1. Tower Hamlets Front Door/ Triage Team
Dr Rebecca Adams, Consultant in Child and Adolescent Psychiatry
Dr Olivia Kneen, Clinical Psychologist/ Triage Lead

2. Key aims of Triage/ Front Door
Improve client experience by making contact with clients in a more timely manner and providing information
Reduce waiting list for initial assessment
Improve our DNA rates
Eliminate lengthy process of LRP and be more responsive to incoming referrals by having more weekly meetings
Screen for risk more effectively
Allocate to the right clinician/ team at front door
Reduce the amount of cases allocated for internal transfer
Embed a Thrive Framework to allocations (short term vs longer term)

3. Overall Task/ Mission Statement
To triage or provide a welcome call to all referrals to TH CAMHS within 2 weeks and signpost to the appropriate service within or outside of CAMHS on a triage/ consultation basis.

4. Triage Process 1
1. All incoming referrals will be screened for risk by Duty
Duty to initiate any initial liaison required (e.g. more key referral information needed)
2. Referral taken to next triage meeting (x3 per week) to be allocated to one of three outcomes:
Definitely appropriate Allocate and welcome call
Definitely not appropriate NTO letter sent out
Triage Required Triage clinician to conduct triage assessment

5. Triage Process 2
3.Triage clinician conducts either welcome call or triage assessment (telephone/ face to face) / liaison with professional network:
4.Discussion in next triage meeting –
 Possible Outcomes:
Accepted for Tier 3 CAMHS – allocated to brief or long term work
Recommendations made/ signposted to relevant self help material or to other organisations and then closed to Tier 3 CAMHS

6. Triage Process 3
5. Triage clinicians to feedback outcome of triage assessment/ liaison to family
and complete relevant letter updating outcome to referrer and family (to be sent out by admin)
6. Admin to send out first assessment letters on basis of allocation

7. CAMHS Tower Hamlets Referral received and logged on RIO by admin
CAMHS Duty Team – Duty clinician screens referral for risk, urgency and appropriateness and immediate liaison
CCCAMHS Triage – Clinicians contact families to triage/ welcome to service/ further liaison
First Liaison
Not accept
Allocations / Triage Meeting (x3 per week)
advice/signpost/discharge
Emergency/
Urgent Self Harm: A&E or clinic
CAMHS in Social Care
Book forwards for
-Routine assessment
-Urgent assessment
(Time specified)
Conduct Team
Assertive Outreach
Assessment & Treatment
E&B Team x2 :
-Brief Intervention
-Longer term work---Eating disorders
Neurodevelopmental Team:
ASD, ADHD, LD
Bipolar and Psychosis Team
(and ultra high risk)
London Borough Tower Hamlets team
Max: 3 weeks
MDT Pathway Meetings
Discuss and Review Care Plan and Goals
Discharge
Parent Training
CYP IAPT Groups
Internal referral:
-specific therapy
- co-worker

8. Time frames
Every newly referred young person/family to receive a telephone call within 2 weeks.
Aim for all initial assessments to be conducted within 5 weeks (target reached in April 2016)

9. Changes to Allocation Process
Emotional & Behavioural Pathway
We will allocate to either :
SHORT TERM - “First steps” (up to 6 sessions) or
LONGER TERM (6 sessions plus)
This is in line with the THRIVE Model of care and this will aim to improve throughput through the service

10. THRIVE MODEL

11. Results of Triage transformation:
Initial results for triage – very encouraging: Wait times reduced to 5 weeks for initial assessment (achieved by April 2016) Decrease in DNA rates Increase in client satisfaction with front door process

12. 1. Waiting time for first appointment significant reduced
2. DNA Rates Down
Despite referrals steadily rising

13. What next for Front door TH?
Service hubs/ drop in to be trialled in outreach settings (Emmanuel Miller Centre, Spotlight Youth Centre etc.) to improve accessibility
Embedding text messaging as routine prior to first assessments

14. Discussion
Any thoughts/ questions/ feedback?