Stockton CAMHS: 2009

Stockton map

Service description

The Stockton CAMHS team is a Specialist tier 3 provision, age range 0 to 18 years. The team is multi-disciplinary and provides mental health assessment and a range of evidence based treatment/interventions. Staffing is 28 whole time equivalents (includes LAC service and Tier 2 Team) serving a total population of 187,000. We receive 750 referrals per year.

CAPA experience

CAPA was introduced as part of a New Ways of Working strategy to bring about positive change in how services are delivered. The full report ‘Capacity and Demand Modelling: implementation of the Choice and Partnership Approach (CAPA)’ can be downloaded from www.newwaysofworking.org.uk. Previous short-term strategies had had negative long-term consequences when focused only on parts of the service. Managing the change process was difficult and worked well with clear involvement from the participating team associated with effective managerial leadership and support.

Impact on Users

Improved Patient Pathways: the service now operates with a clear central point of access for service users and agreed consistent pathways internally, which provide a more equitable service for young people. Service users are being offered quicker initial appointments and the team is managing the systems without generating a waiting list.

Impact on team

Moral has improved, less a feeling of ‘being on the treadmill’ Team functioning has improved Better understanding of each other’s roles, skills and competencies

What do we like?

Using an approach that has an evidence base was helpful in overcoming the inevitable challenges in bringing about change.

What helped us?

The team undertaking this project was a well-established CAMHS team with a low turn over of staff. There was a problem solving culture and a ‘can do’ attitude generally. Leadership in the team encouraged inclusion, ownership and democratic problem solving.

Any problems and advice?

‘Initial anxieties from team in relation to proposed changes, some resistance from team members. Use of the information sharing forums and the establishment of working parties within the team helped to engender a sense of ownership and influence over the changes. The Team began to feel that they were integral to the process rather than having systems imposed on them.’

‘Concerns from professional groups regarding the skill and competency work. ‘ ‘Some groups felt threatened by the exercise and suspicions voiced that this was a way to reduce costs and erode professional expertise. It was important over this time to ensure that communication and information was consistent and clear. ‘

‘In a less well established team with poor morale, more time may be needed to prepare and introduce the model to the service. ‘

And finally

‘Teams/managers wishing to adopt this approach may wish to consider inviting other teams who have been successful in their implementation to visit and share experiences. Conversion of a critical mass, motivated and enthusiastic leadership and nomination of a key ‘champion’ will be crucial to success.’

Lessons Learned

‘Finding the balance between supporting staff, allaying anxieties and information sharing with maintaining project momentum.’ ‘It was important that realistic and appropriate timeframes were set and worked towards.’ ‘Ensuring that objectives were clear, owned by the team and understood by everyone involved.’

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

Overall implementation score of 86% = full.