Anywhere CAMHS and Handle Demand
1. Eligibility Criteria
- Write down the gaps
- Take all the criteria to the commissioning meeting
- Agree the revised criteria
- Then make sure you check every referral against your eligibility criteria and monitor how well they are working!
Anywhere CAMHS now requires referrers to see the child before referral as they discovered that, to their surprise, quite often the child had not been seen.
2. Diversion Criteria
- Talk to those agencies to agree that you can divert suitable cases to them and vice versa
- Write these agreements down
- Take these agreements to the commissioning meeting.
They provide training and support for local health visitors and school nurses who now see families with children under 10 who have non-complex behavioural or emotional problems such as separation anxiety. Parents can refer themselves to the service.
3. Priority Criteria
- As a team reduce the number of priority streams to two
- Agree which problems will go into each category
- Define how quickly each priority will be seen
- Take to the commissioning meeting.
The team decided that their emergency criteria were psychosis, Body Mass Index < 15 and severe risk of death (actual harm or very clear suicidal intent). Emergencies are seen within 48 hours, according to need. The psychiatrists and nurses see the young people with possible psychosis or low body weight and all the team are on the rota for self-harm assessment.
4. Service Level Agreement
- Calculate your capacity
- Describe how many first appointments, core interventions and specialist interventions you can do
- Describe what staffing and skills you need to do this
- Take this information to the commissioning meeting
- Get managers and commissioners to agree an SLA based on this information.
Anywhere CAMHS negotiates to provide 400 new interventions for families per year and 15 assessments for autism.
5. CAMHS Strategy
- Write down what is needed to meet the gaps
- Calculate the capacity needed and skills
- Take to the commissioning meeting
- Agree the plan for the next 3 to 5 years
- Agree the plan for the next 3 to 5 years including how any money will be spent or redirected.
They realised that their commissioners did not have sufficient understanding of what they did, so they invited them to visit different parts of the service.
6. Full Booking
- Start a system that offers users a choice of at least two appointments on different days and at different times when they contact you for an appointment
- Have a system for vulnerable families who may not be able to contact you to book in. Still offer choice
- Make sure full booking applies to all parts of your service, not just the first appointment.
Since implementing CAPA, Anywhere CAMHS has no waiting list and now writes to families on the day that their referral is accepted. When they phone in to arrange an appointment the admin staff offer a choice of two on different days and at different times and book them in.
7. Screen referrals by direct contact
- Offer a first appointment that focuses on offering informed choice to users
- Ensure the first appointment motivates and facilitates change
- Provide educational materials/videos etc at the first appointment
- Write back to the family and referrer within a few days of the first appointment.
Anywhere CAMHS establishes a system where they can see families quickly and directly. They use information leaflets, brief intervention techniques and rapid written feedback to family and referrer. Families that return to the service book their next appointment at the end of their first appointment. A letter goes to the family and referrer within 48 hours, summarising the contact and plan.
8. Flex your capacity
Anywhere CAMHS aims to see families within 4 weeks of referral. The team monitors the referral rate weekly and ensures enough Choice appointments are available so that all families can be seen within the 4 weeks.