It was introduced to England in 1991 DEPARTMENT OF HEALTH ( 1990 ) Care Programme Approach Circular HC ( 90 ) 23/LASSL ( 90 ) 11 .
It was introduced to England in 1991 Department of Health ( 1990 ) . 
 '' Care Programme Approach '' Circular HC ( 90 ) 23/LASSL ( 90 ) 11 .