# Rules of Thumb

Here are two rules of thumb that can quickly give you a feel for the situation in CAMHS. Health warning: rules of thumb don’t give exact answers! They are a rough guide, so this may mean that they don’t exactly agree with each other!

If you roughly want to know:

- How many referrals you can accept per week
- What percentage of your FTE needs to be working in Choice and Core Partnership work to manage your referrals

Then this is the section for you….

## 1. How many referrals can you accept?

### You can accept the same number of referrals per week as your full time equivalent staff.

Example: Anywhere CAMHS has 12 FTE clinical staff. They can roughly manage to accept 12 referrals per week.

The range depends on how well CAPA has been implemented, the quality of the service leader- ship and the amount of cultural change that has occurred.

Working out…

- Each referral accepted will need the Choice hours plus the subsequent Core Partnership hours. The Choice time is 1 hour
- The Core Partnership time used is 7.5 hours x the transfer % from Choice to Partnership (say 66%) = 5 hours. The total is thus 1+5 = 6 hours per referral accepted
- So each referral takes 3 clinical half days (at 2 appointments per half day)
- If each FTE member of the team has 30% ( i.e. 3 out of their 10 half days) of their job plan in Choice and Core Partnership then in their 3 half days they can see and treat 1 accepted referral (on average) per week. Thus each FTE can accept 1 referral per week.

INFO: we find that many teams can deliver between 30% and 40% of Choice and Core Partner- ship work if CAPA is fully implemented. More easily if the 1st CAPA Key Component – Leadership – is securely in place.

## 2. What percentage of your FTE needs to be working in Choice and Core Partnership to manage your referrals?

### The percentage of Choice and Core Partnership work needed to be deployed is the number of accepted referrals per week divided by the FTE x 3.

Working out…

- As stated above, to manage one accepted referral, you need 3 half day in Choice and Core Partnership
- So the number of half days needed is the number of accepted referrals x 3
- So the % of the whole team equivalent needed is = half days needed divided by total half days available
- This is accepted referrals x 3 divided by [FTEx 10] (to convert to half days).

Example: Anywhere CAMHS accepts 12 referrals per week. Their FTE is 14. They need 12 x 3 = 36 half days deployed per week for the Choice and Core Partner- ship these referrals generate.

They have 14 FTE staff and so have 14 x 10 = 140 half days in the team. As they need 36 half days in Choice and Core Partnership they will need 36 / 142 = 26% of their capacity to be deployed in this Choice and Core Partnership. Should be fine!

## Caution

These are rough rules of thumb. Numbers can make things seem absolute and true!

They are meant to be simple and used as a guide to where you could or should be. One key variable we have excluded to make them simpler is that an assumption is made that all staff work all the time! If you want to tune them a little more account for the fact that staff work 87% of the time (leave) and amend the numbers by 13%. This would produce

- Rule 1: becomes 0.87 of the FTE. So 90% to 1 is the ‘real’ range.
- Rule 2: becomes 1.13 x referrals x 3 / (FTE x10). 1 is still pretty near!

In practice we suggest do the team job plan and then, if the numbers are close, try it and see rather than worry about decimal places. The world is too fuzzy for that.

## Any Service Translation

### Rule of Thumb 1

How many referrals can you accept per FTE?

- Choice time + (Core Partnership average x transfer %) = hours per referral
- Average Choice and Core Partnership hours per clinician divided by hours per referral = referrals per clinician

### Rule of Thumb 2

What % of your service needs to be providing Choice and Core Partnership to manage referrals?

- Using hours per referral from above
- Hours x accepted referrals = hours needed
- Hours needed divided by team FTE hours = % needed