The Waiting List Blitz
To implement CAPA some services need to clear a first appointment waiting list.
The secret is to plan CAPA first and then precede it with a blitz. The Core Partnership work generated by the blitz then goes into already planned vacant Core Partnership appointments.
Not all services will need to do a blitz. It depends on the number of service users waiting compared to the staff group size. If you have decided as a team to offer, say, 10 Choice appointments a week then 80 people would be seen in the 8 week blitz period. If the number waiting is much smaller than this then just starting CAPA may be enough. A waiting list blitz is really just starting CAPA but flexing the Choice capacity so that all those waiting can be seen in the first 8 weeks and deferring the Core Partnership clinic onsets until the blitz is complete.
1. Set a start date
We suggest that when starting the transition to CAPA you create a gap between accepting the referral and the initial Choice appointment. Say 8 weeks. These 8 weeks between referral and Choice gives you 8 weeks to carry out the blitz. When you are underway this gap will fall as you gradually flex your Choice capacity.
Let’s say that you decide to start CAPA on 1st December. This means you will have the Choice and Core Partnership diaries planned so that both Choice appointments and first Core Partnership appointments will be available from 1st December. As we’ve “allowed” an 8-week window, all referrals accepted after 1st October will therefore be considered CAPA referrals and be asked to book into a Choice appointment after 1st December. We suggest starting with an 8-week lead in to allow clinicians to rearrange their diaries to accommodate the new system.
Service Users on the Waiting list
To start CAPA on the 1st December everyone on your current waiting list has to be seen in the ‘free’ 8 weeks between 1st October and 1st December. Anyone choosing to continue in the service as a result of a Choice appointment in the blitz will need to be booked into Core Partner- ship clinics, which must be available from the 1st December.
Anywhere CAMHS decide to start CAPA from 1st December. They make the following plan:
1. CAPA will start on the 1st December, so…
- Choice clinics are established in a diary from 1st December
- Core Partnership clinics will also start from 1st December. A diary is started
- Blitz will start from the 1st October.
2. All referrals from 1st October will be offered the opportunity to fully book (this means being offered two or more Choice appointments as their referral is accepted) into Choice appointments after 1st December (an 8 week wait)
3.The waiting list blitz will start 8 weeks earlier on the 1st October and finish by the start of CAPA on 1st December
4.Those choosing a Core Partnership appointment from the blitz Choice appointments will go into the vacant Core Partnership slots from the 1st December
5. When all of those from the blitz have entered Core Partnership the Core Partnership slots will be free for those seen in CAPA from 1st December. By the time they begin Choice proper on 1st December the team will know the wait to Core Partnership and can explain this to families.
2. How Many?
You know how many are on your waiting list. But many of these will not need appointments (maybe up to 50% if they have been waiting more than 6 months). You may want to plan for 80% uptake of an offer of an appointment to allow a wide safety margin. However in practice it may be nearer 40 % – 50% depending on the length of your waiting time.
Ask all those on the waiting list to confirm that they still want to be seen. Those that do can then be invited to ring and book themselves one of the appointments you have allocated for the waitng list blitz. You will need to have a system for vulnerable people or families perhaps contacting their referrer if they don’t reply.
3. Who and When?
This is the trickiest bit, as the team needs to find a large number of appointments in already existing, and fairly full, diaries.
When the team in East Herts did this in 2005 everyone found any spare slots they had and made it available for the waiting list blitz. Some staff were able to find a lot and others only a few. No target number of appointments was expected from individuals but there was a strong team belief that, as a whole staff team, they should, and could, blitz the list. There was a small amount of money made available to allow staff to work extra hours if they wanted to.
Every week the team reviewed how many of the waiting list families were opting in and whether there were enough appointments. If not they had to find some! It was a fairly chaotic time, but energising and extremely satisfying!
Undertaking lots of first appointment work in the blitz is easiest if:
- The clear expectation is that the assessing clinician will not see the family in Core Partnership i.e. the follow up burden is not relevant and
- A simple form is used for Choice / assessment summaries and so admin is quick and easy for clinicians and the admin staff.