Steve Kingsbury and Ann York

Letting Go of Families Part of the ELF Tends to be one of the Habits we find hardest Helps with E: Extend capacity F: Flow management

Habit Handle Demand Extend capacity. Let go of families. Process map and redesign. Flow management. Use Care Bundles. Look after staff. Average 43% 40% 30% 38% 8% 68% Data from 100 teams in 2005 Average total score 38% (42/111)

Variation Natural variation Users are different We are different Artificial variation How we do things (structures and processes) Research shows that artificial variation affects services most!

L et go of families Every contact with a family / young person involves a Choice of Another appointment or Not… How do we decide which is which?

L and Artificial variation in CAMHS We tend to have well thought through standard processes to get into the service But how do you get out? DNA?

Letting go exercise I Get into small groups Think about the reasons that make it hard to let go Choose what you think are the most important 3 and write them on post it notes…

Working towards ending What is your prevailing team value system? Long term support of vulnerable families to promote development Quick crisis resolution and close What is yours?

Letting go exercise II Get into small groups Think about the reasons that make it hard to let go Then think of things you or our service could do to make it easier Choose what you think are the most important 3 and write them on post it notes…

Solutions… Closing tends to be easier when End point is clear e.g. menstruation returns in anorexia nervosa Psychosis resolves You are leaving! End point is clear- you won’t be there! Families don’t want to start again Limited session models Endpoint is clear- used up the sessions But the work may not be done The family / young person have made the changes they wanted (CHOICE!)

And… …You have time to close Admin/liaison time in job plan Review times with families Multidisciplinary discussion and supervision

Recap: Always work towards ending Ensure it is in your literature Remind users at all stages Remind referrers! Remind yourself! Have standard processes to help you