External Waits to Choice

Definition: A problematic external wait is either

Let’s consider the two problems…

A waiting list:

If you have a waiting list to Choice then this must be because you have not yet implemented Key Component 3 (Handle Demand) i.e. you are not yet using full booking to Choice. Decide how to do this (see the Implementation section). Choice clinicians need to make vacant appointments available using some sort of central diary system. Families should then be able to choose a Choice appointment from a range on offer when they contact the service. Make sure you have a system for vulnerable families who may not be able to organise themselves to book in this way.

A Lengthening wait

If you have implemented CAPA, with full booking to Choice and flexing your Choice capacity, then we can’t see why you would have an increasing wait from referral to Choice, without choosing to do so. In traditional CAMHS, when the follow up work was connected to the initial assessment, the number of initial assessments is limited by the staff capacity. In CAPA however, Choice and Partnership activity are separated and so any number of Choice appointments can be offered to match the accepted referral demand. In other words, in CAPA you can guarantee to balance demand and capacity for Choice.

So if you do have a lengthening external wait then you must have fixed the Choice capacity and it is less than the demand. What might be the reasons for that?

Let’s look at each in turn.