26. Segmented Clinics

Do you know what types of clinical contact the different types of problems you see need?

Do you have 'clinics' or dedicated time for these contacts?

Have you ensured these dedicated times are based on processes that are needed rather than just on diagnosis?

Do you know how much clinical capacity you need for these processes?

Have you considered segmented clinics/capacity for eating disorders; ADHD medication reviews; CBT for OCD...?

Group those with similar needs together

Rationale

Segmented clinics are those that have families with similar needs being seen at the same time - much like a swimming pool with slow, medium and fast lanes. This smoothes flow.

The can be for single skills set such as grouping adhd medication reviews together or clustering skills.

For example teenagers with anorexia will probably need some individual work, some family work and the physical monitoring including weight. This cluster of skills ( a small care bundle) could work together in a segmented clinic.

You do not have to see them in a 'clinic' if your service cannot work in this way e.g. a very small team covering large geographical areas and doing lots of home visits. In these circumstances you need to focus on allocating segmented capacity to those with similar needs, rather than insisting users come to a 'clinic'.

Ideas for Action

  • Put families and children with similar process steps into one clinic or segmented capacity time.
  • This may not be by diagnosis, but may be. e.g. Eating Disorders may be best managed in a special clinic as they need similar things and take similar therapeutic capacity. However, ADHD cases, although may seem similar, are not necessarily. Simple cases may only need assessment and six monthly reviews. Co-morbid ADHD (such as with conduct disorder) may follow a more similar path to young offenders