Anywhere CAMHS and Extend Capacity

9. Know your capacity

  • Combine these into a team job plan (see the Implementation section)
  • See if your capacity and demand balance
  • If not, how can you mange this e.g. does the balance of what you do need to change?

Anywhere CAMHS with 10 Full Time Equivalent clinicians calculate that they can see 640 new assessments, of which 400 can be taken on for intervention per year. Each clinician knows their individual capacity, which varies considerably.

10. Avoid unnecessary follow-ups

  • As a team, list what other partner agencies could be approached to offer follow up contact to families
  • Contact those agencies to propose this arrangement.

Anywhere CAMHS asked families of children on stimulant medication to say where they would like to get the growth of their child monitored. Many opted for the school nurse rather than come to the clinic so often, with telephone contact in between.

11. Use meetings effectively

  • Find out when all the meetings are
  • For a week, record in each meeting
  • Whether they start and end on time
  • Whether the task was achieved - If not, why?

Anywhere CAMHS no longer has a whole team referrals meeting. A rota of pairs of clinicians meet for 15 minutes daily and use the service eligibility and diversion criteria to manage referrals.

12. Redesign and extend clinical roles

Do a team exercise:

  • Who has what skills and to what level (think skills not profession)
  • List the skills that the team lacks
  • List the skills that the team does not have enough of
  • Decide, as a team, who could extend their skills or role.

Each member of Anywhere CAMHS takes part in the overdose rota. Training has been provided and there is always a psychiatrist available for telephone consultation.

13. Activity standards

  • Complete individual and team job plans (See Implementation section). Work out everyone’s new case activity.

Anywhere CAMHS clinicians have completed team job planning and worked out their capacity. Andy, the family therapist, has calculated he should take on 9 new cases a quarter (13 weeks) and do 10 to 12 follow-up appointments each week.

14. Monitor Activity

  • Agree who will be responsible for routinely collecting activity for each team member and the whole team
  • Have a system to report that activity to each clinician and their supervisor
  • Make sure an individual’s activity (cases, contacts, indirect work etc) are routinely discussed in supervision.

Anywhere CAMHS decides to have a sheet in the office that shows how many new cases a quarter each of them should see. They tick the relevant number of boxes as they take on each case. Everyone in the team knows what everyone else is doing.

15. Demand and capacity recruitment

  • As a team, list skill gaps
  • Decide how much more of this skill you need
  • Find out if there are existing staff that could develop these skills
  • Agree the level of seniorities of staff you need in your service for your demand e.g. more senior grades to provide strategic leadership and supervision.

The ADHD clinic at Anywhere CAMHS has a long waiting list (bottleneck) and a Clinical Nurse Specialist is recruited to help with initial direct screening.