit support for carers as part of the model, reflecting that good community mental health care depends on the people around the person, not just the person alone.
An Accessible, Flexible System
Integrated and place-basedA more accessible and flexible system, designed around integrated, place-based teams so people can get help without being passed between services or thresholds.
Keeping the Picture Current
A second pair of eyesPersonalised care and support planning only works if the record reflects how the person is actually doing — and that drifts between reviews. CareVoice is care intelligence built to keep that picture current, flagging change a busy period might hide for the team to act on. It surfaces what to look at; the practitioner decides what happens next.
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What care professionals have said after using CareVoice
"This platform is a brilliant step forward for making care plans and assessments faster and easier. The design is clear, the process is streamlined, and it's exactly the kind of tool that can save time while keeping everything well-organised. I can see it making a real difference for field teams. Well done to the entire brilliant team behind CareVoice"
Harriette Nyuybinni
Domiciliary Care Field Supervisor
"CareVoice has empowered me as a social worker working with young children. It has streamlined my workflow and provided me with reliable assistance. The detailed analysis and suggestions I receive allow me to confidently delegate my assessments, freeing up my time. Most importantly, the service is affordable, offering great value for money."
Abuh Mowoh
Social Worker, Essex County Council
"As part of our quality assurance efforts, CareVoice has helped us not only ensure compliance but also maintain high standards in line with our regulatory requirements. I really appreciate the voice capture feature and the concept of using voice recognition technology to streamline assessments. This is a very forward-thinking approach that will enhance our processes significantly."
Runya Murape
Quality Assurance Manager
Questions
Frequently asked questions
Is the "care plan approach" the same as the Care Programme Approach?
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"Care plan approach" is almost always a way of referring to the Care Programme Approach (CPA) — the national mental health framework — rather than a general term about planning care. CPA is a specific, named approach for coordinating mental health care, introduced by Department of Health guidance in 1990. If you searched for "care plan approach" and wanted to understand how CPA works or what replaced it, this is the right topic. The two phrases point to the same thing in most contexts.
What is the Care Programme Approach (CPA)?
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The Care Programme Approach was the framework used in England to coordinate the care of people using specialist mental health services. Introduced by Department of Health guidance in 1990 and refreshed in 2008, it was built around four things: a thorough assessment of health and social care needs, a written care plan, a named care coordinator, and regular review. It was a policy framework rather than something created by an Act of Parliament, and for community mental health services it has since been superseded by a newer model.
When was the Care Programme Approach replaced?
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For community mental health services, CPA was superseded over the period from 2019 to 2022, not on a single date. The Community Mental Health Framework for Adults and Older Adults was published by NHS England in 2019; the NHS Standard Contract removed the requirement to use CPA from 2021/22; and NHS England issued a position statement confirming the change in 2021, updated to version 2.0 in March 2022. It is a common mistake to say CPA was "replaced in 2023" — the 2023/24 figure that circulates is a funding target in the NHS Long Term Plan, not the year of replacement.
What replaced the Care Programme Approach?
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For community mental health, CPA has been replaced by the approach set out in the Community Mental Health Framework for Adults and Older Adults, published by NHS England in 2019. The new model moves from generic care coordination to intervention-based care, introduces a named key worker within a clearer multidisciplinary team, and puts high-quality, co-produced, personalised care and support planning at the centre — while retaining the sound care-planning principles CPA was built on.
Does the Care Programme Approach still exist anywhere?
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Yes. The move away from CPA applies to community mental health services, but CPA continues to be used in some settings, including secure services and prisons, and elements of it persist in certain specialist services. It has not been removed across the board, so if you work across different types of mental health service it is worth confirming which framework applies in each rather than assuming CPA has ended everywhere.
What does the new community mental health model look like?
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The Community Mental Health Framework describes an integrated, place-based model: a named key worker within a clearer multidisciplinary team; a shift from generic coordination to meaningful, intervention-based care; high-quality, co-produced and personalised care and support planning; explicit support for carers; and a more accessible, flexible system so people can get help without being passed between services. It is designed to keep the strengths of CPA — good coordination and care planning — while improving access and personalisation.
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Care Programme Approach: Sources
The NHS England and Department of Health sources behind the currency claims on this page.
- NHS England — Community Mental Health Framework for Adults and Older Adults (2019)
- NHS England — Care Programme Approach position statement (2021, version 2.0 March 2022)
- NHS Standard Contract 2021/22 — removed the requirement to use CPA
- NHS Long Term Plan (2019) — the community mental health commitment
- Department of Health — original CPA guidance, 1990
- Department of Health — Refocusing the Care Programme Approach (2008)
- Note: the "£1bn by 2023/24" figure is a funding target, not a replacement date
- CPA continues in some settings, including secure services and prisons
Who This Guide Is For
Anyone working in, moving into, or trying to understand community mental health care.
- Community mental health team staff
- Care coordinators and key workers
- Mental health nurses and social workers
- Approved mental health professionals (AMHPs)
- Registered managers in mental health services
- Supported living and specialist service staff
- People using services, families and carers
- Students and new starters in mental health
Performance
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