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This position paper focuses on the current tensions and challenges of aligning inpatient care with innovations in mental health services. It argues that a cultural shift is required within inpatient services. Obstacles to change including traditional perceptions of the role and responsibilities of the psychiatrist are discussed. The paper urges all staff working in acute care to reflect on the service that they provide, and to consider how the adoption of new ways of working might revolutionise the organisational culture. This cultural shift offers inpatient staff the opportunity to fully utilise their expertise. New ways of working may be perceived as a threat to existing roles and responsibilities or as an exciting opportunity for professional development with increased job satisfaction. Above all, the move to new ways of working, which is gathering pace throughout the UK, could offer service users1 a quality of care that meets their needs and expectations.

The Care Programme Approach (CPA) is the fundamental framework for supporting the care and treatment of individuals with severe and complex mental health needs. National consultations with stakeholders (Department of Health, 2006) identified a lack of consistency in the implementation of the CPA across England, informed fresh guidance (Department of Health, 2008a) and highlighted the need for a valid and flexible training initiative to support the workforce in this important aspect of their practice. In response, a partnership team was commissioned by the Department of Health to design and disseminate such a learning resource. This paper details the first impressions of this resource from those who requested the materials and subsequently responded with an online evaluation questionnaire (n=27).These early responses demonstrate that the CPA learning resource is viewed by respondents as flexible, easy‐to‐use and comprehensive. In addition, DVD narratives of professionals, service users and carers' experiences of CPA in adult mental health services were identified as valuable elements of the resource as they assist trainers in the illustration of critical themes. Further results explore its utility in the training environment and highlight flexibility of delivery as an important feature. This enables the resource to be integrated with existing training materials or to guide the development of new training initiatives. As further evaluations are collected and analysed, they will feed into a process of incremental improvement of the learning package to ensure that it meets the requirements of the multidisciplinary workforce.

The New Ways of Working national programme was started by psychiatrists (through the Royal College of Psychiatrists) when it became apparent that the roles they were being asked to carry out were unrealistic in their demands. This had contributed to a drop in recruitment and early retirement for psychiatrists in post. The New Ways of Working programme led to a reconfiguration of mental health services in many areas and an increase in the numbers of psychiatrists as well as improved levels of job satisfaction.This paper describes some of the challenges that still need to be met if New Ways of Working is to be fully implemented.