Capacity is the combination of our skill base (staff) and the “kit” required to deliver that skill. If we have enough rooms (our kit) our capacity is fixed by the number of staff we have and their current job plans. Again capacity is not the number of clinical staff we have but the number of clinical hours they can deploy. The illustration of the crate is to help you see that our capacity, in terms of hours, is fixed but that the number of pieces of fruit we can fit in will vary a lot on the size of the fruit. We can get in an awful lot more Kiwi fruit than melons!

Example 2: Anytown CAMHS has 7 FTE clinicians. Each provides 8 sessions of clinical work (1 team meeting, 1 admin and 8 direct clinical). In each session a clinician can do 2 clinical appointments (direct clinical hours) plus supporting admin. (This is an approximation as all staff should also be doing supervision and CPD but these tasks are fitted around the defined hours and simplified as above).

7 FTE x 8 sessions x 2 direct clinical hours per session = 112 direct clinical hours per week for 45 weeks (holiday and sick / study leave) = 112 x 45 = 5040.

Example 3: To understand how the maths works we can combine the above two examples. We have shown that the 800 referrals a year produce a demand for 4320 direct clinical hours and that the team can provide 5040 direct clinical hours. Thus if they were 100% efficient (impossible) there is a spare capacity of 730 direct clinical hours per year. Thus they can reduce their waiting list by 80 cases per year (730 hours divided by 9 hours per family = 80 cases). However we suggest the aim should be to work at 80% to allow spare capacity for emergencies etc, (in line with the recommendations of the Modernisation Agency). This means that their 5040 hours becomes 4032 hours (5040 x 80%), which is 288 hours less than they need. Their waiting list will climb by 32 cases (they are 288 hours short which at 9 hours per family = 32 referrals not seen).

If they don’t do something different! Implement CAPA!!