AT A GLANCE
THE CHALLENGE
Waiting times for Child and Adolescent Mental Health Services (CAMHS) in Hull and East Riding were longer than the national average, particularly from referral to assessment and assessment to treatment. Both teams were facing high ‘did not attend’ (DNA) rates – up to 11.1% in some cases – which was impacting on clinical time. There was a need to streamline processes, pathways, referral criteria and decision making.
More neurodiverse young people were being referred who needed personalised approaches to treatment and therapy. A more family-centred approach was required with a change to the skill mix. While team spirit was strong, the service needed a shared identity and vision.
WHAT THEY DID
Sponsored by NHS England, the 26-week transformation project was led by trust clinicians and managers alongside colleagues from NHS North East and Yorkshire region – with support from the national CLEAR team. Insights were gathered from more than 40 staff and a workshop held with the Humber Youth Action Group. Data for 6,448 referrals over five years was analysed and combined with the qualitative findings to identify key problems and develop new ways of working.
CLEAR RECOMMENDATIONS
A new model of care was recommended focusing on a more streamlined, personalised and family oriented first contact process. This included consolidation of the Hull and East Riding teams and a clearly defined autistic and neurodiverse pathway.
The team proposed that families should be better integrated throughout the treatment processes and there should be enhanced access for children and young people who live in remote and rural areas with outreach centres and a mobile therapy bus.
More efficient administrative practices could be developed with timetabled clinics and better use of technology including text appointment reminders and the use of artificial intelligence (AI). Referral criteria and job roles could be better defined and the overall CAMHS offer reinforced and communicated internally and externally. Young people should be directly involved in developing the service, including improving the website and communication channels.
FORECAST IMPACT
Waiting times and DNAs would be reduced as well as an improved experience for young people and their families with a seamless flow from first appointment to therapy.
Teams working more effectively together, and with external stakeholders, sharing a better understanding of the CAMHS offer and a common vision. Families would be more involved throughout the treatment process, and there would be more equitable access for young people previously disadvantaged because of their geography.
Potential cost savings of more than £1m could be achieved by eliminating the £934,992 cost of DNAs (if 100% successful), reducing misaligned referrals (£88,236) and using AI assisted tools to achieve 75% administrative efficiencies with a total of 2,516 hours saved a year.
