5: Full Booking to Partnership

If the service user is going to return for Partnership work a system exists whereby they can leave the Choice appointment with a booked Partnership appointment with the selected clinician/s. This requires a Partnership diary and no internal waiting list.

Why have full booking?

Well, full booking extends your capacity by moving clients into anticipated capacity (planned Core Partnership appointments), rather than waiting for capacity to appear. This improves your flow.

In traditional CAMHS an appointment is offered when the clinician has a space. But this usually involves a delay between the clinician deciding they have space and the actual appointment. The capacity in between is lost.

To implement Full Booking to Partnership you need a clinic diary system of blank Core Partner- ship appointments available to fully book into. This needs team and individual job planning to be done.

What happens if you don’t use full booking?

You will be lose some capacity and are likely to develop internal waiting lists.

We have met many teams that have good systems to manage first appointments but then put clients on treatment waiting lists. Whilst this helps you meet you first appointment targets it is not a good service for service users or staff. It is stressful to be seen, choose a service but then not know when you will be seen again. Time is wasted managing the waiting list, responding to anxiety in the waiting clients and referring agencies. Some teams start CAPA by putting Choice in place as a first step but not Partnership – all that happens is a waiting list to Partnership develops. Much better to put all key components in place at the same time.

In Richmond CAMHS (where Ann works) a natural experiment occurred (twice!) that showed the importance of full booking. When Core Partnership clinics were started, two out of the three clinics offered full booking and the third decided to put cases on a waiting list from Choice, to be considered by the group and seen when the clinicians decided. The referrals to all three clinics was balanced to their capacity. The two offering full booking flowed well, with no waits. The third developed a lengthening waiting list. It was simply resolved by reinstating full booking.

The second time full booking to Partnership was suspended was when a new electronic care record system was introduced. This was such a big change that staff felt they needed a breather. Rapidly, Core Partnership waiting lists developed! When full booking was reintroduced they disappeared.

Note

If the time between Choice, Core or Specific Partnership creeps up, don’t assume demand and capacity imbalance. Revisit the 7 HELPFUL Habits (see Troubleshooting section and web- site). Process Map (P) to ensure the problem is not with Letting Go (L) or Flow Management (F). If it is true imbalance, look at Handling Demand (D) and Extending Capacity (E) in discussion with commissioners.