1. Eligibility Criteria

Do you have clear written guidelines that referrers can read? 

Do you check every referral against your eligibility criteria?

Have you developed your eligibility criteria in collaboration with other local agencies, including the voluntary sector?

Did you consult with users in developing your eligibility criteria?

Which children and adolescents can be referred?

Rationale

Everyone wants specialist CAMHS to do everything, even things we cannot do (such as relieve family stress due to poor housing and poverty). But CAMHS actually sits within a comprehensive system of many agencies and professionals. So what can other services offer families? Transparency is everything, including openness about lack of services.

Ideas for Action

  • Get into honest discussions with team, commissioners and partner agencies.
  • Be specific about who you see and for what.
  • Name any exclusion criteria.
  • Describe types of problems, diagnoses and severity.
  • Acknowledge gaps in your service.
2. Diversion Criteria

Do you ensure that there is redirection of a referral that does not meet your criteria?

Do your referrers know where to refer to if your service is not suitable?

If children and young people are not eligible for your service, where can they go instead?

Rationale

Ensures that children and young people not eligible for CAMHS are redirected as safely and as promptly as possible.

Ideas for Action

  • Develop clear local pathways with partner agencies. Increasing consultation may support this process.
  • Avoid providing the same service by several agencies (e.g. paediatrics and CAMHS doing identical ADHD assessment work) unless local capacity is such that user choice can be prioritised.
  • Publish a directory of services that families could choose to use and ensure it is freely available
3. Priority Criteria

Do you have only two priority streams?

Are your emergency criteria clearly defined?

Would a user understand what constituted an emergency?

Have you defined how quickly someone with an emergency could expect to be seen?

Have as few priority criteria as possible

Rationale

Many services have emergency, urgent, soon and routine waiting lists. A ‘routine’ family may never get seen- the churn produced by those prioritised leave them as the sediment. Limiting priorities means everyone is seen more quickly by minimising multiple waiting list queues, reducing variation and smoothing flow. Multiple priority levels can also consume a lot of team discussion time trying to allocate referrals. More details about Churn and Variation are given in the section on Demand and Capacity on the left hand menu bar.

Ideas for Action

  • Limit the number of priority criteria.
  • Be specific.
  • Aim for only two levels such as ‘psychiatric emergency’ (for example same day to 48 hours according to need and user choice) and routine (everyone else). Routine means that they need to wait their turn.