Lincolshire CAMHS

Lincoln map

Service description

Lincoln is a Specific, Tier 3 CAMHS. We have 15 FTE with staff from nursing, psychiatry, psychology, social work and education. We serve a whole population of 212K and average 20 referrals per week.

CAPA experience

Preparation took 7 months and we started in February 2007 and successfully continues!

Impact

Waiting time to first appointment reduced from 25 weeks to 6 weeks. Abolished waiting list of 77.

‘The turnaround has been remarkable and from a service that at one stage was reporting monthly to Board because of our waiting times, we are now acknowledged as one of the services performing well within the Trust.’

What do we like?

‘the transparentness of how many new cases each of us should be seeing’ ‘the ability to make decisions about whether to offer a service in situ with a family not just from the referral letter’ ‘above all the reactions of families and referrers who are pleasantly surprised at how quickly they/their patients will be seen.’

What helped us?

‘Overall a sense that 28 week waiting time we had to change! Doing nothing was not an option.’ ‘Individuals drive and enthusiasm!’ ‘Able and committed admin support has to be probably at the top of my personal list about what helps.’ ‘Being a cohesive team helped us survive the inevitable anxieties and tensions.’ ‘A Management CAPA lead and a CAPA facilitator as two separate people.’ ‘Having an early implementer site was crucial. And absolutely critical in that was the strength of leadership that A brought to the clinical team. There was some strong support in the team but also many waverers. It is true to say that this success would not have been achieved without her and the committed support of respected practitioners and managers like C.’ ‘..a real morale booster as the teams often felt they were ahead of the game having been regularly told they are a bit of a rural/coastal backwater, we were up to speed with new changes/new bid monies/ successful in 2 bids for pilot sites.’ ‘a team member with a head for figures to my “shopping list” for the essential elements of a team starting CAPA.’ ‘The book proved useful to dip into and keep us on track with the CAPA model from time to time: we judged it important to try and replicate “pure” CAPA and prove its workability for us before venturing into adapting it. ‘

Any problems and advice?

‘ Team support and time to change was also an important ingredient we are now several months down the line and it needed to take that long for true Cultural shifts to occur…don’t rush it but keep up the pace so it doesn’t flounder. ‘

And finally

‘We couldn’t have done it without the strength of the team and our respect for each other and each others different views …’

Overall implementation score of 86% = full.

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.

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

‘The amber for item 5, full booking, is explained as we do have a partnership diary with everyone’s availability pre booked. However, we have a reflection meeting with all the Choice clinicians prior to the Choice clinic and then again straight after the clinic where we decide the best clinician after reflection then the clinician contacts the family straight away to book them into the slot (either by letter with the Choice summary or by phone if it is urgent Partnership). We think this works really well and makes us think together about skills and needs but is kept in a tight framework and timescale e.g. same day discussion.’

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