# Rules of Thumb

Here are three rules of thumb that can quickly give you a feel for the situation. Health warning: rules of thumb don’t give exact answers! They are a rough guide, so this may mean that they don’t exactly agree with each other!

## If you roughly want to know:

- How many referrals you can accept per week?
- What percentage of your FTE needs to be working in Choice and Core Partnership work to manage your referrals?
- The number of Core sessions you need to do Choice and Core Partnership?

Then this is the section for you….

## How many referrals you can accept

You can accept the same number of referrals as your full time equivalent staff.

Example: Anywhere CAMHS has 12 FTE clinical staff. They can roughly manage to accept 12 referrals per week.

The range depends on how well CAPA has been implemented, the quality of the service leadership and the amount of cultural change that has occurred.

#### Working out…

- Each referral accepted will need the Choice hours plus the subsequent Partnership hours.
- The Choice time is 1 hour.
- The Partnership time used is 7.5 hours x the transfer % from Choice to Partnership (say 66%) = 5 hours.
- The total is thus 1+5 = 6 hours per referral accepted
- So each referral takes 3 clinical sessions (at 2 appointments per session)
- If each FTE member of the team has 30% ( i.e. 3 out of their 10 sessions) of their job plan in Choice and Core Partnership then in their 3 sessions they can see and treat 1 accepted referral (on average) per week.
- Thus each FTE can accept 1 referral per week.

INFO: we find that many teams can deliver between 30% and 40% core clinical work (Choice and Core Partnership) if CAPA is fully implemented. Most easily if the 1st CAPA component - Leadership - is securely in place.

## What percentage of your FTE needs to be working in Choice and Core Partnership work to manage your referrals?

The percentage of Choice and Core Partnership work needed to be deployed is the number of accepted referrals per week divided by the FTE x 3. Working out…

As stated above, to manage one accepted referral, you need 3 clinical sessions of time per week to be available in Choice and Core Partnership So the number of sessions needed is the number of accepted referrals x 3 So the % of the whole team equivalent needed is = sessions needed divided by total session available This is accepted referrals x 3 divided by [FTE x 10] (to convert to sessions)

Example: Anywhere CAMHS accepts 12 referrals per week. Their FTE is 12. They need 12 x 3 = 36 sessions deployed per week for the Choice and Core Partnership these referrals generate.

They have 10 FTE staff and so will need 36 / (10 x 10) = 36% of their capacity to be deployed in Choice and Core Partnership. Doable…

## The number of Core sessions you need to do Choice and Core Partnership…

…is about 3 times the number of accepted referrals a week.

Working out:

Each accepted referral needs 3 sessions for Choice and Core Partnership So multiply the number of accepted referrals by 3 to give the number of Choice and Core Partnership sessions the team will need to offer.

Example: Anywhere CAMHS completes their team job plan. They accept 12 referrals a week and so need 12 x 3 = 36 Choice and Core Partnership sessions. After team job planning they find that they have 20 core sessions a week available i.e. they are 16 sessions per week short! So they discuss what to do, analyse individual job plans and what work they really need to do and revise accordingly.

## Caution

These are rough rules of thumb. Numbers can make things seem absolute and true! They are meant to be simple and used as a guide to where you could or should be. One key variable we have excluded to make them simpler is that an assumption is made that all staff work all the time! If you want to tune them a little more account for the fact that staff work 87% of the time (leave) and amend the numbers by 13%. This would produce

Rule 1: becomes 0.87 of the FTE. So 90% to 1 is the ‘real’ range. Rule 2: becomes 1.13 x referrals x 3 / (FTE x 10). 1 is still pretty near! Rule 3: becomes core sessions needed x 1.13. Still near 1!

In practice we suggest do the team job plan and then, if the numbers are close, try it and see rather than worry about decimal places. The world is too fuzzy for that.