The full and final report from COCAPP-A has been published, and can be downloaded here. Led by Alan Simpson, this cross-national comparative case study investigated inpatient mental health care planning and coordination and their relationships to recovery and personalised care in six NHS organisations in England and Wales. COCAPP-A is the partner project to COCAPP, which asked similar questions about community mental health care in the same six sites.
The full COCAPP-A report is a substantial document, but also comes with summaries. Here’s the plain English one to give people a flavour:
Care planning processes in mental health wards should be personalised, conducted in collaboration with service users and focused on recovery.
We conducted a study on 19 wards in six NHS mental health hospitals in England and Wales. Over 330 service users, 320 staff and some carers completed questionnaires and took part in interviews. We also reviewed care plans and care review meetings.
We aimed to identify factors that helped staff in, or prevented staff from, providing care that was discussed with service users and that supported recovery.
When the ward seemed more recovery focused, service users rated the quality of care and the quality of therapeutic relationships highly. Staff rated the quality of relationships with service users better than did service users.
Staff spoke of the importance of involving service users in care planning, but from both interviews and care plan reviews it appeared that, often, this did not happen. Staff were trying to work with people to help their recovery, but they were sometimes unsure how to achieve this when service users were very distressed or had been detained under the law. Service users and carers often said that care was good and provided in an individualised way. Keeping people safe was important to staff, and service users were aware of measures taken to keep them safe, although these were not always discussed with them.
Our results suggest that there is widespread commitment to safe, respectful, compassionate care. The results also support the need for research to investigate how staff can increase their time with service users and carers, and how they can involve people more in discussions about their own care and safety.
There’s plenty of work ahead with journal articles to be produced, derived from the larger document. As the COCAPP and COCAPP-A teams now have community and hospital data relating to the same organisations we also have the opportunity to draw conclusions from both studies. This work has already commenced: Michael Coffey and Sally Barlow have taken a paper titled, ‘Barriers to, and facilitators of, recovery-focused care planning and coordination in UK mental health services: findings from COCAPP and COCAPPA’ to this year’s #MHNR2017, Refocus on Recovery and ENMESH conferences.Follow @benhannigan