Capital & Coast AMHS, NZ: 2013

The Wellington map

Story supplied by Tony Littlejohns, Operations Manager

Name of Service

Capital & Coast General Adult Mental Health Services , Wellington, New Zealand.

Beginning

CAPA Initially began as a pilot in one General Adult Community Mental Health Team in February 2009. It has now expanded to include all four of the general adult community mental health teams as well as other specialist teams including Maori Mental Health, Health Pasifika, Community Alcohol and Drug Services. We have now amalgamated this approach with the Child and Adolescent Mental Health Services, who were already developing the model themselves.

Description

285,000 total population

There are approximately 300 referrals per month that are received by the combination of the above teams. The mental health services are served by multidisciplinary teams.

Prior to CAPA there were multiple entry points with individual teams each having their own systems for processing referrals and allocations. Since CAPA this has been standardised and simplified.

CAPA experience

Prior to CAPA access to service was inconsistent with variable response leave leading to confusion and frustration for referrers.

The service has now adopted several features of the CAPA model, specifically handling demand and capacity and full allocation booking into Choice Appointments. The reason why these aspects of the model were introduced first is because access into the service appeared to be the area which was most inefficient, with referrals being inconsistently declined and complaints from referrers. A hurdle to overcome has been that the CAPA model has been designed very much with services for children in mind. The instigators of CAPA have chosen to focus on parts of the model that might give some early indication of its successful implementation in general adult services. Now that some improvements have been realised, this has given further confidence to adopt aspects of the model further.

Impact

Now three years after commencement the service has improved it’s access with a considerable drop in waiting times.

What do we like?

  • The service has not been formally evaluated, however we have had compliments from service users and referrers, who say that access to service is easier with the service being more responsive.
  • There has been a decrease in complaints about access to services since CAPA
  • Team Leaders report fairer system for allocation of referrals
  • Workloads are more predictable and peaks in demand easier to manage

What helped?

  • Dissatisfaction with previous model, both from referrers and staff.
  • Champions in different positions in the service, including management, clinical leads, team leaders and clinicians.
  • Attendance at CAPA training days, (adult MH staff attending workshops for children’s services).
  • The CAPA work books and web page
  • Local discussion groups and workshops run by local staff
  • Personal visits by founders of CAPA, Ann and Steve a great boost!
  • Early data collection which showed improvement

Problems and advice?

Critical to get buy-in of staff who can influence clinicians, in our case we had some great pioneering work by inspirational team leaders.

And finally

We have had some very encouraging results and we are confident we will make even more ground as we further adopt more aspects of the CAPA model in the future. We have been having a series of away-days, we have been determining specialist [advanced] and core skills and two or our general adult mental health teams aim to implement Partnership early next year.

CAPA Compliance: 59%

Team photo