Mental Health Foundation Report 2009
In January 2009 the Department of Health commissioned the Mental Health Foundation to undertake an independent evaluation of the CAPA in England to:
- Examine how well CAMHS adopted the components of CAPA
- Understand the impact of adopting CAPA for services and families
The full report was published December 2009
Method
Phase 1 was a national survey of CAMHS in England and Phase 2 involved visits to six teams.
Results
Phase 1
442 teams were sent a questionnaire- 213 staff replied. 92% had heard of CAPA and 97 teams stated they were implementing CAPA. 53 of these 97 teams then completed a more detailed survey and, on average, were implementing 6 out of the 11 CAPA key components (range 1 to 10.5).
Seven teams were able to supply audit data pre and post CAPA implementation. This showed that showed waits to a first appointment dropped from 7-108 weeks before implementation to 5-12 weeks after.
Phase 2
Benefits reported by CAPA teams were:
- Reduced waiting times: 92% of families were seen within 13 weeks compared with the national average of 78% (CAMHS mapping). Families were pleasantly surprised at how quick they could get into the service
- Reduced demands on the service
- More formalised team working and better planning infrastructure
- Greater transparency for staff and families
Challenges
Few teams were implementing job plans or full booking systems, which resulted in internal waits to Partnership, and few were handling demand in the way recommended by CAPA. However, most were conducting Choice appointments within an appropriate framework. Teams felt the need for more information and support in how to apply CAPA to complex and long term cases.
National recommendations
CAPA should be rolled out gradually, for teams to opt-in
- A national support framework for CAPA should be established
- An enhanced training package should be available
- A national online network and directory of CAPA implementers could be developed
- The CAPA implementation training and support package needs to address the commonly held CAPA Myths
- Case studies to illustrate how the system can work in different types of services
Local Implementer recommendations
Facilitative team management is crucial- an informed manager, a clinical lead, and an administrative lead (CAPA Key Component 1)
- CAMHS teams implementing CAPA need mechanisms to facilitate effective team working: peer group supervision and regular away days (CAPA Key Components 10 and 11)
- Children’s Trust directories should be used to promote multi-agency work or to signpost families
- Successful implementation of CAPA should involve staff from a variety of roles within the CAMHS
- Monitoring and feedback are integral prior to, during, and after the implementation phase
- Local regional support systems should appoint a number of local CAPA champions
Next steps
The Department of Health (England) has asked the National CAMHS Support Service to prepare a costed options paper that considers possible responses to the report recommendations.
Comments from Ann and Steve
All this supports our experiences of the impact of CAPA on teams and families, including our own survey in 2007. The study also found that there are many misunderstandings of CAPA- hence our writings in the book and on the website about the CAPA myths! We know from many teams who have done service audit (some reported in the book and on the website (LINK) that families feel engaged, access is improved and teams function more efficiently and effectively. But planning and ongoing monitoring is key!