Community mental health services have improved steadily over the last four years, but trusts must ensure gains are sustained when systems change next month, the Healthcare Commission has said.

A survey of 14,000 service users published today found 74 per cent knew who their care co-ordinator was, compared with 67 per cent in 2004. More users had received a copy of their care plan, up from 49 per cent to 59 per cent, and more had received a care plan review, up to 55 per cent from 49 per cent.

But the report highlighted some concerns. Almost a quarter of clients reported they had not been involved in deciding what was in their care plan. Nearly two thirds had not had access to talking therapies, although half of these wanted them.

Approaches to care

Healthcare Commission chief executive Anna Walker said much improvement was underpinned by the care programme approach, which from next month will be restricted to people with more complex mental health needs. She said: "The survey shows that there remains a significant number of service users who say their care is not co-ordinated and that they are not involved in decisions about their treatment."

She said when the new system comes into effect "trusts should ensure the principles of the care programme approach continue to apply to every service user".

Overall 78 per cent of service users rated their service as excellent, very good or good.

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