Implementation of the Key Components of CAPA

(Kingsbury and York, 2007)

In November 2007 we contacted services known to us and put a request out on an international discussion forum (FOCUS Mailbase; focus@cru.rcpsych.ac.uk) through an online questionnaire. We asked for general information about their services, whether or not they had implemented CAPA and the impact. We asked for ratings on items 2 to 11 of the 11 Key Components of CAPA i.e. omitted Item 1: Management and Leadership (we hadn’t highlighted this item then).

What we found out

113 people responded. Of these, 15 were managers (13%).
40 said they had implemented CAPA. On average, CAPA had been in place for 8 months.
Teams received on average 47 referrals per FTE per year: 50% were in the range 57 to 33 FTE.

Waits to first appointment:

CAPA services

Average waits before CAPA: 20 weeks
After CAPA: 73% had waits to Choice of 6 weeks or less

Non-CAPA services

Wait to first appointment on average 12 weeks.
Only 33% had waits of 6 weeks or less

CAPA compliance and average waits to Choice:

So we found that implementing CAPA had a significant effect on reducing waits. A score of 7 or more on the 10-item scale seemed to be correlated with successful impact in terms of waits.

CAPA Component Implementing CAPA
(% fully compliant)
Not implemented CAPA
(% fully compliant)
Language 77 10
Fully Booked to Choice 85 26
Choice Framework 92 31
Fully Booked to Partnership 77 3
Selecting Clinician by Skill 77 23
Extended Core Skills 71 44
Goal Setting 51 48
Job Planning 69 37
Small Group Supervision 67 55
Team Away Days 53 44
Waiting time to Choice = 6 weeks or less 73 33
Average score out 10 components 7.1 2.5

Some comments

It seems to us that some of the given answers can only be made sense of if we assume the question
wasn’t quite understood!

For example – we have never come across a team that is doing small group – peer group supervision , let alone 55% in non-CAPA teams. We also doubt the team
away days being at least four times a year as that seems very rare in out experience.

Finally we know clinicians have goals for the work with the family but we think clear and jointly agreed goals, which are written down (perhaps using the CORC
methodology) are also not very common.