1. CAPA The Choice and Partnership Approach Summary of research and evaluation to 2010 Ann York and Steve Kingsbury rowe.york@btinternet.com steve.kingsbury@hertspartsft.nhs.uk www.camhsnetwork.co.uk

2. Overview  This slide set is an overview of the current audit and research into CAPA  Full details are available on the website www.camhsnetwork.co.uk

3. How many studies? National (3)  1 UK 2007  1 England 2009  1 New Zealand 2010 Local (16) CAMHS  2 NZ  1 Australia  13 UK Adult (1)  1 NZ Published data: all UK CAMHS  1 national (England)  2 UK New Ways of Working studies  1 redesign report (Richmond)  7 local and 1 national: CAPA book and website Type of Data  Quantitative e.g waits: 15  User views: 10  Staff views: 12  Referrer views: 3

4. National evaluation: England 2009 Mental Health Foundation 97 teams implementing  Av 6 out of 11 Key Components, range 1- 10.5  waits to a first appointment dropped from 7-108 weeks before to 5- 12 weeks after CAPA (N=7)  Families satisfied  Reduced demands on the service  More formalised team working and better planning infrastructure  Greater transparency for staff and families

5. National evaluation: England 2009 Mental Health Foundation  Few teams were implementing Job plans (Key component 8) Full booking systems (K c 5) Handling demand ( K c 3) Recommendations: including  CAPA should be rolled out gradually, for teams to opt-in  A national support framework for CAPA should be established

6. National Survey, 2007 Steve Kingsbury & Ann York Online survey 40 teams out of 113 were using CAPA On average CAPA in place 8 months Waits: CAPA teams Before CAPA: average 20 weeks After CAPA: 73% had waits to Choice of 6 weeks or less Non- CAPA teams Wait to first appointment on average 12 weeks. Only 33% had waits of 6 weeks or less CAPA compliance on items 2-11: CAPA teams 7.1 Non-CAPA: 2.5

7. National evaluation NZ 2010

8. Local studies  13 UK Sheffield Somerset Lincs Wakefield Bristol Exeter Gloucs Stockton Stockport Rochdale Glasgow East Herts Richmond  2 NZ CAMHS  1 Australia  1 NZ GAMHS

9. User views  2 NZ  8 UK Mix of direct interviews and questionnaires Overwhelming majority extremely positive Families said they were  Seen quickly  Felt listened to and  Got new ideas

10. Staff views Data  9 UK  1 NZ Results  Increased job satisfaction  Increased morale  Anxiety about change  Improved team working  More focussed  Love team discussion  Increased learning

11. Quantitative impacts 8 UK 1 NZ Waits  Pre CAPA: range from 5 - 9 months  Post CAPA: range from 1 - 6 weeks Transfer to Partnership  range 66 - 90% Waits to Partnership  4 weeks (some teams developed longer waits due to not implementing full booking) DNAs:  5- 10 %

12. Adult Mental Health 1 NZ (4 GAMHS) Waits Pre CAPA: 35 days Post CAPA: 20 day DNAs Pre CAPA: 3% Post CAPA: 2.8% Activity 12% increase in referrals 11% increase number offered appt 11% increase in patients seen