Care Programme

Approach
 A brief overview of the previous four Stepping Forwards
exploring aspects of the Care Programme Approach
The Care Programme Approach is the process by which all
Suffolk Mental Health Partnership NHS Trust services are delivered

FOREWORD
Welcome. Its been a real privilege to work on this booklet and to look back over the
previous Stepping Forward events held in both East and West Suffolk. Stepping Forward
has become an invaluable opportunity for Suffolk Mental Health Partnership to give
information about the Care Programme Approach (CPA) and get feedback on how service
users and family carers experience it.

The workshops have only been going a short while but they have already had a
considerable impact on how CPA is being provided in Suffolk. For example: In the very
near future CPA will have its own website that will improve the information available to
service users/ family carers and the general public. Without Stepping Forward and the
contributions of all those that have attended, this would not have been possible.

Thanks to everyone who attends Stepping Forward to help make a difference in the way
CPA is delivered in Suffolk. We hope everyone gets as much enjoyment out of looking
back over what has been achieved in the previous four Stepping Forward events as we
did putting this booklet together.

Chris Crisell, admin support

CONTENTS
Page no
2 Stepping Forward programme
4 Stepping Forward One
6 Stepping Forward Two
7 What happened at Stepping Forward Two
9 Stepping Forward Three
10 Stepping Forward Charter
11 Stepping Forward Four
12 Comments from Stepping Forward Four
13 Recovery (a poem by C. Swann)
14 Work in progress
15 Developing your ideas
16 Conclusion
17 Developmental issues
18 Useful addresses
18 Future activity

Page 1
STEPPING FORWARD WITH THE
CARE PROGRAMME APPROACH (CPA)
SHARING A VISION
As a result of the Service User Survey Management Report (2005)
the SMHP Trust hosted two workshops looking at CPA and the
recovery process. The first for Service users and family carers was on
the 8th Sept 2006 at Kesgrave Community Centre. This led directly on
to the funding of a CPA & clinical risk manager/ practice educator Post.

Jeannie Wright was appointed into this post
in November of 2006 (just two days before
the consultation for the Refocused CPA
document was announced by the
Department of Health).
During this consultation period the
education & workforce development
department initiated a CPA education
development group involving practitioners,
service users and family carers in the
planning, delivery and evaluation of
CPA training.
From this the following activities
occurred during 2007/2008:
• A CPA Health & Social Check was
introduced.
• Service users and family carers
commenced teaching on CPA courses
in the classroom
• The life stories project commenced to
provide educational DVDs for training.
• CPA practice development groups met
in East and West Suffolk.
• The tagged crisis contact card was
designed.
• Care Programme Approach Association
(CPAA) membership for 12 staff was
provided by the Trust.
• Facility for eight voice recognition
Care Plan production kits were
made available
• A clinical risk & recovery practice
educator, (Derek Jones) was also
appointed in May 2008.
• Larry Nicholas was appointed to the
centre for service excellence for public
& patient involvement (PPI).
• Approval for a CPA web site was given.
• Workshops for service users, family carers
and staff were commenced under the
Stepping Forward banner.
• Writing the Positive Risk Management
Policy and Refocused CPA Policy
commenced.

• The draft for a service user care plan

pack and care coordinator resource
pack was developed.

Page 2
Refocusing CPA has presented an
opportunity for substantial changes in
the way we work with service users and
family carers. The language of Refocusing
CPA acknowledges the importance of the
relationship between service users, family
carers and practitioners in providing
person centred services. This booklet
traces the process we have followed in
SMHP Trust to respond to service user and
Page 3
family carer needs at both a service and
individual level. The purpose of tracing
that journey is to identify the status that
CPA and Stepping Forward should have
within SMHP NHS Trust.
Jeannie Wright.
CPA and clinical risk manager/
practice educator
Jeannie Wright.
STEPPING FORWARD ONE
KESGRAVE CONFERENCE CENTRE 1
27th MARCH 08
At the first event our message was:

The Care Programme Approach (CPA)

and care plans are the process we use to
make sure you receive properly planned
and coordinated care. The event is
intended to raise the profile of the CPA
process. It is hoped that many users
and family carers will attend to share
the day and become involved in future
developments within the Trust.

Our Speakers for the day:

Elaine Hanzak shares her personal
journey of her spiral into and out of
puerperal psychosis following the birth
of her son. She described the stages of
her journey including the publication
of her book, subsequent speaking
engagements and her desire to make
a difference for future sufferers.
Aly Gynn, a service user who has been doing
a lot of work for the National Autistic
Society lately. They have just had a high
profile campaign to put through policy
to Government about the needs for
adults with autism.
Len Peace is a family carer who uses his
experience of contact with the mental
health services to speak at many service
user and family carer educational events
in Suffolk.

Tanya Kennard-Campbell is a registered

mental health nurse and has personal
experience of recovery. She has extensive
experience in delivering “recovery and
well-being” workshops to communities
and organisations.

Page 4
THE WORKSHOPS COMMENTS
AND ACTION PLANS
Four groups provided six typed A4 pages of comments about their
service experience and proposed some actions.
Samples of feedback
1. Communication about recovery is
essential, we want more Psychiatrists
here to talk to. Many care coordinators
did not know about this meeting.
The rhetoric of recovery does not
compare with reality.
2. Set up more ways for clients to provide
feedback on experience of services.
Expectations of CPA too high, with a
lack of communication about our illness.
3. ‘Proper’ employment opportunities
are needed for those in recovery; real
work and wages help to improve
self-worth. Must be simpler to gain
benefits when a blip happens. Need
more information on all support
networks that are available.
4. Need to see improvements in CPA and
clinical practice, access to help is difficult
if its not the general practitioners (GP)
that is a block confidentiality is used as
a barrier - families feel blocked out.
Page 5
Actions
1. Follow up on today and often - make
things happen. Improved circulation
of event to service users family carers,
staff and the public.
2. Create “Buddy” support. Create a
website Information/ patient resource
centre - or Library. Develop a resource
on other services. Help service users
and family carers to be fully involved
in delivering training – help service users
to tell their story. Service users and
family carers should be fully involved
in the interview process.
3. Training courses needed that assist
with self management, body language,
presentation skills.
4. Improve communication between all
sectors of SMHP and other agencies.
Wellness recovery plans to back up CPA.
Always provide written information
about CPA to service users and family
carers and it should be in the waiting
rooms and the GP surgeries. We
understand that clinicians ‘move on’
but we would expect continuity of
how the service is delivered even if
done by different clinicians.
STEPPING FORWARD TWO
KESGRAVE COMMUNITY CENTRE 2
17th JULY 08
Our speakers for the day: Workshops

Robert Bolas, deputy chief executive Facilitated group work was held to:
& director of nursing,
Suffolk Mental Health 1. Critique the CPA Service User Leaflet
Partnership NHS Trust 2. A CPA Web site - what should it
gave an update on our address for you?
Foundation Trust 3. Identify what positive risk taking
application and status should mean in the CPA?
and the expected
outcomes of
Calling for Life Stories for CPA
Refocusing CPA.
For some people, the journey of recovery
will mean the involvement of the mental
Peter Moore from the expert patient
health services. This may be in response
programme community interest company.
to a crisis or for others it may be longer
Peter talked about the expert patient
term engagement and support. People’s
programme as “The spark that caused
values, beliefs and expectations can have
a revolution in my life”. The EPP CIC has
an impact on the way relationships
been working hard to develop new
between the individual, family carers
courses designed to meet people’s
and service provider develop. There
different needs, including those in
may be events that could arise throughout
marginalised groups. Some of the other
the period of contact with the mental
courses available include family carer’s
health team that influence the relationship.
courses, a persistent pain programme,
For some there is the experience of
staying positive (workshops for teenagers
disengagement and moving on, which
living with long term health conditions),
can also present some difficulties.
new beginnings (mental health) as well
We want to know about your experiences,
as several disease specific courses.
and if necessary find ways to improve the
way the CPA process works.
Dr Sati Sembhi Consultant psychiatrist
SMHPT, coastal recovery team spoke
about the psychiatrists' role in recovery.
Dr Sembhi has also worked in New Zealand
where care management is also based on
the recovery philosophy. She has specific
interests in cultural psychiatry, family
interventions and perinatal psychiatry.

Page 6
WHAT HAPPENED AT
‘STEPPING FORWARD TWO’
ON 17th JULY 08
The Stepping Forward Event at the
Kesgrave Community Centre was the
third since June 2006 to explore how
service users, family carers and staff
experience the Care Programme Approach
(CPA) and ‘recovery’ process.
Bob Bolas (SMHP director of nursing) and
the lead for implementing new guidance
on CPA. Bob opened the day’s activity
with a talk about the present status of
the Foundation Trust application, the
Care Programme Approach and the concept
of recovery. Bob was keen to attend as
he said that for Recovery to become a
reality then days like ‘Stepping Forward’
create the opportunity to develop the
‘partnership’ approach with service
users and family carers that is going
to move things along.
Larry Nicholas PPI manager described
how the issues raised at the first Stepping
Forward Day held in March had been
addressed. He gave a progress report on
issues such as improving communication
and finding ways to offer good quality
information to service users and family
carers. The CPA website is now more than
an idea, and the information technology
department have assisted in getting to a
point where web pages can now be
developed. The next ‘Stepping Forward
Three’ has been agreed to be held in
Bury St Edmunds in answer to the request
of some service users and family carers
2
Jeannie Wright had contact with some
service users and family carers who
will assist her in the training department
by their contribution to a ‘life story project’.
This will enable people to tell their life
experience and how CPA has impacted on
that - either good or bad and can be used
in teaching sessions with the Trust’s staff.
The stories will be captured on DVD and
can be arranged in any way that the
person felt comfortable with, in person
or anonymous. Derek Jones would like
to hear from people who may wish to
be involved in the development of the
CPA website.
Our first speaker Peter Moore told us
about the expert patient programme.
All trainers have themselves used the
programme, and Peter told us how it had
transformed his own life after being
unwell for many years. It was good to
hear about the programme content as well
as to be inspired by his personal journey
of recovery.

Page 7
Dr Sati Sembhi attended (in response to Who we are:
‘where are the psychiatrists’ from the
previous Stepping Forward day). Bob Bolas
Dr Sembhi gave a very clear account SMHP deputy chief executive,
of her own professional experience of director of nursing
working with recovery, and explained
the importance of choice, individual Derek Jones
responsibility and partnership between clinical risk & recovery practice educator
the service user, family carer and
professional. By listening to the expertise Peter Moore
of the individual service user and expert patient programme community
combining this with more general interest company
knowledge of mental health research,
it’s possible to provide services where Larry Nicholas
everyone feels they have the best public & patient involvement manager
information, and the right to make
informed choices about their care. Dr Sati Sembhi
consultant psychiatrist
The attendees then divided into
three workshops to discuss: Jeannie Wright
CPA & risk manager & practice educator
• The development of the CPA website
• Positive risk taking and what it means
to us
• How we can develop a local leaflet to
inform people about what CPA is.

Jeannie, Larry and Derek want to thank

everyone, not only for attending, but for
the positive involvement and contributions
made in the workshops.

Jeannie Wright and Derek Jones,

Page 8
STEPPING FORWARD THREE
QUAKER HOUSE, BURY ST EDMUNDS
30th OCTOBER 08
Our speakers for the day:
Robin Murray-Neill works for the Care
Services Improvement Partnership (CSIP)
as part of the National Institute for
Mental Health in England (NIMHE)
national social inclusion programme
and personalisation team. This involves
working with organisations and
individuals to educate and inform
them about the process of delivering
individual budgets for service users.
Individual budgets are part of the
‘refocusing the CPA guidance’ as one
choice that trusts should be offering
to service users.
Tom Clements is a member of
Suffolk User Forum (SUF) and helped
to write the drafts of the CPA leaflet.
The latest version of the leaflet was
available in the information pack for
the day. Tom talked about recovery from
his own personal experience. He was
presented with an achievement trophy
by his colleagues as this was his first
presentation of his life story.
Richard Hodgson spoke about his role in
the CPA process as care coordinator.
Richard is a senior occupational therapist
at Newmarket hospital and also undertakes
the role of care coordinator. Richard talked
about how he and Tom work together in
the recovery process
Page 9
3
Workshops
(samples of feedback)
1. Self Directed Support
- with Robin Murray-Neill
• People wanted a transparent system of
equal access made available giving
greater choice and control in the
support that service users receive.
• Care coordinators must give helpful
information to service users and family
carers. “It’s as if when we ask about
direct payments they don’t know
anything about it.”
2. CPA and Recovery
- with Tom Clements & Richard Hodgson
• “Recovery is from where I am to where
I am going”
• “Addressing my aspirations”
• “Working towards small achievable goals”
• “Working in collaboration”
• “Recognising my fear of failure”
• “Turning round the ‘can’t do’ feelings”
• “Developing assertiveness - that’s a
real asset”
3. How can we make a People's
Charter a real and living thing?
It was thought that the Stepping Forward
meetings should have a Charter.
The suggestions were:
Charter for citizens including family carers
and SMHP staff who attend the Stepping
Forward meetings in Suffolk.
STEPPING FORWARD CHARTER

Stepping Forward Charter The Stepping Forward Group will accept

ALL aspects of who I am, my age; abilities;
sexuality and gender; my race, culture
S ervice Users, Carers and Staff. and spirituality.

T raining and Information Sharing. Stepping Forward Events will be held

regularly and in locations agreed by the
E mpowerment Group. If required, Forums will be
P artnership Working arranged to address specific needs of
those of us undertaking specific roles.
S peaking Out
At Stepping Forward Events we will all
listen to each other, treat each other with
respect and make sure that we are heard.

We will all be willing to help each other

and be willing to allow clarification of
what is being talked about if any of us
do not understand.

A record will be made of the work we

do at the meetings. The records will be
used to give feedback to our organisations
to inform future service developments.

Page 10
STEPPING FORWARD FOUR
KESGRAVE CONFERENCE CENTRE
19th FEBRUARY 09
Our speakers for the day:
Larry Nicholas - trust public & patient
involvement manager talked about the
public & patient involvement strategy
for the Suffolk Mental Health Partnership
Trust. Larry facilitated group work on
improving involvement in your mental
health service. Discussion as to whether
the Stepping Forward group has a clear
brief in PPI.
Larry Nicholas
Nigel Moyes - A resident of the Richmond
Fellowship discussed benefits and with
Robin Murray-Neill from social care team
Department of Health gave the latest news
and answered questions about benefits.
Chris Crisell - CPA support administrator
was able to show the latest version of
the CPA website to the audience that
had been developed with Donna Frankis
(who needs the assistance of her guide
dog Nikki) and Colin Williamson.
Garrie Parker - Suffolk Family Carers gave
an enthusiastic and challenging
presentation, sharing his views of
how a service user/ family carer council
might work.
Page 11
4
Workshops
1. How can you influence good
CPA practice?
• Participants suggested an assessment
for all statutory and voluntary
organisations by each other and
also service users views of them.
• Good practice is tailoring support
to each person as an individual.
• Listen to family carers and recognise
and act appropriately on their concerns.
• Why don’t more staff come to these
meetings? They could learn from us.
2. How can we turn the ideas of
this group into an official
communication channel?
• Stepping Forward needs more teeth -
need more managers and funds for
these meetings.
• Have more focussed meetings with
just one subject and a wider range
of feedback mechanisms needed.
• Must continue with current projects,
the need for training and carry on
the good work.
COMMENTS MADE AT
STEPPING FORWARD FOUR
• Concern for people who are unable
to attend and feel isolated. How can
we attract a wider range of people
to such events?
• Can we get someone from each
community mental health team
(CMHT) to come to these days and
learn with us and feedback to
their teams.
• Do staff have enough training about
listening and hearing and the time to
build trust - these things are valued
by service users. Can they be valued
by the Trust?
• It seems to be about the quality of
the relationship - medication is not
the only answer.
• Recovery meetings would give people
a forum to share their experiences,
what helped, who helped, what didn’t.
A focus on recovery for survivors
of psychiatry.
• Appreciation of environment of
people working together to
solve problems.
• More locally based meetings needed.
• Mental health services should provide
low level support in the community to
prevent recurrence of illness - people
need to feel safe.
• Need a better method of telling the
Trust if CPA’s not functioning.
Page 12
4
• CPA website looks excellent, could be
the answer to my questions.
• The website looks very interesting and
easy to use. People need to access
privately and add their comments.
• The conference is not age inclusive.
• Not sure where stepping forward
is leading.
• Not Learning Disabilities (LD) focused,
more adult mental health (AMH)
orientated.
• Need more Information about
the CPA process.
• Not child and adolescent mental
health service (CAMHS) focused,
more (AMH) orientated.
• I don’t enjoy conferences.
• Too many abbreviations are used.
• Need for a CPA basics day.
• There should be more background
information available about the
speakers on the day.
• Everyone should introduce themselves
around the table to get a better
perspective of the direction of the
views they are coming from.
 Recovery to me is:
Walking in a room full of strangers,
And not being afraid.
Being happy to catch a train alone.
Doing that college course you have always
wanted to do.

Feeling good when someone says

hello, Carla,
How are you?

Being proud to say,

Ive lived through mental illness,
Look at me now!!!
Being respected for my knowledge,
And asked my opinion.
Being able to talk to others,
Because I,ve been there.

Having the experience to help others

Find their wings and fly.
To be able to be angry,
Without it being blamed on my illness.
Lighting up the room,
When I walk in, once more.
Sharing these feelings with others and being heard

Thank you

Carla Swann S.U.F

7th May 2006

Page 13
WORK IN PROGRESS
Life Stories:
The Life Stories DVDs are being made
with the generous help and contribution
of service users and family carers, and
once made will be used in the Trust for
teaching purposes only. The DVD is a
collection of true stories set in a Care
Programme Approach context to illustrate
the activities that makes up the CPA.
That is: the referral from family doctor
or any other agency; assessment; care
planning; review and Care Co-ordination.
This is done through the experiences of
people who have had or still do experience
mental distress and the people that support
and take care of them. We are interested
in the process of recovery from mental
distress and the challenges that face
people when trying to pick up their
preferred lifestyle again.
The way people contribute is led by
themselves and their involvement is always
at a level that maintains their comfort in
the process. When someone decides to help,
an individual appointment is made with the
person at their convenience and it is agreed
how to capture their contribution in their
chosen setting. To ensure that people are
in control of the process and how it is used;
a contract is made so that service users and
family carers can specify what restrictions
they may want to put on their part of the
process e.g. they may wish to use another
name. People are also free to withdraw
consent later on if they change their mind.
Page 14
Training:
The DVD will not be copied and will be
treated within the Suffolk Mental
Health Partnership Trust with the same
degree of responsibility that applies to
other Service user or family carers data.
The idea came about as a result of service
users and family carers feeling unprepared
for the pressure of a regular commitment
to a training schedule they provide for
staff about their experience of CPA.
To enable their contribution to be
available at all times the DVDs are a
good training resource. The next DVD to
be made is the story of three service users,
following their recovery, who wish to illustrate
some of the problems encountered by
people trying to regain employment
after mental illness.
Please contact Jeannie Wright for more
information on the Stepping Forward
DVD. Tel: 01473 329347.
email: jeannie.wright@smhp.nhs.uk
DEVELOPING YOUR IDEAS

Through the previous Stepping Forward gatherings you have been talking
about how we can improve our services. I hope that by reading the
introduction you will have seen what has been achieved so far.

At the first Stepping Forward it was
suggested that a CPA specific website
would be useful. It should provide you
with information and also enable you to
communicate with other interested people
about CPA. Although the website is not
yet complete the work is being done to
make everything you asked for a reality.
The CPA website will be part of the SMHP
website that exists now. We have looked
at all the comments from the previous
Stepping Forwards to come up with a
format that is both welcoming and easy
to use.
Through the work done during this process
it was suggested that a logo should
accompany the website and give CPA in
Suffolk its own identity. The logo will be
decided by service users, family carers and
professional (see logo’s below).
This gives CPA in Suffolk an instantly
recognisable identity and will show a
professional approach. The competition
closed on 17/5/09.
Another project from Stepping Forward
Two is the development of the CPA leaflet
produced by service users for service users.
The leaflet is a good example of how
Stepping Forward is closing the perceived
distance between service users and
professionals. Because those involved with
Stepping Forward have been able to work
closely with each other we aim to produce
a leaflet that is not just informative but
written in a style preferred by you.

Page 15
CONCLUSION

The Stepping Forward process has:
• Helped to enhance effective
communication - e.g. what is CPA;
recovery; expert by experience; the
role of my Care Coordinator;
individual budgets.
• Helped to promote effective
partnerships; SMHP Staff with –
e.g. SUF; Suffolk Family Carers; East
Suffolk Advocacy Network (ESAN);
Mind; Richmond Fellowship and
Suffolk Employment Care.
The value of the Stepping Forward
process is:
• SMHP Trust routinely listening and
recording the needs of service users
and family carers.
• Enabling people in vulnerable
circumstances and poor health to
get their experiences and views heard.
• SMHP Trust acknowledging the
contribution of its customers in
adding value to its care delivery.

• Encouraged participation in decision • In facilitating an opportunity for SMHP

making – e.g. designing. Trust to act on the views of service users
and the public in its decision making
• Information leaflet; content of the day; about the Care Programme Approach.
how we can be more helpful.

• Provided an opportunity to debate issues;

workshops for key care issues e.g.
recovery; service user and family carer
involvement; positive risk taking; direct
payments and individual budgets.

• Helped to ‘capture’ the creativity of

individuals and groups in finding new
solutions to problems e.g. communication
by website; text; buddy system; life
stories; training and poetry.

Jennie Wright and Derek Jones in the office.

Page 16
DEVELOPMENTAL ISSUES

• For SMHP Trust to cement the joint
work of the education and workforce
development department and patient
and public involvement by jointly
funding the Stepping Forward
Programme for the future.
• Enable our local service groups and
staff to acquire the skills and resources
needed to ensure that all people can be
effectively involved in decisions about
the delivery of secondary mental
health services.

• To provide an annual budget for the
Care Programme Approach
developmental work e.g. facilitate
the “buddy” system; text service;
personalisation programme.
• Please contact Jeannie Wright for more
information on the Stepping Forward
DVD. Tel: 01473 329347.
email: jeannie.wright@smhp.nhs.uk

• To provide resources to enable the CPA

website to “go live” and be maintained
for service users; carers; staff and the
public and also to allow the publication
of the CPA service users leaflet.

• To integrate the Stepping Forward

programme into the clinical
governance strategy for SMHP Trust.

• Enable the voice of hard to engage

groups to be heard in more creative
ways, these are; black and minority
ethnic communities; older people;
people with learning disabilities;
disabled people; children and young
people who receive services under
the Care Programme Approach.

Page 17
USEFUL ADDRESSES

Suffolk User Forum PALS Office Public & patient Involvement

Suffolk House, St Clements Hospital Larry Nicholas
St Clements Hospital, Freepost RRKY-AAKL-UEUS PPI Manager
Foxhall Road, Suffolk Support Services Foundation Trust
Ipswich, P.O. BOX 170 Project Office
IP3 8LS IP3 8PS St Clements Hospital
Freepost RRKY-AAKL-UEUS
ESAN East Suffolk Education Suffolk Support Services
Advocacy Network and Workforce PO BOX 170
St Clements Hospital, Development Department, IP3 8LS
Foxhall Road, 1st Floor, St. Clements
Ipswich, Hospital, SMHP Voluntary Services
IP3 8LS Foxhall Road, Mark Stewart
Ipswich, Voluntary Services Manager
Suffolk Family Carers IP3 8LS. Suffolk Mental Health
Units 6 & 8 Partnership NHS Trust
Hill View Business Park, Respite Foundation Trust
Old Ipswich Road, 3 Constable Court, Project Office
Claydon, The Street, Belstead, St Clements Hospital
IP6 0AJ Ipswich, Foxhall Road
IP8 3LY Ipswich
IP3 8LS

FUTURE ACTIVITY
Stepping Forward Five Stepping Forward Seven
5 Kesgrave Conference Centre
21/05/09 7 Kesgrave Conference Centre
19/11/09

Stepping Forward Six Stepping Forward Eight

6 Quaker Meeting Room,

Bury St Edmunds
8 Kesgrave Conference Centre
18/02/10
20/08/09

Page 18
 USER AND CARER INVOLVEMENT WITHIN
THE CARE PROGRAMME APPROACH (CPA)
PROCESS IN SMHP TRUST

Our successes 2007/2008

The Care Programme Approach (CPA) and Care Planning is the process
we use to make sure you receive properly planned and coordinated care.

Involvement as Service User’s and Carers

1 - Service Users Engaging as partners in their own Care Plan
2 - Carers engaging as partners in the Carers Assessment and Care Plan.
3 - CPA Training Development Group
4 - Users & Carers lecturing in the CPA Classroom
5 - Contributing to the CPA stories project

Involvement with Clinicians

6 - Suffolk (West) CPA Practice Development Group
7 - Suffolk (East) CPA Practice Development Group
8 - Contributing in an Open Event like todays.

Involvement with
SMHPT Management
9 - Suffolk CPA Practice Development Group
10 - Standards Committee

11 - Future Involvement with the

Foundation
Trust

NORTH

S.U.F.
WEST EAST

© 2009. SMHPT. Ref: Comms/SMHPT/0154