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CAPA: The Choice and Partnership Approach

Summary of research and evaluation findings up to 2010 by Ann York and Steve Kingsbury, exploring the impact of CAPA on service delivery, wait times, and user satisfaction. Recommendations for gradual rollout and national support framework are provided.

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CAPA: The Choice and Partnership Approach

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  1. CAPA The Choice and Partnership ApproachSummary 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. 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 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

  4. National evaluation: England 2009Mental 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 2009Mental 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

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