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The NHS and Community Care Act, 1990: Recent government policy and legislation

  • Graham Thornicroft (a1) (a2)
Extract

This is the first in a series of articles to be published serially in the Psychiatric Bulletin on recent government policy and legislation. Each article will describe a different piece of legislation and place it in its international perspective, highlighting how it will affect individual psychiatric practice, users of mental health services and the working relationship with purchasers and managers. The articles are aimed at all practising psychiatrists and those in training who wish to familiarise themselves with the important recent legislation that is having a profound effect on the practice of psychiatry in the UK. The legislation that will be covered includes the NHS and Community Care Act, The Health of the Nation community care plans and mental illness specific grant, the care programme approach, discharge and aftercare planning procedures, NHS trusts, fundholding and commissioning general practitioners and the purchaser provider split. There will be a summarising article to reflect common themes and trends. The series was commissioned by Dr Sara Davies and Dr Jeanette Smith, Trainee Editors at the Psychiatric Bulletin.

The National Health Service and Community Care Act, 1990, enacts some provisions contained in the Working for Patients and Caring for People White Papers. The former measures were introduced immediately in 1990 and contain, for example, the legal basis for NHS trusts and fund-holding GPs. Most of the community care sections of the Act were delayed in their implementation until April 1993. The key element is allocating the main coordinating responsibility as ‘lead agency’ to local social service authorities; they are charged with conducting ‘needs assessments’ on clients presenting with problems. Whether, however, there is a legal obligation upon social services departments to provide care for people with unmet needs to not yet dear.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Audit Commission (1986) Making a Reality of Community Care. London: HMSO.
Blom-Cooper, L. & Murphy, E. (1991) Mental health services and resources. Psychiatric Bulletin, 15, 665668.
British Medical Association (1992) Priorities for Community Care. A BMA Report. London: BMA.
Department of Health and Social Services Inspectorate (1991) Care Management and Assessment Summary of Practice Guidance. London: HMSO.
Griffiths, R. (1988) Community Care: an Agenda for Action. London: HMSO. Page V.
House of Commons (1990) The National Health Service and Community Care Act. London: HMSO.
Laming, H. (1992) Implementing Caring for People. Assessment. London: Social Services Inspectorate. Department of Health.
Murphy, E. (1987) Community care: I problems. British Medical Journal. 295, 15051508.
Murphy, E. (1988) Community care: II possible solutions. British Medical Journal. 296, 68.
Onyett, S. (1992) Case Management in Mental Health. London: Chapman & Hall.
Secretaries of State for Health, Social Security, Wales and Scotland (1989) Caring for People. Community Care in the Next Decade and Beyond. London: HMSO. (Cmnd 849). (Page 21).
Secretaries of State for Health, Wales, Northern Ireland and Scotland. (1989) Working for Patients. London: HMSO.
Secretaries of State for Health, Wales, Northern Ireland and Scotland. (1990) Medical Audit. Caring for People. London: HMSO.
Thornicroft, G. (1991) The concept of case management for long-term mental illness. International Review of Psychiatry. 3, 125132.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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The NHS and Community Care Act, 1990: Recent government policy and legislation

  • Graham Thornicroft (a1) (a2)
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