Gloucester CAMHS

We work in a Tier 3 CAMHS in a diverse urban setting with high levels of deprivation within a predominantly rural county. Referrals accepted from all professionals. In 2006/7 we had 338 referrals and accepted approximately 69% into Tier 3, with many being signposted as the new tier 2 service developed. Ages 0-18, LD and 24/7 out of hours on call system catered for. Population 124,578. DSH rota provided. Small multi-disciplinary team with many part time staff 5.98 FTE.

CAPA experience

Planning took 9 months. We started July 2006. We developed standard letters and job plans. There were lots of heated debates! The waiting list blitz of 39 families took 1 month.

Impact

Most families seen within 3-4 weeks for Choice and 4 weeks for Partnership. Feedback from staff and users was positive. 100% of families liked to telephone booking system; felt involved in the decision-making and would recommend the service to a friend. 80% of staff reported higher levels of job satisfaction.

What do we like?

‘I enjoy being part of a positive, fresh, pro-active initiative with like-minded colleagues and a united and supportive team ethic.’ ‘GPs think it’s brilliant.’

What helped us?

‘Team commitment to reduce waiting list.’ ‘Needs a champion/team management.’ ‘Backing from CAMHS Management Team, Trust Executive, local Emotional Well-being Board and commissioners.’ ‘Admin staff.’ ‘Containing our anxiety.’

Any problems and advice?

‘Staff reductions equal quantifiable loss of capacity- wait for Choice and Partnership increased.’ ‘Actual demand has risen - showing hidden need [previously] artificially suppressed by waiting list.’ But this has led to ‘commissioners acknowledge we are under-resourced.’ ‘Self-harm follow-up needs integrating.’ ‘Job plans need to be set with service needs in mind, not just individual’s own preferences.’ ‘Pick a good moment to start…’

And finally

‘It’s like we’ve been through something epic as a team’ ‘We’ve bonded.’

CAPA 11 components

This is the rating scale of the 11 components of CAPA: a green light is fully implemented, amber is partial and red is not implemented.

No.	Component	Score
1	Leadership	2
2	Language	2
3	Handle Demand	2
4	Choice Framework	2
5	Full Booking	2
6	Selecting by Skill	2
7	Extended Skills	2
8	Job Plans	2
9	Goal Setting	1
10	Peer Group Supervision	2
11	Team Away Days	2

A full implementation of CAPA - 97% (see CAPA-CRS)!