Good clinical guidelines not only improve outcomes, they can help nurses achieve their personal goals

The development of guidelines has been an important feature in improving mental health nursing in recent years. The 1990 Community Care Act began a change process that continues today – that of implementing best practice based on current knowledge and experience. The Care Programme Approach (CPA) was perhaps the first substantial guideline on the care of those with severe enduring mental health problems. Originally, these guidelines were cumbersome and confusing but the recent partnerships between health and social services have given rise to a CPA framework in which plans are based on individual need and local circumstances. Other changes in the NHS have also led to local guidelines, protocols, care pathways and standards. Mental health trusts, care trusts and primary care trusts have a responsibility to work together to promote best practice.