1. The CAPA Basics Ann York & Steve Kingsbury 2010

2. What is CAPA? …the Choice and Partnership Approach  a clinical system that evolved in Richmond CAMHS from 2000  developed and implemented wholesale in East Herts. CAMHS 2005 and  now being used in many CAMH teams across the world

3. CAPA workshops

4. What CAPA is…and isn’t… It is about  Doing the right things = on the right goals  With the right people = with the right skills  At the right time = with no waits By applying the majority of the 7 HELPFUL Habits

5. CAPA Myths p19 There are lots of myths! The Mental Health Foundation report these…  Choice means they can choose anything (p33)  Partnership is limited to 6 - 7 sessions (p37, 41, 53) or 3 (p 53)  Only allowed one Choice appt and for 1 hour (p38)  Choice does no assessment (p38)  Complex cases don’t fit into CAPA (p 49)  Not allowed to do specialist work (p 49)  Job plans are inflexible (p 50)  No long term work (p54)

6. Values of CAPA  Users are at the heart of the process  “Led by them and guided by us”  Shift in clinician stance to Facilitator with expertise rather than expert with power

7. CAPA Links (NZ)

8. CAPA Links

9. What are the 7 HELPFUL Habits? p 158  Broad framework that can guide service redesign  Evidenced based in terms of theory and clinical experience  Mix of Lean Thinking/demand and capacity techniques and quality parameters  Meets most standards that we need to apply  Can be done in steps or as one

10. 7 HELPFUL Habits H andle Demand (9 items) E xtend Capacity (7) L et Go of Families (3) P rocess Map (4) F low Management (7) U se Care Bundles (3) L ook after staff (4) There are 36 items 7-HAT self-rating tool CAPA is a system that integrates these…

11. The CAPA system…

12. There are 4 ideas that separate CAPA CAMHS from more “traditional” models. These are... 1. Choice 2. Core and Specific work 3. Selecting clinician to Partnership 4. Team Job Planning The 4 Big Ideas p 27-31

13. Why do CAPA? p 16 Gains Users:  Reduced waits  Increased engagement  Collaborative & respectful Teams  Learning culture  Togetherness  Transparent  Its Fair! Managers  Flexible workforce  Defines capacity

14. Why does CAPA work?  It is our experience that CAPA seems to enable CAMH teams to deal with their current workload in what seems a much more efficient and effective way  Uses the ELF of the 7 HELPFUL Habits of Effective CAMHS 1. Team organisation E xtend Capacity Capacity planning Core and Specialist work 2. Task Alliance L et Go of Families Focus on patient goals Family ownership of change Therapeutic alliance 3. Demand and Capacity F low Management Flow management

15. Why would you NOT do CAPA? p 17  Can’t think of a reason!  Challenges...  Transparency  Monitoring and activity targets  Accepting limits  Working in focus  Requires flexibility  Anxiety about perceived reduction in professional power  Being more human in “flatter” relationships