Ideas re External Waits to Choice

Definition: A problematic external wait is either

  • A waiting list of people and their families waiting for the offer of a Choice appointment or
  • A lengthening wait for an appointment i.e. the waits for booked Choice are increasing.

Let’s consider the two problems…

A waiting list

If you have a waiting list to Choice then this must be because you have not yet implemented Key Component 3 (Handle Demand) i.e. you are not yet using full booking to Choice. Decide how to do this (see the Implementation section). Choice clinicians need to make vacant appointments available using some sort of central diary sys- tem. People and families should then be able to choose a Choice appointment from a range on offer when they contact the service. Make sure you have a system for vulnerable service users who may not be able to organise themselves to book in this way.

A lengthening wait

If you have implemented CAPA, with full booking to Choice and flexing your Choice capacity, then we can’t see why you would have an increasing wait from referral to Choice, without choosing to do so by not offering enough Choice appointments. In traditional service models, when the follow up work was connected to the initial assessment, the number of initial assessments was limited by the staff capacity. In CAPA however, Choice and Partnership activity are separated and so any number of Choice appointments can be offered to match the accepted referral demand.

In other words, in CAPA you can guarantee to balance demand and capacity for Choice.

So if you do have a lengthening external wait then you must have fixed the Choice capacity and it is less than the demand. What might be the reasons for that?

  1. You designed the Choice capacity based on job plans, without considering the accepted referral rate
  2. You did match Choice demand and capacity but the referral rate has risen and you haven’t flexed the capacity to meet it
  3. You decided not to flex the Choice capacity when the referral rate rose and/or you lost staff (e.g. maternity leave) and so you prioritised maintaining the existing Partnership capacity rather than moving some to Choice, or temporarily moving some specific, or other time, to Choice.

Let’s look at each in turn…